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Re: Prognosis For HCM/RCM

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  • acrocat@rocketmail.com
    Hi Dick I would love it if there were a drug out there to improve or eliminate HCM in cats. Everyone would. HCM comes with a grave prognosis in humans as
    Message 1 of 13 , Feb 2, 2012
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      Hi Dick

      I would love it if there were a drug out there to improve or eliminate
      HCM in cats. Everyone would. HCM comes with a grave prognosis in
      humans as well, so a drug to cure or lessen the severity of HCM would
      have a huge market.

      There are two maxims in science which apply to your statement:

      >I personally have seen what appears to be clear
      > echocardiographic evidence that medications (enalapril) have resulted
      in visible
      > improvement of Jesse's condition (HCM/RCM).

      The first is:
      The plural of "anecdote" is not "data." :) That's self-explanatory.

      The other is, association is not causation. This means that if you eat
      a banana and then puke, it does not mean that bananas are toxic or that
      they cause vomiting when ingested by humans. You ate one, and then got
      sick, but it does not mean that the banana made you sick. Another
      example would be if you started an exercise program and then had patches
      of itchy skin on your torso. This does not mean that exercise causes
      rashes in humans. (It probably means you're irritated by whatever type
      of fabric you're wearing, or the soap you use for exercise clothes,
      etc.) Association (bananas and stomach upset, and exercise and rashes)
      is not causation.

      So, starting enalapril and seeing a change in echo dimensions does not
      mean that enalapril cures or mitigates HCM. There are hundreds of
      thousands of animals and millions and millions of people on enalapril
      who have not had any cardiac benefits from enalapril. We'd expect this,
      as it has no direct action on the heart.


      --- In feline-heart@yahoogroups.com, nyppsi@... wrote:
      > While it is commonly preached & accepted that HCM is not a reversible
      or
      > curable affliction, I repeatedly read posts indicating that
      echocardiograms
      > have, in some cases, shown reductions in the thickness of atrium
      walls
      > after a period of medication and reduction or elimination of valve
      leakage.

      You've also probably read more posts in which someone said their cat had
      CHF, or a saddle thrombus, or passed away, I'd bet. Many of these cats
      were on the same meds and supplements--what about them?

      I'd also note that wall thickness can change with the disease; it is
      heart function (specifically diastolic--the relaxation--function) that
      you'd monitor. As I described in a recent post, some cats lose
      thickness as the disease progresses. It's also possible for the walls
      to get thicker or thinner for reasons that are entirely and completely
      mysterious. A cat can be diagnosed with bad HCM and then "plateau" for
      months or years. Other cats crash within weeks or months. HCM does
      what it wants--no one can pull it off of whatever track it's on, and
      believe me people have tried their absolute best.

      As for valve leakage, I assume you still mean cats. In cats with the
      obstructive form of HCM (called HOCM, or HCM with SAM), lowering the
      heart rate can lower the obstruction i.e. the valve is less "leaky."
      This is because the leakage is more prominent when the heart rate is
      higher, not because they've been cured by a heart-rate-lowering drug.
      Of course, if their HCM regresses (again, for reasons that are unclear),
      the obstruction can lessen as well.

      > Cardiologists always seem to tend to take the "worst case" approach,
      > conceding only that medications may slow the progress of the
      condition, but not
      > reverse it.

      Again, humans with HCM have the full force of a pharmaceutical industry
      which would find a cure for HCM incredibly lucrative behind them, and
      they aren't getting cured. I'm sorry, there is no medication to reverse
      HCM. There just isn't.

      > I don't want to take the negative fatalistic viewpoint that seems
      > to be the stock-and-trade of veterinary cardiologists. I often wonder
      if,
      > in some cases, that's their way of generating more echo business
      ($450.00 a
      > pop in my area).

      I'm glad you don't want to take the view that cardiologists are
      withholding lifesaving medications for HCM cats out of greed. That
      would be an unfair and incredibly cynical view.

      Adriann



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    • ERIC LEE
      I am sorry. I worked 12 hours yesterday so I didnt type so well. He ha an upper repiratory so thats why I asked my vet for antibiotics. I am just being very
      Message 2 of 13 , Feb 3, 2012
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        I am sorry. I worked 12 hours yesterday so I didnt type so well. He ha an upper repiratory so thats why I asked my vet for antibiotics. I am just being very cautious and worrysome
         
         
        Thank you for all of your replies!!!

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      • acrocat@rocketmail.com
        Most URIs are caused by viruses and not bacteria, so antibiotics won t help. If he has yellow snotty stuff, then antibiotics would help.
        Message 3 of 13 , Feb 3, 2012
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          Most URIs are caused by viruses and not bacteria, so antibiotics won't help. If he has yellow snotty stuff, then antibiotics would help.
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