Re: [FH] Stragles Echo
- Hello Cathy -- It sounds like Winston is doing great! If he is eating and breathing fine and isn't getting any more fluid in his lungs or chest, then I really would not worry too much (easier said that done). The thing about Duffer is that she wasn't breathing fine by the 6 month echo (and had not been for a few weeks but I didn't know what I was noticing, feel very bad about that). Her breathing was a little fast and it was definitely labored, not smooth, like shuttering or stuttering or something. I can't describe it very well. Now, between her first and second echo, she had also had a steroid shot, which could have resulted in the CHF. My specialist doesn't think that it is clinically significant in terms of the timing and whatnot but I am not so sure. She told me when Duffer was diagnosed that some cats do well for a long time and others don't and we just have to see. That is why she recommended that Duffer have a repeat echo at 3
months, which we did in July. At that time her measurements improved and her condition is considered stable. From all of this and from talking to the specialist, I have the impression that the heart condition can change quickly. I don't have any firm research or anything to back that up, it is just my experience and from talking to her. Duffer is considered to be in early HCM, so I don't have experience with late stage.
Maybe you could call your cardiologist and ask about how fast Winston's condition could change and whether there are any alternative treatments if it did change. Maybe you could split the difference and go back at 4 months? I totally understand what you are saying about wanting to do the best for your kitty. It is really hard sometimes to know what to do. Sorry I can't be more helpful.
From: cathy coleman <catherama@...>
To: starbright102005 <starbright102005@...>; email@example.com; Kristen G <apacheadd@...>
Sent: Thursday, August 27, 2009 6:49:33 PM
Subject: Re: [FH] Stragles Echo
Your comments here make me wonder something. You said the hearts sometimes change fast. How fast? My Winston has HCM in an advanced stage. It was just discovered when he had emegency surgery to remove a benign growth. He's on a number of meds (pimobendan, enalapril, plavix, and a small amt of lasix as he still has a "scant amount of fluid" in his chest). He's been doing remarkably well since he left the hospital at the end of May. He's eating fine and does not appear to be in pain. I keep an eye on his breathing rate and that seems to be fine as well. He's checked on a regular basis for the fluid in his chest by the critical care clinician at Tufts.
Here's what I'm wondering though and here's the dilemma ..... I know he should probably be seen by a cardiologist again. He was seen when he was at Tufts in May and had a heart echo at that time. His heart was significantly enlarged and there was what they referred to as "some smoke" This is how he got his diagnosis and prognosis which was not very good at all. They said most cats at this stage live 6 months to a year.
It's now been a little over 3 months since then, and I'm wondering if it's time for another cardiologist consult and echo. I'm torn about this. If something needs to change in his care I need to know. If it's gotten so bad, I have to let him go, I need to know, but if knowing won't change the treatment protocall then I'm not sure I need to know nor am I sure I should put him through it. Also..... a factor is money. I'll be paying off his medical bills from the spring for the next year. I'm guessing it will be another $400 or so for the cardiologist and the testing. It might be well worth it though. I don't want to miss something important. It's so hard to know sometimes what to do. His behavior is good. He's basically himself - slightly less active perhaps than he has been in the past. He's such a sweetie and like all of you I'm sure I just want to do the best for him.
Anyone out there have experience w/ cats w/ end stage HCM? Do their hearts tend to change very quickly (quicker than a cat with an earlier stage of the disease)? Have you had to change treatment based on the echo results? I'm leaning towards waiting until 5 months to do the echo and cardio consult but .. when I read things like this, I wonder..
Any thoughts or advice are sure welcome,
Cathy & WinstonAt the height of laughter, the universe is flung into a kaleidoscope of new possibilities. ~Jean Houston
--- On Thu, 8/27/09, Kristen G <apacheadd@...> wrote:
>From: Kristen G <apacheadd@...>
>Subject: Re: [FH] Stragles Echo
>To: "starbright102005" <starbright102005@...>, firstname.lastname@example.org
>Date: Thursday, August 27, 2009, 9:59 AM
>Hi Carole -- From what I have read, the fact that a cat has a murmur does not indicate anything about whether the cat will have underlying heart disease or a heart condition. In other words, a murmur can mean nothing. The only way to tell is with an echo -- then you will know for sure what is going on with Kitty.
>One word of caution, though -- my cat Duffer was referred to a specialist because the vet heard a heart murmur. The first echo did not reveal anything wrong with her heart -- only that her measurements were slightly off but not enough to be clinically significant. It was the repeat echo 6 months later that revealed her HCM. So, be sure to follow up if the first echo doesn't find anything because the hearts do change rather quickly. Duffer was in CHF by the second echo. (Now she is fine, by the way.)
>I hope this helps!
>____________ _________ _________ __
>From: starbright102005 <starbright102005@ yahoo.com>
>To: feline-heart@ yahoogroups. com
>Sent: Thursday, August 27, 2009 2:39:21 AM
>Subject: [FH] Stragles Echo
>She is a longed haired calico, around 13 years of age. Weights just under 14 pounds. Great little eater. Her echo no change, so i am grateful! We do not have to return for a year. Dx'd July 2007, altho i believe she was HCM the previous year before or so. She is taking 1/4 atenolol oonce per night, and her enalpril one tap , mornings. One of my other kitties , Kitty a short hair tabby, aprox 3 years of age, weight around 10 pounds or so, heart murmur #3. Taking her for her first echo in Sept. Do they always have cardiac issues when their is a murmur involved? Thanks much, Carole , Stragles, Kitty and the rest of the feline crew!
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