Re: [FH] Cat with CRF, heart disease just diagnosed
- Hi Ellen.
My heart goes out to you and Ashton. It can be extremely difficult to manage a cat with both CRF and heart disease. So many times, what we do to help the kidneys has an adverse effect on the heart and vice versa. It's kind of like walking a tight-rope. Tipping too much one way or another can have bad consequences.
Epogen is known to cause systemic hypertension (in other words, high blood pressure), which certainly could have an effect on the heart. However, whether that's the case with Ashton or not is difficult to say for sure. It's just as likely (probably even moreso) that Ashton's heart is diseased. You mentioned HCM which is a common cause of heart failure. Has Ashton's blood pressure been measured recently? If it's high, you may want to ask your vet about amlodipine or something similar to lower it. This drug needs to be used cautiously in cats in heart failure also and some vets like to use it together with enalapril (which Ashton already takes, I believe.)
Another thing that you can do at home is measure his sleeping respiratory rate. Just count the number of breaths Ashton takes in 60 seconds when he is sleeping. If the value starts to trend upward, let your vet know immediately. In normal cats, less than 30 breaths per minute is typical. With heart failure and fluid building up in the lungs, the value will go up usually.
Good luck to you and Ashton. I know how these situation are for all involved.
Lorie Huston, DVM
From: ellenmsp <ellencmoore@...>
To: feline-heart <email@example.com>
Sent: Fri, Jan 28, 2011 8:33 pm
Subject: [FH] Cat with CRF, heart disease just diagnosed
My cat Ashton is 9 and 1/2 years old, and has been getting fluids and epogen for CRF for almost a year - dx in Feb 10. His creatinine was at 6, and then dropped to 3 after 150 ccs fluid daily and has been between 3-4, BUN was around 130 initially, and has dropped and held around 80 (it may have been even lower early on), but now creatinine is back up to 7 as of yesterday (was 3.9 in Oct). The PCV had been 18 last Feb, went up to 32 after months on epogen, was 32 in October but is now 17. Phos was around 4 in Oct and is now 9 so am going to add aluminum hydroxide.
Yesterday 130 ccs of fluid drawn out mostly on left side of chest area (pleural effusion). Cardiac u/s showed some fluid around his heart, enlarged heart, mitral valve regurgitation on both sides (?). The vet did mention mild HCM but mostly just said he's in heart failure which is difficult to treat when there is also CRF. We are increasing epogen to get his PCV back up (she did not think it was antibodies). Does epogen ever *cause* heart problems in cats?
epogen 3x/week 100u/kg up from once/week
Enalapril once/day 1.25 mg
Lasix twice/day 6.25 mg
100 ccs LRS every other day (was 150 every day)
pepcid 2.5 mg/day
He is about 7-8 lbs, his weight actually dropped a pound after the fluid was drawn off. He is not eating much (was eating dry K/D and some wet when I could get him to eat it) but he is feeling and breathing much better with the fluid drawn off. We are rechecking on Monday but any experiences or advise or suggestions appreciated!
Ellen & Ashton
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