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Question medicate or not?

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  • mickthecat
    My cat Satori was diagnosed with HCM at a year old. He had a 4/6 murmer, mild hypertropy and mild atrial enlargement. He was on Atenolol for 5 years and all
    Message 1 of 10 , Jun 5, 2010
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      My cat Satori was diagnosed with HCM at a year old. He had a 4/6 murmer, mild hypertropy and mild atrial enlargement. He was on Atenolol for 5 years and all of the hypertrophy and his murmer went away. The cardiologit said there was no longer any sign of heart disease and to take him off the meds. As he is a big cat he didn't think that he still had a very mild enlargement of the atrium was a real indicator of anything to worry about. I did take him off the meds and now 2 years later his murmer is back at 2/6 and he just had an echo and his atrial enlargement while still mild, has increased. There are also some issues on the Doppler that weren't there before. No hypertrophy at all now though.

      However, the cardiologist says all of this is very mild and meds are not indicated (he is the same cardiologist who told me to take him off meds two years ago). He was dismissive of the idea that the Atenolol actually reversed the disease process, said there is no evidence that can happen. I know it is unusual but the echos over the years clearly show a progressive slow shrinking of the enlargement of the atrium and a slow improvement of the hypertrophy while he was on the meds. And now that he has been off he has a murmer again and enlargement.

      My vet wants to follow what the cardiologist says. I can understand this recommendation if you look at the cat in isolation as it is mild but neither will listen to me about how the meds seemed to be helping, historically. The cardiologist even said it doesn' matter what happened in the past only what is current. One of his previouos cardiologists also said that the meds seemed to be curing the disease even though they aren't supposed to

      Am I carzy for wanting to put him back on the Atenolol? Both vets act like I am. The cardiologist said most people don't WANT to medicate their animal and he woould never medicate the cat if it was his based on the echos. My vet said she would write the prescription if I insisted.

      What should I do?
    • Helen
      Personally, I would get a second opinion from another cardiologist. Take the echo and whatever else you just had done so you don t have to pay for it again.
      Message 2 of 10 , Jun 6, 2010
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        Personally, I would get a second opinion from another cardiologist. Take the echo and whatever else you just had done so you don't have to pay for it again. But if you feel your concerns aren't being taken seriously, it's time to go to someone else. Maybe someone on the list here knows a good cardiologist in your area...??

        Toby's cardiologist initally did not put him on atenolol or enalapril. But said she would if that's what I wanted. She said it wasn't indicated until he went into CHF. Well, I didn't want to just sit around waiting for that to happen so he is on both now. And part of the reason I insisted on the medications was because of the possibilty that they MIGHT reverse some of the issues. Our cardiologist said there was no clinical research to support that theory, but that she thought there were no real concerns from starting on the meds. So since they likely wouldn't hurt him and could possibly help him, I wanted the meds.
        It sounds like you had some success with the meds on the past so I would trust your instincts.
        Wishing you the best,

        ~Helen, Zima, & Toby~

        On Jun 5, 2010, at 10:03 PM, "mickthecat" <mickthecat@...> wrote:

        My cat Satori was diagnosed with HCM at a year old. He had a 4/6 murmer, mild hypertropy and mild atrial enlargement. He was on Atenolol for 5 years and all of the hypertrophy and his murmer went away. The cardiologit said there was no longer any sign of heart disease and to take him off the meds. As he is a big cat he didn't think that he still had a very mild enlargement of the atrium was a real indicator of anything to worry about. I did take him off the meds and now 2 years later his murmer is back at 2/6 and he just had an echo and his atrial enlargement while still mild, has increased. There are also some issues on the Doppler that weren't there before. No hypertrophy at all now though.

        However, the cardiologist says all of this is very mild and meds are not indicated (he is the same cardiologist who told me to take him off meds two years ago). He was dismissive of the idea that the Atenolol actually reversed the disease process, said there is no evidence that can happen. I know it is unusual but the echos over the years clearly show a progressive slow shrinking of the enlargement of the atrium and a slow improvement of the hypertrophy while he was on the meds. And now that he has been off he has a murmer again and enlargement.

        My vet wants to follow what the cardiologist says. I can understand this recommendation if you look at the cat in isolation as it is mild but neither will listen to me about how the meds seemed to be helping, historically. The cardiologist even said it doesn' matter what happened in the past only what is current. One of his previouos cardiologists also said that the meds seemed to be curing the disease even though they aren't supposed to

        Am I carzy for wanting to put him back on the Atenolol? Both vets act like I am. The cardiologist said most people don't WANT to medicate their animal and he woould never medicate the cat if it was his based on the echos. My vet said she would write the prescription if I insisted.

        What should I do?







        [Non-text portions of this message have been removed]
      • Mmayer11
        Your experience is new to me. But one thing I have heard over and over from caretakers and *good* vets...trust your instincts. Why not seek another opinion. I
        Message 3 of 10 , Jun 6, 2010
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          Your experience is new to me. But one thing I have heard over and over from caretakers and *good* vets...trust your instincts.
          Why not seek another opinion. I think I would do that next. Then if you still feel as you do now, I would ask your vet for a Rx. But one thing you should keep in mind, it's best if you have vets...specialist as well as regular... who are all on the same page as you. It's necessary b/c you will still have to have your boy monitored by a cardio. Why not also contact the previous cardio who supported the idea that the meds actually improve the condition.

          HTH



          Marianna








          [Non-text portions of this message have been removed]
        • Judi Levens
          I can only relay my experience, which is similar. Max went into CHF as a result of steroids, but he was dx with HCM at that time and put on lasix and
          Message 4 of 10 , Jun 6, 2010
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            I can only relay my experience, which is similar. Max went into CHF as a result of steroids, but he was dx with HCM at that time and put on lasix and enalapril. After 8.5 mos we went to the cardiologist and they said his disease was mild to moderate and he didn't need any meds (at the time he was dx it looked quite severe.) Now, there is some evidence that cats who go into CHF from steroids can have a reversal of the diseasse (to a point) and get off meds, so I happily took him off meds. Four-five months later when we went for a follow up echo the cardiologist was concerned that he had progressed to moderate and that if he could progress so fast in a short time that the disease was very progressive and he went back on his meds, and the progression stopped and even reversed some. So, again (there is now a new doctor...we use UC Davis) in October of this past year the doctor wanted to take him off his meds. I said absolutely not...in his case he has had good success with enalapril...he said the same thing, that there was no evidence to support that and it wasn't necessary...I stuck to my guns and he stayed on enalapril. (He wanted to try diltiazem, but we tried that before and he wouldn't take it.)

            Since then, Max suffered a mild clot during the winter which thankfully resolved itself. We go tomorrow for his next echo, and I am hoping for the best...it's been 2 years and 8 months since his initial dx and so far he's done very well...I call him my 'Milagro Max'...let's hope the good luck continues. anyway, I can empathize with your situation, and I believed then and now that enalapril was very beneficial to Max's heart and to stopping and even reversing somewhat the disease. Good luck...Judi and Max










            To: feline-heart@yahoogroups.com
            From: mickthecat@...
            Date: Sun, 6 Jun 2010 05:03:04 +0000
            Subject: [FH] Question medicate or not?





            My cat Satori was diagnosed with HCM at a year old. He had a 4/6 murmer, mild hypertropy and mild atrial enlargement. He was on Atenolol for 5 years and all of the hypertrophy and his murmer went away. The cardiologit said there was no longer any sign of heart disease and to take him off the meds. As he is a big cat he didn't think that he still had a very mild enlargement of the atrium was a real indicator of anything to worry about. I did take him off the meds and now 2 years later his murmer is back at 2/6 and he just had an echo and his atrial enlargement while still mild, has increased. There are also some issues on the Doppler that weren't there before. No hypertrophy at all now though.

            However, the cardiologist says all of this is very mild and meds are not indicated (he is the same cardiologist who told me to take him off meds two years ago). He was dismissive of the idea that the Atenolol actually reversed the disease process, said there is no evidence that can happen. I know it is unusual but the echos over the years clearly show a progressive slow shrinking of the enlargement of the atrium and a slow improvement of the hypertrophy while he was on the meds. And now that he has been off he has a murmer again and enlargement.

            My vet wants to follow what the cardiologist says. I can understand this recommendation if you look at the cat in isolation as it is mild but neither will listen to me about how the meds seemed to be helping, historically. The cardiologist even said it doesn' matter what happened in the past only what is current. One of his previouos cardiologists also said that the meds seemed to be curing the disease even though they aren't supposed to

            Am I carzy for wanting to put him back on the Atenolol? Both vets act like I am. The cardiologist said most people don't WANT to medicate their animal and he woould never medicate the cat if it was his based on the echos. My vet said she would write the prescription if I insisted.

            What should I do?






            [Non-text portions of this message have been removed]
          • Westgold
            What Helen says is my exact opinion too. I would never ever want to change Tigger s meds, he s doing so well! But a second opinion is definitely called for
            Message 5 of 10 , Jun 6, 2010
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              What Helen says is my exact opinion too. I would never ever want to change Tigger's meds, he's doing so well! But a second opinion is definitely called for if you are worrying about it. If things are going well, why would you want to change? Why take a chance? I realize this isn't the same thing, but I guess there's a lesson in it. Tigger had horrible herpes when I got him. I treated him with Lysine for three months before I got it under control. After a couple years he was so perfectly clear all the time, I followed what someone said on one of the lists, and decided to cut back on the amount of lysine I gave him. Well in no time at all the herpes came back with a vengeance, and although it got a lot better when I went back to the original dose, in 3 years I have never been able to get him so perfectly controlled as he was before I tried to cut back the dose. Don't mess with success.
              ----- Original Message -----
              From: Helen
              To: mickthecat
              Cc: feline-heart@yahoogroups.com
              Sent: Sunday, June 06, 2010 3:42 AM
              Subject: Re: [FH] Question medicate or not?



              Personally, I would get a second opinion from another cardiologist. Take the echo and whatever else you just had done so you don't have to pay for it again. But if you feel your concerns aren't being taken seriously, it's time to go to someone else. Maybe someone on the list here knows a good cardiologist in your area...??

              Toby's cardiologist initally did not put him on atenolol or enalapril. But said she would if that's what I wanted. She said it wasn't indicated until he went into CHF. Well, I didn't want to just sit around waiting for that to happen so he is on both now. And part of the reason I insisted on the medications was because of the possibilty that they MIGHT reverse some of the issues. Our cardiologist said there was no clinical research to support that theory, but that she thought there were no real concerns from starting on the meds. So since they likely wouldn't hurt him and could possibly help him, I wanted the meds.
              It sounds like you had some success with the meds on the past so I would trust your instincts.
              Wishing you the best,

              ~Helen, Zima, & Toby~




              [Non-text portions of this message have been removed]
            • Suze Winn
              I am wondering if herpes comes with HCM? My Wasabi has herpes in his nose and is a heavy breather, since he was a kitten. I always wondered about this as I
              Message 6 of 10 , Jun 6, 2010
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                I am wondering if herpes comes with HCM? My Wasabi has herpes in his nose and is a heavy breather, since he was a kitten. I always wondered about this as I keep reading in some of these posts that some of the cats have herpes along with cardiac problems.

                I also treat with Lysine and keep him on a fairly reg. schedule. Atenolo is added twice daily too.

                suze wasabi, kirin and meiko

                To: sparklejunkey@...; feline-heart@yahoogroups.com
                From: westgold@...
                Date: Sun, 6 Jun 2010 15:43:03 -0400
                Subject: Re: [FH] Question medicate or not?




























                What Helen says is my exact opinion too. I would never ever want to change Tigger's meds, he's doing so well! But a second opinion is definitely called for if you are worrying about it. If things are going well, why would you want to change? Why take a chance? I realize this isn't the same thing, but I guess there's a lesson in it. Tigger had horrible herpes when I got him. I treated him with Lysine for three months before I got it under control. After a couple years he was so perfectly clear all the time, I followed what someone said on one of the lists, and decided to cut back on the amount of lysine I gave him. Well in no time at all the herpes came back with a vengeance, and although it got a lot better when I went back to the original dose, in 3 years I have never been able to get him so perfectly controlled as he was before I tried to cut back the dose. Don't mess with success.

                ----- Original Message -----

                From: Helen

                To: mickthecat

                Cc: feline-heart@yahoogroups.com

                Sent: Sunday, June 06, 2010 3:42 AM

                Subject: Re: [FH] Question medicate or not?



                Personally, I would get a second opinion from another cardiologist. Take the echo and whatever else you just had done so you don't have to pay for it again. But if you feel your concerns aren't being taken seriously, it's time to go to someone else. Maybe someone on the list here knows a good cardiologist in your area...??



                Toby's cardiologist initally did not put him on atenolol or enalapril. But said she would if that's what I wanted. She said it wasn't indicated until he went into CHF. Well, I didn't want to just sit around waiting for that to happen so he is on both now. And part of the reason I insisted on the medications was because of the possibilty that they MIGHT reverse some of the issues. Our cardiologist said there was no clinical research to support that theory, but that she thought there were no real concerns from starting on the meds. So since they likely wouldn't hurt him and could possibly help him, I wanted the meds.

                It sounds like you had some success with the meds on the past so I would trust your instincts.

                Wishing you the best,



                ~Helen, Zima, & Toby~



                [Non-text portions of this message have been removed]



















                [Non-text portions of this message have been removed]
              • Westgold
                Ok, when I read my own post I see it s not completely clear. I meant that I never would have taken my cat off the meds in the first place. If he was well and
                Message 7 of 10 , Jun 6, 2010
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                  Ok, when I read my own post I see it's not completely clear. I meant that I never would have taken my cat off the meds in the first place. If he was well and having success on the meds, and I wouldn't mess with that. Your cat is not on the meds now, but you're wondering if you should go back on them. Those meds have saved and/or extended the lives of countless kitties because they work. I don't think that HCM can be healed. The body can do a lot of healing over time, and I believe that murmurs can sometimes be healed, but I don't believe that HCM can he healed. And if there's still even a little there, I think meds are called for. Just my opinion.
                  ----- Original Message -----
                  From: Westgold
                  To: Helen ; feline-heart
                  Sent: Sunday, June 06, 2010 3:43 PM
                  Subject: Re: [FH] Question medicate or not?



                  What Helen says is my exact opinion too. I would never ever want to change Tigger's meds, he's doing so well! But a second opinion is definitely called for if you are worrying about it. If things are going well, why would you want to change? Why take a chance? I realize this isn't the same thing, but I guess there's a lesson in it. Tigger had horrible herpes when I got him. I treated him with Lysine for three months before I got it under control. After a couple years he was so perfectly clear all the time, I followed what someone said on one of the lists, and decided to cut back on the amount of lysine I gave him. Well in no time at all the herpes came back with a vengeance, and although it got a lot better when I went back to the original dose, in 3 years I have never been able to get him so perfectly controlled as he was before I tried to cut back the dose. Don't mess with success.
                  ----- Original Message -----
                  From: Helen
                  To: mickthecat
                  Cc: feline-heart@yahoogroups.com
                  Sent: Sunday, June 06, 2010 3:42 AM
                  Subject: Re: [FH] Question medicate or not?

                  Personally, I would get a second opinion from another cardiologist. Take the echo and whatever else you just had done so you don't have to pay for it again. But if you feel your concerns aren't being taken seriously, it's time to go to someone else. Maybe someone on the list here knows a good cardiologist in your area...??

                  Toby's cardiologist initally did not put him on atenolol or enalapril. But said she would if that's what I wanted. She said it wasn't indicated until he went into CHF. Well, I didn't want to just sit around waiting for that to happen so he is on both now. And part of the reason I insisted on the medications was because of the possibilty that they MIGHT reverse some of the issues. Our cardiologist said there was no clinical research to support that theory, but that she thought there were no real concerns from starting on the meds. So since they likely wouldn't hurt him and could possibly help him, I wanted the meds.
                  It sounds like you had some success with the meds on the past so I would trust your instincts.
                  Wishing you the best,

                  ~Helen, Zima, & Toby~

                  [Non-text portions of this message have been removed]





                  [Non-text portions of this message have been removed]
                • Westgold
                  You re doing everything right. I do not believe they are connected at all. Most cats have been exposed to herpes (a virus), but it doesn t manifest in all of
                  Message 8 of 10 , Jun 6, 2010
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                    You're doing everything right. I do not believe they are connected at all. Most cats have been exposed to herpes (a virus), but it doesn't manifest in all of them. But the stress of having hCM and being treated, etc, might very well bring it out. If your cat has a runny eye or two with clear liquid, that is undoubtedly herpes. 500 mg l-lysine twice a day will control it -- but it can never be cured. Herpes is forever.
                    ----- Original Message -----
                    From: Suze Winn
                    To: westgold@... ; sparklejunkey@... ; feline-heart@yahoogroups.com
                    Sent: Sunday, June 06, 2010 3:56 PM
                    Subject: RE: [FH] Question medicate or not?


                    I am wondering if herpes comes with HCM? My Wasabi has herpes in his nose and is a heavy breather, since he was a kitten. I always wondered about this as I keep reading in some of these posts that some of the cats have herpes along with cardiac problems.

                    I also treat with Lysine and keep him on a fairly reg. schedule. Atenolo is added twice daily too.

                    suze wasabi, kirin and meiko


                    ------------------------------------------------------------------------------
                    To: sparklejunkey@...; feline-heart@yahoogroups.com
                    From: westgold@...
                    Date: Sun, 6 Jun 2010 15:43:03 -0400
                    Subject: Re: [FH] Question medicate or not?


                    What Helen says is my exact opinion too. I would never ever want to change Tigger's meds, he's doing so well! But a second opinion is definitely called for if you are worrying about it. If things are going well, why would you want to change? Why take a chance? I realize this isn't the same thing, but I guess there's a lesson in it. Tigger had horrible herpes when I got him. I treated him with Lysine for three months before I got it under control. After a couple years he was so perfectly clear all the time, I followed what someone said on one of the lists, and decided to cut back on the amount of lysine I gave him. Well in no time at all the herpes came back with a vengeance, and although it got a lot better when I went back to the original dose, in 3 years I have never been able to get him so perfectly controlled as he was before I tried to cut back the dose. Don't mess with success.
                    ----- Original Message -----
                    From: Helen
                    To: mickthecat
                    Cc: feline-heart@yahoogroups.com
                    Sent: Sunday, June 06, 2010 3:42 AM
                    Subject: Re: [FH] Question medicate or not?

                    Personally, I would get a second opinion from another cardiologist. Take the echo and whatever else you just had done so you don't have to pay for it again. But if you feel your concerns aren't being taken seriously, it's time to go to someone else. Maybe someone on the list here knows a good cardiologist in your area...??

                    Toby's cardiologist initally did not put him on atenolol or enalapril. But said she would if that's what I wanted. She said it wasn't indicated until he went into CHF. Well, I didn't want to just sit around waiting for that to happen so he is on both now. And part of the reason I insisted on the medications was because of the possibilty that they MIGHT reverse some of the issues. Our cardiologist said there was no clinical research to support that theory, but that she thought there were no real concerns from starting on the meds. So since they likely wouldn't hurt him and could possibly help him, I wanted the meds.
                    It sounds like you had some success with the meds on the past so I would trust your instincts.
                    Wishing you the best,

                    ~Helen, Zima, & Toby~

                    [Non-text portions of this message have been removed]





                    [Non-text portions of this message have been removed]
                  • Kristen G
                    I don t know if this helps, but my Duffer has been on Enalapril for 1.5 years since the diagnosis of HCM and CHF.  She was much sicker than Satori.  The
                    Message 9 of 10 , Jun 6, 2010
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                      I don't know if this helps, but my Duffer has been on Enalapril for 1.5 years since the diagnosis of HCM and CHF.  She was much sicker than Satori.  The Enalapril has actually improved her heart measurements -- and, yes, my specialist does attribute the improvements to the enalapril.  Her atrial enlargement has reduced on the meds.  If I were you, I would suggest to the team (vet/cardio) that you TRY going back on the meds for 6 months, do another ultrasound, and SEE what happens.  If they agree that the meds are not going to HURT, then why not try it to see if it will help.  I know that my specialist probably will never consider removing Duffer's enalapril and I wouldn't want to either!  It has kept her stable so far (fingers crossed).  I would want to try it and see if it helps.  Duffer goes for an ultrasound every 6 months.

                      Best to you --
                      Kristen




                      ________________________________
                      From: mickthecat <mickthecat@...>
                      To: feline-heart@yahoogroups.com
                      Sent: Sun, June 6, 2010 1:03:04 AM
                      Subject: [FH] Question medicate or not?

                       
                      My cat Satori was diagnosed with HCM at a year old. He had a 4/6 murmer, mild hypertropy and mild atrial enlargement. He was on Atenolol for 5 years and all of the hypertrophy and his murmer went away. The cardiologit said there was no longer any sign of heart disease and to take him off the meds. As he is a big cat he didn't think that he still had a very mild enlargement of the atrium was a real indicator of anything to worry about. I did take him off the meds and now 2 years later his murmer is back at 2/6 and he just had an echo and his atrial enlargement while still mild, has increased. There are also some issues on the Doppler that weren't there before. No hypertrophy at all now though.

                      However, the cardiologist says all of this is very mild and meds are not indicated (he is the same cardiologist who told me to take him off meds two years ago). He was dismissive of the idea that the Atenolol actually reversed the disease process, said there is no evidence that can happen. I know it is unusual but the echos over the years clearly show a progressive slow shrinking of the enlargement of the atrium and a slow improvement of the hypertrophy while he was on the meds. And now that he has been off he has a murmer again and enlargement.

                      My vet wants to follow what the cardiologist says. I can understand this recommendation if you look at the cat in isolation as it is mild but neither will listen to me about how the meds seemed to be helping, historically. The cardiologist even said it doesn' matter what happened in the past only what is current. One of his previouos cardiologists also said that the meds seemed to be curing the disease even though they aren't supposed to

                      Am I carzy for wanting to put him back on the Atenolol? Both vets act like I am. The cardiologist said most people don't WANT to medicate their animal and he woould never medicate the cat if it was his based on the echos. My vet said she would write the prescription if I insisted.

                      What should I do?







                      [Non-text portions of this message have been removed]
                    • elfinmyst@aol.com
                      Hi My Maxi was diagnosed as a kitten and went onto atenolol as a precaution. His meds keep him stable and it does seem to delay the progression. My experience
                      Message 10 of 10 , Jun 7, 2010
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                        Hi

                        My Maxi was diagnosed as a kitten and went onto atenolol as a precaution.
                        His meds keep him stable and it does seem to delay the progression.

                        My experience is atenolol helps the heart in the early stages and yes, I`ve
                        also had a reversal of HCM thickness with Trixi but she is on so many meds
                        its impossible to say which has helped. Personally I think the vetmedin is
                        a wonder.

                        Atenolol doesn't seem to help as much with heart failure but in my
                        experience it has always helped slow down the HCM progression. Josh stopped
                        atenolol when he went into actual heart failure.

                        My advice is get a second opinion, Ask for the scans and pictures to be
                        sent to a second cardiologist or get a telephone consultation. It is perfectly
                        ok for you to do this and there is evidence from tales on this forum of
                        atenolol helping, even if that isn't scientific.

                        Trixi's HCM is reversed to a large degree. My cardiologist calls her a
                        miracle. This was partly due to a heart attack she had which actually destroyed
                        some of the thickened heart muscle and I would say thanks to the wonderful
                        meds and supplements she takes. Ok, it's no trial and no science, but you
                        know your cat best. Trust your instinct.

                        Lyn

                        _www.myfurkids.co.uk_ (http://www.myfurkids.co.uk/)


                        [Non-text portions of this message have been removed]
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