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Re: [feline-heart] Heart Disease & sub-Q fluids

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  • JettawayFCRs@aol.com
    I would be very concerned about giving fluids to a cat with heart disease. My own vet gave my sweet Quincy fluids, twice, even tho I told them he had
    Message 1 of 10 , Jan 1, 2002
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      I would be very concerned about giving fluids to a cat with heart disease.
      My own vet gave my sweet Quincy fluids, twice, even tho I told them he had
      previously been diagnosed with a heart murmur by my previous vet. Three
      different vets at my clinic listened and did not hear it. Looking back, they
      did not take much time to listen, either. In fact, one said later, he was
      purring so loud, she could not hear anything-but at the time, she said he did
      NOT have a murmur. Turns out his murmur was at least a grade 4, which is
      pretty easy to hear. At the time, Quincy had been sick, with classic
      symptoms of a heart problem, altho I myself did not know that at the time,
      including a blood clot in his leg (which the vet said was a sprained knee),
      and the vet thought, altho he was not very dehydrated, fluids might make him
      feel better. I knew from reading emails lists that that was not a good idea
      if a heart problem was present. So, I warned them about the murmur, and they
      ignored me. The second time they gave him fluids, and an enema, he went into
      congestive heart failure, which the cardiologist we were FINALLY sent to,
      said was caused by the fluids. Quincy's suffering and eventual death could
      have been prevented, had my vets seen that his symptoms added up to a heart
      problem, and had they referred us to a specialist a week or two sooner. By
      the time we got to one, they said he was not in too bad of shape and would
      recover, but he was too weak from fighting to stay alive without eating for
      so long. His illness and death still haunts me as I know he suffered
      needlessly. At the vet school where Quincy was finally treated, they said
      fluids need to be given very carefully, and they do them as an IV drip, where
      about 1 drop at a time goes in, and the cat is monitored carefully. I would
      not give fluids to a cat with a heart condition, unless a cardiologist was
      consulted.

      Heidi
    • Anyes Moscrip
      ... Yes, we managed CRF, HCM, and high blood pressure. It is a balancing act but it can be done. The first thing is to make sure that the heart condition is
      Message 2 of 10 , Jan 1, 2002
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        elevine41 wrote:

        > Hi Everyone,
        >
        > I was just wondering if anyone on this list has a cat that also has
        > CRF & is giving sub-Q fluids? Blue Boy has the decks stacked against
        > him, with Diabetes, CRF & HCM, & I would so like to improve his
        > quality of life for whatever amount of time he has left, but I am
        > terribly afraid to start him on fluids, for fear of sending him into
        > Congestive heart failure, & hastening his departure from me...

        Yes, we managed CRF, HCM, and high blood pressure. It is a balancing act but it can be
        done.

        The first thing is to make sure that the heart condition is being treated with proper
        medication. My kitty could not handle -any- subq's prior to being put on Diltiazem.
        While on Diltiazem, she could process 80 to 120cc of fluids/day for 6 months.
        We also made sure to withhold fluids for 24hrs anytime she showed early signs of fluid
        build up. These included deliberate, slower breaths using lower hips as bellows,
        decrease in appetite with gain weight, more lethargic behaviour, lower body
        temperature. The changes were very subtle. We administered Dandelion extract twice a
        day for prevention of fluid build up, 4 times a day to stop early build up. We were
        able to avoid ER trips for those 6 months. Stress is not good for heart patients, and
        invariably Lucie would go into full congestive heart failure if we had to go to the
        ER. So it is important to try to manage this at home before you get to a crisis
        point. I recommend you get a stethoscope and learn what your cat's normal heart beat
        sounds like, so that when the heartbeat becomes muffled you know the difference.

        The treatment was easier to manage once we realized we had a heart patient with kidney
        problems, not the other way around. After all, it is really a moot point how good the
        kidney values are if the heart stops beating. This is one where the heart takes
        precedence over all else and our decisions day to day were based on that.

        Finally, you have to be flexible with your treatment and take it day by day. You know
        your cat better than anyone else and you learn to read his body language on a daily
        basis so that you can evaluate how much fluid to give. Our vet and IM specialist told
        us to use our best judgment as they realized that we always knew what Lucie could
        handle on any given day, better than they could. It was a team effort. They trusted
        us and we trusted them. It is important that you find vets who will work with you.

        I hope this helps,
        Anyes and the girls
      • pfeifferv2001
        Dear Eve, Roscoe is diabetic, severe HCM and CRF. A month ago he had blood clot in his leg and was unable to walk. was 10% dehydrated and ultrasound showed a
        Message 3 of 10 , Jan 1, 2002
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          Dear Eve,

          Roscoe is diabetic, severe HCM and CRF.

          A month ago he had blood clot in his leg and was unable to walk.
          was 10% dehydrated and ultrasound showed a little fluid around his
          heart. - A mess! Heart problems were not diagnosed prior to this.

          He is now on 30 mg. diltiazem per day and vet thought he could
          tolerate 60 cc. sub-Q per day.

          He has definitely improved. Clot has dissipated,he can walk around
          the garden quite easily (sometimes a bit shakily) He is very alert
          with a good appetite and his coat has improved tremendously.

          I am not monitoring as closely as Anyes, but will go for another
          ultrasound tomorrow. That will show how he is handling the fluids.

          I'll post results. ( He is also quite old - almost 19)

          Hope this helps, Valerie and Roscoe
        • elevine41
          ... disease. ... he had ... Three ... back, they ... he was ... said he did ... which is ... classic ... the time, ... sprained knee), ... make him ... good
          Message 4 of 10 , Jan 1, 2002
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            --- In feline-heart@y..., JettawayFCRs@a... wrote:
            > I would be very concerned about giving fluids to a cat with heart
            disease.
            > My own vet gave my sweet Quincy fluids, twice, even tho I told them
            he had
            > previously been diagnosed with a heart murmur by my previous vet.
            Three
            > different vets at my clinic listened and did not hear it. Looking
            back, they
            > did not take much time to listen, either. In fact, one said later,
            he was
            > purring so loud, she could not hear anything-but at the time, she
            said he did
            > NOT have a murmur. Turns out his murmur was at least a grade 4,
            which is
            > pretty easy to hear. At the time, Quincy had been sick, with
            classic
            > symptoms of a heart problem, altho I myself did not know that at
            the time,
            > including a blood clot in his leg (which the vet said was a
            sprained knee),
            > and the vet thought, altho he was not very dehydrated, fluids might
            make him
            > feel better. I knew from reading emails lists that that was not a
            good idea
            > if a heart problem was present. So, I warned them about the
            murmur, and they
            > ignored me. The second time they gave him fluids, and an enema, he
            went into
            > congestive heart failure, which the cardiologist we were FINALLY
            sent to,
            > said was caused by the fluids. Quincy's suffering and eventual
            death could
            > have been prevented, had my vets seen that his symptoms added up to
            a heart
            > problem, and had they referred us to a specialist a week or two
            sooner. By
            > the time we got to one, they said he was not in too bad of shape
            and would
            > recover, but he was too weak from fighting to stay alive without
            eating for
            > so long. His illness and death still haunts me as I know he
            suffered
            > needlessly. At the vet school where Quincy was finally treated,
            they said
            > fluids need to be given very carefully, and they do them as an IV
            drip, where
            > about 1 drop at a time goes in, and the cat is monitored
            carefully. I would
            > not give fluids to a cat with a heart condition, unless a
            cardiologist was
            > consulted.
            >
            > Heidi

            Thanks for sharing your experience with me. I am very sorry about
            Quincy. Blue has been seen by a specialist, but not in
            Cardiology...his HCM is pretty severe, very little area left for the
            blood to flow through...his CRF is moderate? Bun 59, & Crea 3.61. If
            my memory serves me right, it has been said that you can get by
            without sub-Q's until the Crea reaches the 4's, so I won't even
            consider it at this point, & I will have my specialist consult with a
            cardiologist, before I ever would! He is still drinking quite a bit,
            & if I could just get him to eat more & stop losing weight, I would
            be a little more comfortable...

            Eve
          • CatWoman
            ... Muffin is CRF and, presumably, HCM (he was born with a congenital heart problem - enlargement - and thickened walls in the interior). At this point, he s
            Message 5 of 10 , Jan 1, 2002
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              Bill & Linda Fischbach wrote:
              >
              > Hi Eva,
              >
              > Our Mittens has CRF and HCM. He hasn't started sub-qs yet, but it
              > may be soon. (We lost a cat to CRF in 2000, so we know how to do
              > them.) We are concerned about giving fluids with the heart problem.

              Muffin is CRF and, presumably, HCM (he was born with a congenital
              heart problem - enlargement - and thickened walls in the interior).

              At this point, he's drinking water and does not feel dehydrated,
              so we're not doing SubCu - yet.

              Diana
            • elevine41
              ... has ... against ... into ... balancing act but it can be ... treated with proper ... put on Diltiazem. ... 6 months. ... early signs of fluid ... hips as
              Message 6 of 10 , Jan 1, 2002
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                --- In feline-heart@y..., Anyes Moscrip <anyes@i...> wrote:
                >
                >
                > elevine41 wrote:
                >
                > > Hi Everyone,
                > >
                > > I was just wondering if anyone on this list has a cat that also
                has
                > > CRF & is giving sub-Q fluids? Blue Boy has the decks stacked
                against
                > > him, with Diabetes, CRF & HCM, & I would so like to improve his
                > > quality of life for whatever amount of time he has left, but I am
                > > terribly afraid to start him on fluids, for fear of sending him
                into
                > > Congestive heart failure, & hastening his departure from me...
                >
                > Yes, we managed CRF, HCM, and high blood pressure. It is a
                balancing act but it can be
                > done.
                >
                > The first thing is to make sure that the heart condition is being
                treated with proper
                > medication. My kitty could not handle -any- subq's prior to being
                put on Diltiazem.
                > While on Diltiazem, she could process 80 to 120cc of fluids/day for
                6 months.
                > We also made sure to withhold fluids for 24hrs anytime she showed
                early signs of fluid
                > build up. These included deliberate, slower breaths using lower
                hips as bellows,
                > decrease in appetite with gain weight, more lethargic behaviour,
                lower body
                > temperature. The changes were very subtle. We administered
                Dandelion extract twice a
                > day for prevention of fluid build up, 4 times a day to stop early
                build up. We were
                > able to avoid ER trips for those 6 months. Stress is not good for
                heart patients, and
                > invariably Lucie would go into full congestive heart failure if we
                had to go to the
                > ER. So it is important to try to manage this at home before you
                get to a crisis
                > point. I recommend you get a stethoscope and learn what your
                cat's normal heart beat
                > sounds like, so that when the heartbeat becomes muffled you know
                the difference.
                >
                > The treatment was easier to manage once we realized we had a heart
                patient with kidney
                > problems, not the other way around. After all, it is really a moot
                point how good the
                > kidney values are if the heart stops beating. This is one where
                the heart takes
                > precedence over all else and our decisions day to day were based on
                that.
                >
                > Finally, you have to be flexible with your treatment and take it
                day by day. You know
                > your cat better than anyone else and you learn to read his body
                language on a daily
                > basis so that you can evaluate how much fluid to give. Our vet and
                IM specialist told
                > us to use our best judgment as they realized that we always knew
                what Lucie could
                > handle on any given day, better than they could. It was a team
                effort. They trusted
                > us and we trusted them. It is important that you find vets who
                will work with you.
                >
                > I hope this helps,
                > Anyes and the girls

                Anyes,

                Yes, very informative....however makes me even more fearful, as I
                live in a small town, my regular vet is not that knowledgeable about
                Blue's conditions, & the specialist is 2 1/2 hours away from me, a
                very stressful trip for Blue...so I guess I'm better off using my
                best judgement & taking him as far as I can on my own, & by email
                back & forth with the specialist... Thanks for the info.

                Eve
              • elevine41
                ... Valerie, You definetly know what I m going through! Blue is only 11, will be 12 in April, if I can get him there... He was diagnosed with the CRF & HCM in
                Message 7 of 10 , Jan 1, 2002
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                  --- In feline-heart@y..., "pfeifferv2001" <valeriepfeiffer@h...>
                  wrote:
                  > Dear Eve,
                  >
                  > Roscoe is diabetic, severe HCM and CRF.
                  >
                  > A month ago he had blood clot in his leg and was unable to walk.
                  > was 10% dehydrated and ultrasound showed a little fluid around his
                  > heart. - A mess! Heart problems were not diagnosed prior to this.
                  >
                  > He is now on 30 mg. diltiazem per day and vet thought he could
                  > tolerate 60 cc. sub-Q per day.
                  >
                  > He has definitely improved. Clot has dissipated,he can walk around
                  > the garden quite easily (sometimes a bit shakily) He is very alert
                  > with a good appetite and his coat has improved tremendously.
                  >
                  > I am not monitoring as closely as Anyes, but will go for another
                  > ultrasound tomorrow. That will show how he is handling the fluids.
                  >
                  > I'll post results. ( He is also quite old - almost 19)
                  >
                  > Hope this helps, Valerie and Roscoe

                  Valerie,

                  You definetly know what I'm going through! Blue is only 11, will be
                  12 in April, if I can get him there... He was diagnosed with the CRF
                  & HCM in June of this last year. He takes 1 5mg of Lotensin a day,
                  along with Pepcid AC, Cyproheptadine, & Pet-Tinic, as his last blood
                  work showed that he was slightly anemic. His neuropathy from the
                  diabetes is quite bad, he can barely walk...it hurts me so bad to see
                  him like this, but he still comes to me to "talk" & to get his daily
                  brushing, & likes to watch the birds outside, so I don't feel like
                  he's given up yet...now if I can just come up with a way to make him
                  feel a little "perkier", I would be happy.

                  Eve
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