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Re: "Boo" diagnosed with DCM

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  • kittykatwhiskas
    Hi Adriann, Thanks for taking the time to write. The steroid was actually given by the vet BEFORE we knew she was suffering from DCM. She has always had bad
    Message 1 of 9 , Dec 29, 2011
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      Hi Adriann,

      Thanks for taking the time to write.

      The steroid was actually given by the vet BEFORE we knew she was suffering from DCM. She has always had bad allergies and so when she developed the outstretched neck, gasping for air it was diagnosed by her primary vet as asthma. The long lasting steroid was given and by the next day she could not breathe. I rushed her back to the vet and this is when it gets scary... her clear x-ray the day before was now cloudy with buildup in her lungs. The vet wanted to give her an antibiotic and I said "she can't breathe!". I immediately rushed her to Cornell and was so happy I listened to my instincts as she was in CHF!

      It was there, at the ER, that she was diagnosed with HCM (later to be diagnosed as DCM). She was in ICU in an oxygen cage for 3 days and the doctors there saved her. She has been home for 6wks and seems to be doing pretty well, with the exception of the "balance" issue.

      She takes the following medications:

      Furosemide 12.5mg - 1/2 tablet twice a day
      Benazepril 5mg - 1/2 tablet once a day
      Plavix 75mg - 1/4 tablet once a day

      After 4wks on the above meds, doing quite well, she went to see a referred cardiologist at Cornell. This is where she was further diagnosed with DCM and given a grave prognosis. Her blood work came back good and based on her doing well up to this point, the doctor added the following meds:

      Pimobendan 1.25mg - 1/2 tablet twice a day
      Spironolactone 25mg - 1/4 tablet twice a day

      Within days of adding these new meds, she was more lethargic, hiding/sleeping in the corner of a room away from me, and saw the "balance problem" when she would wake from a nap. The first time I saw it, she woke from beside me, jumped off the bed and her entire body swayed from side to side. I held her upright so she could balance and she did. That same day she woke from a nap on the couch and as she went to stand she fell right over. It was then that I made the decision to stop the new meds. She was doing great before we added them and it was too much of a coincidence. The next day I spoke with the cardiologist and she agreed to remove these meds for now.

      It has been 1.5wks since we stopped them (she wasn't on them very long) and she is now social again, not sleeping in the corner of a room, but just in the last couple days I have seen some balancing issues once again. I believe the blood pressure issue or low cardiac output makes the most sense as she just had complete blood work done 1.5wks ago. I am just so afraid of adding/changing her meds after what happened last time. She is also completely stressed going to the vet and I am trying so hard to keep her stress-free. Even the cardiologist said she would recommend less frequent visits in her case just because of the stress involved.

      Since I have already written a book ;-), I will add one more item we looked into.... Taurine. Unfortunately, the doc did not take enough blood to run the Taurine test as planned. As I mentioned, due to the stress of taking her there we felt it was not good to bring her back to take more blood. So we went ahead with the Taurine supplement just in case BUT Boo was not a fan. They were so large I had to cut them and even hidden in her treat she would not do it. I couldn't chance her not taking her other meds which she has been so good doing, so I did not force the Taurine on her. I know its a very slim possibility since its in the foods now but wanted you to have all information.

      May I ask what your background is? Sounds like you have some veterinary experience?

      Thanks again. I really appreciate any help, as this is all new to me.

      Laurie and Boo



      --- In feline-heart@yahoogroups.com, "acrocat@..." <acrocat@...> wrote:
      >
      > That is so very annoying that she was given a steroid shot for having trouble breathing. Have you informed the ER of their error?
      >
      > It sounds like she is feeling "light-headed" when she stands after a period of rest. This happens when the brain temporarily doesn't have enough oxygen, usually because the blood can't saturate the brain with sufficient oxygen in that moment. It's happened to everyone at some time or another, usually if you've been bent over or kneeling for a bit and then stand suddenly. What medications is she on? This can be a sign of low blood pressure -- you should speak to your cardiologist about it. It is not dangerous if she still gets around, but it can be influenced by medication.
      >
      > The other possibility is that it is due to poor cardiac output, a hallmark of DCM. She's at rest and everything's fine, then she suddenly moves and her muscles and her brain all need blood and oxygen and her heart needs a few seconds to supply it.
      >
      > Lastly, in cats on Lasix, you always need to keep low potassium (called hypokalemia) in mind for cats who are generally weak. Especially if they don't eat well, cats on Lasix can become hypokalemic rather quickly. Generalized lethargy and weakness can be due to hypokalemia so a blood test should be done asap.
      >
      > Hope this helps, and do keep us posted,
      > Adriann
      >
    • elfinmyst@aol.com
      Hi Laurie I have a cat with HCM who was diagnosed 5 years ago and given a few months to live at the time. After her heart attack due to blood clot she was on
      Message 2 of 9 , Dec 29, 2011
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        Hi Laurie

        I have a cat with HCM who was diagnosed 5 years ago and given a few months
        to live at the time. After her heart attack due to blood clot she was on
        exactly the same medications Boo was on including vetmedin and spiro, exactly
        the same but with atenolol as well. The meds lowered her blood pressure to
        100 and we have symptoms for that. When she's asleep she'll suddenly call
        out and start howling and then we reassure her and she goes back to sleep.
        The only thing anyone can think of is low blood pressure and she has
        consistently been about 90 - 100. I keep her on all meds as she had no chance at
        all after the heart attack and is a real miracle. They only made a repeat
        appointment because I was so upset.

        The thing that comes to mind with Boo is the benazepril which is a drug
        which lowers blood pressure. It takes the strain off the heart. Vetmedin
        (pimobendan) can also lower blood pressure slightly but for my cats it's been a
        life saving drug. The wobbling may be low blood pressure because it does
        drop when you sleep and for a few seconds after she gets up she may be low.
        As she is now wobbling again, I wouldn't blame the new drugs she started.
        All the cardiac drugs can make them sleepy and dopey at first but it goes
        away within a few days.

        But the other thing is what someone mentioned and that would be the
        potassium. She's on two diuretics and lasix strips potassium from the body and
        that causes wobbling and weakness in the limbs. Can you ask for a liquid
        potassium supplement for pets, they come in beef flavour. In the UK it's called
        kaminox, If that is the problem I would highly recommend you restart the
        vetmedin as it really has been a wonder drug in my cats.

        DCM can be caused by lack of taurine but if Boo is on normal cat food, that
        shouldn't be an issue these days.
        Hope that helps some.

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

        [Non-text portions of this message have been removed]
      • acrocat@rocketmail.com
        Hi Laurie ... Keep in mind that her disease symptoms may wax and wane, so coincidence in common in cases of chronic but unstable disease (such as DCM). Both
        Message 3 of 9 , Dec 29, 2011
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          Hi Laurie

          --- In feline-heart@yahoogroups.com, "kittykatwhiskas" <kittykatwhiskas@...> wrote:

          > Within days of adding these new meds, she was more lethargic, hiding/sleeping in the corner of a room away from me, and saw the "balance problem" when she would wake from a nap. ..... She was doing great before we added them and it was too much of a coincidence.

          Keep in mind that her disease symptoms may wax and wane, so coincidence in common in cases of chronic but unstable disease (such as DCM). Both the spironolactone and benazepril can lower blood pressure. They are used as BP drugs in humans, but not in cats as they rarely lower BP enough to treat true hypertension in cats. Pimobendan is a life-prolonging drug in cats and dogs with DCM so if you had to go down to bare-minimum meds, pimo is not one of the ones I'd drop in my own cat. You can discuss this with your cardiologist.

          > Since I have already written a book ;-), I will add one more item we looked into.... Taurine. Unfortunately, the doc did not take enough blood to run the Taurine test as planned. As I mentioned, due to the stress of taking her there we felt it was not good to bring her back to take more blood. So we went ahead with the Taurine supplement just in case BUT Boo was not a fan.

          Are you using the cat taurine tabs? These are enormous due to flavoring and no one likes them. You can get taurine from the health food store in different forms, and some cat supplements like Nu-Cat have it in small amounts. I did know of a single cat who had DCM due to low taurine while on a commercial food so I'd hate to leave a stone uncovered, if you know what I mean. When is your next appointment? Is there any chance your local vet or vet tech would come over to your house to draw blood? I think it's very unlikely that it's due to taurine but since the problem is mostly reversible if it is, it's hard to justify not checking it out if at all possible.
        • kittykatwhiskas
          Hi Adriann, I spoke with the cardiologist yesterday and she also felt it was important to try the Pimobendan again. So we started it this morning with a lower
          Message 4 of 9 , Dec 30, 2011
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            Hi Adriann,

            I spoke with the cardiologist yesterday and she also felt it was important to try the Pimobendan again. So we started it this morning with a lower dose just once a day to see how she reacts. If after a week she is not having bad side effects we will increase the dose. I feel better baby stepping into it. The cardio tells me there is not a lot of research for the effects of Pimo on cats, mainly dogs with DCM which it has proven to help. After getting your message and reading some others who have cats on Pimo I felt more confident giving it another try.

            Thank you so much for the information and guidance.

            Laurie


            --- In feline-heart@yahoogroups.com, "acrocat@..." <acrocat@...> wrote:
            >
            > Hi Laurie
            >
            > --- In feline-heart@yahoogroups.com, "kittykatwhiskas" <kittykatwhiskas@> wrote:
            >
            > > Within days of adding these new meds, she was more lethargic, hiding/sleeping in the corner of a room away from me, and saw the "balance problem" when she would wake from a nap. ..... She was doing great before we added them and it was too much of a coincidence.
            >
            > Keep in mind that her disease symptoms may wax and wane, so coincidence in common in cases of chronic but unstable disease (such as DCM). Both the spironolactone and benazepril can lower blood pressure. They are used as BP drugs in humans, but not in cats as they rarely lower BP enough to treat true hypertension in cats. Pimobendan is a life-prolonging drug in cats and dogs with DCM so if you had to go down to bare-minimum meds, pimo is not one of the ones I'd drop in my own cat. You can discuss this with your cardiologist.
            >
            > > Since I have already written a book ;-), I will add one more item we looked into.... Taurine. Unfortunately, the doc did not take enough blood to run the Taurine test as planned. As I mentioned, due to the stress of taking her there we felt it was not good to bring her back to take more blood. So we went ahead with the Taurine supplement just in case BUT Boo was not a fan.
            >
            > Are you using the cat taurine tabs? These are enormous due to flavoring and no one likes them. You can get taurine from the health food store in different forms, and some cat supplements like Nu-Cat have it in small amounts. I did know of a single cat who had DCM due to low taurine while on a commercial food so I'd hate to leave a stone uncovered, if you know what I mean. When is your next appointment? Is there any chance your local vet or vet tech would come over to your house to draw blood? I think it's very unlikely that it's due to taurine but since the problem is mostly reversible if it is, it's hard to justify not checking it out if at all possible.
            >
          • kittykatwhiskas
            Hi Lyn, Thanks so much for your message and I am so happy to hear your cat has beaten the odds, majorily! It gives me hope for my baby girl :-) I spoke with
            Message 5 of 9 , Dec 30, 2011
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              Hi Lyn,

              Thanks so much for your message and I am so happy to hear your cat has beaten the odds, majorily! It gives me hope for my baby girl :-)

              I spoke with the cardiologist yesterday and we have decided to try the Pimobendan again, a lower dose just once a day to see the reaction. If that goes well, we will increase the dose in a week.

              The cardiologist told me Boo's potassium was normal in her recent blood work, and also told me low blood pressure would not stem from the Lasix. She seemed to think the dizzy episodes were more from a lack of cardio output, which she feels the Pimobendan will help.

              Laurie and Boo


              --- In feline-heart@yahoogroups.com, elfinmyst@... wrote:
              >
              > Hi Laurie
              >
              > I have a cat with HCM who was diagnosed 5 years ago and given a few months
              > to live at the time. After her heart attack due to blood clot she was on
              > exactly the same medications Boo was on including vetmedin and spiro, exactly
              > the same but with atenolol as well. The meds lowered her blood pressure to
              > 100 and we have symptoms for that. When she's asleep she'll suddenly call
              > out and start howling and then we reassure her and she goes back to sleep.
              > The only thing anyone can think of is low blood pressure and she has
              > consistently been about 90 - 100. I keep her on all meds as she had no chance at
              > all after the heart attack and is a real miracle. They only made a repeat
              > appointment because I was so upset.
              >
              > The thing that comes to mind with Boo is the benazepril which is a drug
              > which lowers blood pressure. It takes the strain off the heart. Vetmedin
              > (pimobendan) can also lower blood pressure slightly but for my cats it's been a
              > life saving drug. The wobbling may be low blood pressure because it does
              > drop when you sleep and for a few seconds after she gets up she may be low.
              > As she is now wobbling again, I wouldn't blame the new drugs she started.
              > All the cardiac drugs can make them sleepy and dopey at first but it goes
              > away within a few days.
              >
              > But the other thing is what someone mentioned and that would be the
              > potassium. She's on two diuretics and lasix strips potassium from the body and
              > that causes wobbling and weakness in the limbs. Can you ask for a liquid
              > potassium supplement for pets, they come in beef flavour. In the UK it's called
              > kaminox, If that is the problem I would highly recommend you restart the
              > vetmedin as it really has been a wonder drug in my cats.
              >
              > DCM can be caused by lack of taurine but if Boo is on normal cat food, that
              > shouldn't be an issue these days.
              > Hope that helps some.
              >
              > Lyn:)
              > _www.myfurkids.co.uk_ (http://www.myfurkids.co.uk/)
              >
              > [Non-text portions of this message have been removed]
              >
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