Re: [FH] New Member Intro - Need Help
- Hi -- I am sorry to hear about Missy's condition. Unfortunately she is a complicated case and we do not have any vets on this list. I wish everyone on this list would join the yahoogroups called vettalk and petvetcafe. There are a lot of vets and techs on those lists, and you can get opinions from them. Please post to both our list and them, then we can all see what the vets have to say, as well as the experiences of our list members. Our collective experience is invaluable, but there are some things we cannot help with -- for some things we need a vet. So I hope you'll all consider joining those lists, they have helped me so much.
have a good weekend - Michelle & Tigger Too in Toronto
----- Original Message -----
Sent: Friday, August 07, 2009 11:47 PM
Subject: [FH] New Member Intro - Need Help
I am new to the group. My 11 year old cat Missy, was diagnosed with heart problems earlier this week when we took her to the vet because she was wheezing. The wheezing was fluid in her heart and lungs. I am looking for any help and information. She also has hyper-t.
The specialist gave us a poor prognosis. She told us that once we took our cat home, she would be miserable without the oxygen. (We were advised to hospitalize her, but refused because Missy gets stressed in those type of situations.)
When we brought Missy home her respiration was 64 breaths per minute. Over the next few hours, that dropped down to around 44 breaths per minute. Since then, her respiration has varied between 36 and 44 breaths per minute.
We are worried sick because of some of the stuff the specialist said to us. First of all, some of the information we were given was murky. For example the results of Missy's heart echo and radiographs say "Increased interstital and alverolar pattern over heart base, possible fluid or mass cranial to heart, perihilar edema or possible mass."
No exact diagnosis was given. We were told that the right side of her heart is enlarged and that there was a mass on top of the heart, as well as a mass on one side of the heart. We were told that the mass is most likely cancer. Yet, they told us there is no way to be absolutely sure.
We were pretty much told that Missy could drop dead at any time. So now of course I am a mess and trying not to show it around her because I know cats pick up on that.
Right now, she is having stomach problems and we are having a difficult time getting her to eat. The medications Missy is on are:
Furosemide 6.25MG Twice Daily
Enalapril 1.25MG Daily
Methimazole 5MG Twice Daily
Can anyone give me any input as to if this treatment is good and what we should be doing? Can anyone tell me what their experience has been with such a diagnosis?
Thank you so much!!
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- Hi Jen,
I'm sorry Missy has heart problems now. Many of us here are going through some of the same things. I do understand how scared you are. I've been there too. The initial shock is the worst. None of us ever wants to hear that our kitties have something so bad wrong with them.
Although the vets always make it sound very dire, there are some things you can do to help her feel better. If those masses on and around her heart are indeed cancer, you might want to look into some alternative treatments for that, since I think probably this isn't something that can be treated traditionally.
The supplements they gave you for Missy will (should) help keep the fluid in the lungs at a minimum (the Lasix). You may have to increase or decrease the Lasix, which is a duiretic, as her condition changes.
Enalapril is a vaso-dilator, so it's supposed to help with blood flow. I found a little info on PetPlace.com. http://www.petplace.com/drug-library/enalapril-enacard/page1.aspx
It can cause them to become lethargic, so just watch for that.
She's on Methimazole... is she hyperthyroid? Was she before this heart diagnosis? Many times heart and thyroid disease go hand in hand. Hyperthyroid can affect the heart. Our Snowball had hyperthyroid before she was diagnosed with her heart problems, and they always told us that if we got the thyroid under control, the heart might get better, but we haven't experienced that with her. So we just plug along with her conditions. She's also got CRF, IBD, hypertension and pancreatitis, so we have a lot to deal with.
There are some supplements that may help the heart function better. Things like CoQ10, DMG (dimethylglycine), L-carnitine, Taurine. There's more info about those and dosages in our files. http://tinyurl.com/755ev2
There are a few feline/pet cancer groups that I belong to that you might want to join too, just in case you need that support for Missy.
I hope Missy will be okay for a long time.
Carol and Snowball and the gang
Thank you for your reply! It is all confusing and I am trying to learn all I can before we see our regular vet this week.
I didn't realize there were vet groups too. I will consider joining those too.
Jen and Co.
--- In email@example.com, "Westgold" <westgold@...> wrote:
> Hi -- I am sorry to hear about Missy's condition. Unfortunately she is a complicated case and we do not have any vets on this list. I wish everyone on this list would join the yahoogroups called vettalk and petvetcafe. There are a lot of vets and techs on those lists, and you can get opinions from them. Please post to both our list and them, then we can all see what the vets have to say, as well as the experiences of our list members. Our collective experience is invaluable, but there are some things we cannot help with -- for some things we need a vet. So I hope you'll all consider joining those lists, they have helped me so much.
> have a good weekend - Michelle & Tigger Too in Toronto
- Hi Jen,
I'm so sorry about Missy - it sounds like a very hard week. My cat was also
diagnosed with severe heart disease after going into congestive heart
failure (fluid in the lungs) - he spent the night in the oxygen cage on
injection lasix and some nitroglycerin in his ear, then came home the next
night on lasix and enalapril. (His feline cardiologist then added two more
drugs, based on his clotting risk and need for further heart support.) This
was in early November of last year - the lasix has kept fluid from
accumulating in his lungs again, though I check his resting respiration rate
regularly. I don't have any experience with hyper-t, and all of our heart
kitties are at risk of sudden death - you never know if something sudden
will happen due to the heart disease - but my kitty and many here have had
some quality time left.
Many cats with acute congestive heart failure can be kept comfortable and
out of heart failure at home on lasix, without oxygen, once they're stable
and the immediate crisis is resolved. (At some point, the heart may be
damaged enough that the CHF can't be controlled, but others respond well to
lasix and other diuretics for quite some time.) It's great that you're
watching Missy's respiration rate - I'm curious whether or not that's her
respiration rate when she's asleep or awake and alert? "Normal" for a cat
completely asleep is under 30/minute, I think, though some people on this
list have had their cardiologists give 35 as the cut-off point. But the rate
is always higher when they're awake or actively watching something,
nauseous, etc. Patches came home with his respiration rate in the high 20s,
and it gradually went down over the next few days to his normal of
18-22/minute. At least in his case, they had him on 12.5 mg twice a day for
two weeks (ish, I'm not positive of the time frame anymore) then lowered to
his maintenance dose of 10 mg twice a day. I would talk with the vet or a
feline cardiologist via phone about adjusting her dose to get her breathing
at an ideal rate, then figuring out the dose to keep her there.
What kind of specialist did you see? Veterinary cardiologists are excellent,
or (with the other things going on for Missy) a highly-experienced
internist. (Patches' cardiologist's office is also the home of a veterinary
oncology practice and internal medicine specialists, and also an advanced
veterinary hospital - it may be worth looking into advanced veterinary
facilities to see if they have a similar set up, in terms of the mass.)
While lasix can control congestive heart failure very well, it won't do
anything for a mass, and if it's a mass that will cause progressive heart
damage then that's a situation you'd definitely want a specialist for.
Without whatever procedure they could do to diagnose the mass there's no way
to know whether to try treating it (medically or surgically, if that's an
option - which it may not be, resting on the heart). I wasn't quite clear -
are they sure it was a mass (of whatever kind) and not fluid, or could it
have been either?
I'm so sorry about the poor prognosis given - at least for heart disease, it
is impossible to really get an accurate timeframe. Some kitties go pretty
quickly after diagnosis (or aren't diagnosed until a fatal crisis - cats are
very good at hiding symptoms, and sometimes there aren't any until an acute
event), others live for a year, two, or more even with advanced or severe
heart disease. The mass definitely complicates things - if it is cancer,
that will obviously be a complicating factor. I have no idea what the
treatment options may be, if any, and it may be a situation where you just
want to keep her as comfortable as possible at home. Reglan and zofran are
both anti-nausea meds, if that's playing a role in her lack of appetite
(between being ill and adjusting to new medications), and the reglan/pepcid
combo has really helped Patches. My cousin also got an extra two or three
weeks of eating out of her geriatric kitty with GI lymphoma with pepcid. If
things get desperate, there are appetite stimulants, though you might want
to try a half of the low end of the dose to start with given how fragile she
is. Veterinarians have cans of Hills A/D for kitties without much of an
appetite (mine never cared much for it, but many cats - including my
cousin's - will eat it when they won't eat other things), and I've had good
luck with Fancy Feast or Whiskas (both with gravy) for sick kitties who
aren't eating much. There's also baby food (a brand like Beech Nut - stage
1, chicken/beef/turkey - that DOESN'T contain onions), trying chicken, etc -
they aren't long-term options in terms of necessary nutrients for cats, but
can definitely help supplement a sick kitty's diet if they'll eat it.
I think you're doing great in trying to keep her comfortable and eating -
I'd watch her respiration rate carefully and make adjustments to the lasix
as necessary, since I think there are good odds that the CHF at least can be
pretty well controlled. How the mass will play into that or her prognosis it
doesn't sound like you can know without more of a diagnosis - I assume if it
is a mass and grows, it's going to cause further heart or overall health
problems, which may increase the need for lasix or cause an acute heart
problem. So that may be a situation that you need to play by ear, depending
on how she feels? I'm sorry it's so wishy-washy - I just don't think there's
any way to KNOW how that's going to affect things without knowing more of
what it is, and with Missy being easily stressed and already prone to CHF,
and with a poor prognosis, it may not be worth putting her through the
stress of conclusive diagnostics. But it's even harder (on us) when things
are uncertain, and we just have to play it by ear.
If you do find a specialist, cardiologist or oncologist, who you'd like a
second opinion from, I would think it would be possible to schedule a
consult withOUT Missy and taking copies of all of her tests (echo, x-rays,
any bloodwork, etc). That might be what I would do at this stage - watch her
breathing carefully at home (trying to get things down to "normal" based on
her respiration rate while asleep) and see what another specialist thinks,
given she's already been through the exams and you should be able to get
copies on disc.
Good luck - will be thinking about both of you.
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