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Re: [FH] looking for general info for a friend

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  • Westgold
    Hello -- the ONLY way to tell if a cat has heart disease is through an echo cardiogram and EKG with a real cardiologist. Xrays might show a large heart, but
    Message 1 of 11 , Jul 31, 2012
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      Hello -- the ONLY way to tell if a cat has heart disease is through an echo cardiogram and EKG with a real cardiologist. Xrays might show a large heart, but they won't tell you what is wrong. No surgery should be done until the heart is checked. If this kitty has a heart irregularity, she does need an echo to see if he has heart disease. But a fast heart rate doesn't mean that much, many cats simply freak out because they're at the vet's.

      I do not like this vet at all. How dare she say that the cat will die without a dental!!!! I would get another opinion from an older vet, someone who has listened to a LOT more hearts. If he suggests an echo, then you have to decide. If there is heart disease, then meds can be started right away and will hopefully allow this kitty to live a long happy life. If she really can't afford one, she should ask her new vet about Care Credit or other ways she can work out a payment plan. Not testing is the other option -- and then you never know what will happen. She might not have any heart disease, but if there is heart disease, often the first symptom of HCM is sudden death. That's what happened to one of my kitties.

      I doubt that this cat has dental problems if she's young. Some vets try to do dentals on all cats, if they need it or not, for the money. If a cat bas a bad tooth and is in pain, you can usually tell. They stop eating and are always rubbing their mouth or gums with their paws, etc.

      I do not like this vet you guys saw at all -- see an older vet asap.

      take care -- Michelle & Tigger Too in Toronto

      [Non-text portions of this message have been removed]
    • elfinmyst@aol.com
      Hello Althea The first thing I would suggest is to see a different vet and get a second opinion. It sounds like neither of you have particular faith in this
      Message 2 of 11 , Aug 1, 2012
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        Hello Althea

        The first thing I would suggest is to see a different vet and get a second
        opinion. It sounds like neither of you have particular faith in this vet
        and don't trust her which is never a good thing.

        FORLs can be very painful and cats can hide this for a long time but they
        are usually noticeable and fairly obvious on an examination. Any cat with
        suspect heart disease would normally be referred for a heart scan before a
        dental but for the vet to refuse to do the operation without one is not
        normal. The surgery is risky with heart disease but if there is a FORL it is
        essential.

        The ultrasound is the gold choice standard for diagnosing heart disease. It
        tell so much more than the Xray and is definitely the test to choose. All
        of my heart cats were diagnosed with a murmur as their first symptom.

        This premature atrial contractions can be caused by HCM but also other
        diseases. A good website, relevant to cats is
        _http://www.petmd.com/cat/conditions/cardiovascular/c_ct_atrial_premature_complexes_
        (http://www.petmd.com/cat/conditions/cardiovascular/c_ct_atrial_premature_complexes)

        .

        Lyn

        [Non-text portions of this message have been removed]
      • Laurie Stead
        Hi, Having a cat with undetected heart disease that resulted in her going into CHF, of course I say run to the echo.  BUT that being said, on a more rational
        Message 3 of 11 , Aug 1, 2012
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          Hi,

          Having a cat with undetected heart disease that resulted in her going into CHF, of course I say run to the echo.  BUT that being said, on a more rational level ;-), I completely agree with Michelle.  Go to another vet, don't even tell that vet what was told to you. Let it be a fresh look at the cat and see what if anything they agree on. 

          There are stages of dental needs.... did this vet say what stage the teeth were in?  How old is the cat?

          Also, this is a question for the group really.... there is a new blood test out there that can detect presence of heart disease... is this available?  Of course it does not replace the ultrasound, but for an instance like this where finances are tough...... does it make sense to ask for it? 

          Keep us posted!
          Laurie and Boo




          --- On Tue, 7/31/12, Westgold <westgold@...> wrote:

          From: Westgold <westgold@...>
          Subject: Re: [FH] looking for general info for a friend
          To: "heartrat@..." <56althea@...>, "feline-heart" <feline-heart@yahoogroups.com>
          Date: Tuesday, July 31, 2012, 11:17 PM
















           









          Hello -- the ONLY way to tell if a cat has heart disease is through an echo cardiogram and EKG with a real cardiologist. Xrays might show a large heart, but they won't tell you what is wrong. No surgery should be done until the heart is checked. If this kitty has a heart irregularity, she does need an echo to see if he has heart disease. But a fast heart rate doesn't mean that much, many cats simply freak out because they're at the vet's.



          I do not like this vet at all. How dare she say that the cat will die without a dental!!!! I would get another opinion from an older vet, someone who has listened to a LOT more hearts. If he suggests an echo, then you have to decide. If there is heart disease, then meds can be started right away and will hopefully allow this kitty to live a long happy life. If she really can't afford one, she should ask her new vet about Care Credit or other ways she can work out a payment plan. Not testing is the other option -- and then you never know what will happen. She might not have any heart disease, but if there is heart disease, often the first symptom of HCM is sudden death. That's what happened to one of my kitties.



          I doubt that this cat has dental problems if she's young. Some vets try to do dentals on all cats, if they need it or not, for the money. If a cat bas a bad tooth and is in pain, you can usually tell. They stop eating and are always rubbing their mouth or gums with their paws, etc.



          I do not like this vet you guys saw at all -- see an older vet asap.



          take care -- Michelle & Tigger Too in Toronto



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



























          [Non-text portions of this message have been removed]
        • Carol
          Hello Althea, How nice of you to go along with your friend for support! I take the opposite view and rather like the vet for saying he wouldn t do the dental
          Message 4 of 11 , Aug 1, 2012
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            Hello Althea,
            How nice of you to go along with your friend for support!
            I take the opposite view and rather like the vet for saying he wouldn't do the dental without the kitty having a cheart checkup. There truly are different schools of thought about dentals - we used to see a vet who did an annual dental on an old kitty we had, then we changed vets for a an unrelated reason and she never had another dental. We had other kitties since then and never has a dental been suggested. One of our elderly cats had a tooth break (lower fang) and so surgery was done to remove the tooth and a dental done at the same time - she did have FORLs and had 4 or 5 teeth break off below the gumline. If she had had regular dental earlier in life I'd like to think the FORLs would not have happened.

            Regarding the heart issue -
            We lost our Mellie 4 wks ago, she had a stroke at age 16 in 2008. She had been found to have a rapid heart rate in excess of 220 beats per minute and a moderate murmur. Local vet wanted the murmur checked out and sent us to another local clinic for heart echo. Echo vet said she had advanced HCM which led her two regular vets to both advise putting her down (stroke had been misdiagnosed as seizure disorder and they felt seizures + HCM would be impossible to survive). We chose not to put her to sleep but rather found a cardiologist who could see her in 3 weeks but he was almost 3 hrs away. She survived the wait and cardiologist did his own echo (at a cost that was $100 less than the local vet's echo!). Granted we spent more money in total at the cardiologist's as many more tests were done, but I guess I still resent the monies we spent locally at the clinic that gave us a faulty diagnosis - Mellie did not have HCM at all but her rapid heart rate caused problems with her mitral valve flap and she didn't get proper blood flow to her organs, thus the stroke.

            Your friend would be wise to get a stethoscope and learn to listen to her cat's heart rate at home. In fact, we should all do that with our cats. Mellie's regular vet said he'd been aware of her fast heart rate but thought it due to clinic stress - it was not.

            Off my soapbox now.

            Good luck to your friend!
            carol

            --- In feline-heart@yahoogroups.com, "heartrat@..." <56althea@...> wrote:
            >
            > My friend took her cat to the vet today and I tagged along for company.
            > this was a new vet, fairly young.
            > she started right off stressing how important a dental was for a cat, and how they can have FORLs which can cause a great deal of pain, yet be hiding the pain
            > and the only way to know for sure if they had these FORL's was to do a dental xray...
            > so my friend is all upset right off because she's not even been able to bring her cat in for her annual exam because she's been out of work, and now she's worried and feeling guilty that her cat may have been in pain all this time.
            >
            > Then the vet checks out her heart and suddenly things change- she listened to the cat's heart a long long time, and then checked her pulses in all four legs.
            >
            > she says, sorry this cat can't have a dental til she gets her heart checked out, she's got a high heart rate and I'm hearing an arrhythmia, and she specifically mentions PACs
            >
            > well I've got atrial fibrillation myself and I also know that in people, at least, PACs and PVCs are common and usually harmless and also occur with more frequency under stress.
            >
            > so, we have a stressed out cat, with a high heart rate and some PACs,
            > this doesn't sound too alarming to me.
            >
            > But the vet is talking about her having HCM. She doesn't say she *has* it, only that she could
            > but she could also have a harmless electrical problem
            >
            > ok, I'm with her there, but the next thing is, she won't do the dental unless the cat has an EKG and a cardiac echo
            >
            > I"m confused at this point- why not just an xray? that will show if the heart is enlarged, if there's fluid in the lungs or chest, right?
            > why go straight to the echo?
            >
            > This cat is otherwise very healthy- she's a tiny bit overweight, but she eats well, plays vigorously, and is happy and just looks great. So there's no symptoms of any disease, and no heart murmur or gallop-
            > JUST the high heart rate and some PACs
            >
            > is that all it takes to suspect HCM? or any other serious heart problem?
            >
            > I can understand anyone who has a cat with a serious heart issue will think the cost of the ultrasound and consult would be well worth it,
            > but for an otherwise healthy cat, and an owner who is out of work, this seems a bit excessive to me
            > if there are other less expensive ways to rule out serious heart disease
            >
            > Now the owner is even more upset, because she's worried the cat is in pain from her teeth (the vet never said that not all cats get FORLs, she made it sound like she probably has them- which is why I am calling her an alarmist)
            >
            > now she's worried her cat is going to up and die suddenly (which is what the vet said could happen- without treatment and even WITH treatment)
            >
            > I'm not thrilled that the vet upset my friend this way but aside from that
            > isn't there a bit more to go on for suspecting heart disease than what this vet found in this healthy asymptomatic cat?
            >
            > What led you or your vet to think that your cats had heart disease, if you don't mind my asking?
            >
            > thanks for your time in reading this rather long post. Looking forward to any suggestions or advice you can offer.
            >
            > althea
            >
          • elise eisfelder
            Will a cheap stethoscope do or is a pediatric one needed? Where price should they be and is there a good model or place to buy one? Elise [Non-text portions of
            Message 5 of 11 , Aug 1, 2012
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              Will a cheap stethoscope do or is a pediatric one needed? Where price should they be and is there a good model or place to buy one?

              Elise

              [Non-text portions of this message have been removed]
            • Westgold
              Yes, it s probably time to talk about echoes again, it s been a while and we sadly have a lot of new members. If you are going to do an echo, it needs to be
              Message 6 of 11 , Aug 1, 2012
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                Yes, it's probably time to talk about echoes again, it's been a while and we sadly have a lot of new members.

                If you are going to do an echo, it needs to be done by a real cardiologist. Many regular vets have taken a "class" in echoes, but this it not good enough. They might be able to take the echo properly, but thoroughly interpreting the results takes a lot of training, skill and experience.

                My clinic has 4 vets, and one of them took a "class" on echoes. But when I bought Tigger and my main vet heard the 3-4 murmur, he booked me an appointment with a real cardiologst downtown to have it checked out. Even he didn't trust his colleague with a serious case.

                take care -- Michelle & Tigger Too in Toronto



                ----- Original Message -----
                From: Carol
                To: feline-heart@yahoogroups.com
                Sent: Wednesday, August 01, 2012 9:08 AM
                Subject: [FH] Re: looking for general info for a friend



                Hello Althea,
                How nice of you to go along with your friend for support!
                I take the opposite view and rather like the vet for saying he wouldn't do the dental without the kitty having a cheart checkup. There truly are different schools of thought about dentals - we used to see a vet who did an annual dental on an old kitty we had, then we changed vets for a an unrelated reason and she never had another dental. We had other kitties since then and never has a dental been suggested. One of our elderly cats had a tooth break (lower fang) and so surgery was done to remove the tooth and a dental done at the same time - she did have FORLs and had 4 or 5 teeth break off below the gumline. If she had had regular dental earlier in life I'd like to think the FORLs would not have happened.

                Regarding the heart issue -
                We lost our Mellie 4 wks ago, she had a stroke at age 16 in 2008. She had been found to have a rapid heart rate in excess of 220 beats per minute and a moderate murmur. Local vet wanted the murmur checked out and sent us to another local clinic for heart echo. Echo vet said she had advanced HCM which led her two regular vets to both advise putting her down (stroke had been misdiagnosed as seizure disorder and they felt seizures + HCM would be impossible to survive). We chose not to put her to sleep but rather found a cardiologist who could see her in 3 weeks but he was almost 3 hrs away. She survived the wait and cardiologist did his own echo (at a cost that was $100 less than the local vet's echo!). Granted we spent more money in total at the cardiologist's as many more tests were done, but I guess I still resent the monies we spent locally at the clinic that gave us a faulty diagnosis - Mellie did not have HCM at all but her rapid heart rate caused problems with her m itral valve flap and she didn't get proper blood flow to her organs, thus the stroke.

                Your friend would be wise to get a stethoscope and learn to listen to her cat's heart rate at home. In fact, we should all do that with our cats. Mellie's regular vet said he'd been aware of her fast heart rate but thought it due to clinic stress - it was not.

                Off my soapbox now.

                Good luck to your friend!
                carol

                --- In feline-heart@yahoogroups.com, "heartrat@..." <56althea@...> wrote:
                >
                > My friend took her cat to the vet today and I tagged along for company.
                > this was a new vet, fairly young.
                > she started right off stressing how important a dental was for a cat, and how they can have FORLs which can cause a great deal of pain, yet be hiding the pain
                > and the only way to know for sure if they had these FORL's was to do a dental xray...
                > so my friend is all upset right off because she's not even been able to bring her cat in for her annual exam because she's been out of work, and now she's worried and feeling guilty that her cat may have been in pain all this time.
                >
                > Then the vet checks out her heart and suddenly things change- she listened to the cat's heart a long long time, and then checked her pulses in all four legs.
                >
                > she says, sorry this cat can't have a dental til she gets her heart checked out, she's got a high heart rate and I'm hearing an arrhythmia, and she specifically mentions PACs
                >
                > well I've got atrial fibrillation myself and I also know that in people, at least, PACs and PVCs are common and usually harmless and also occur with more frequency under stress.
                >
                > so, we have a stressed out cat, with a high heart rate and some PACs,
                > this doesn't sound too alarming to me.
                >
                > But the vet is talking about her having HCM. She doesn't say she *has* it, only that she could
                > but she could also have a harmless electrical problem
                >
                > ok, I'm with her there, but the next thing is, she won't do the dental unless the cat has an EKG and a cardiac echo
                >
                > I"m confused at this point- why not just an xray? that will show if the heart is enlarged, if there's fluid in the lungs or chest, right?
                > why go straight to the echo?
                >
                > This cat is otherwise very healthy- she's a tiny bit overweight, but she eats well, plays vigorously, and is happy and just looks great. So there's no symptoms of any disease, and no heart murmur or gallop-
                > JUST the high heart rate and some PACs
                >
                > is that all it takes to suspect HCM? or any other serious heart problem?
                >
                > I can understand anyone who has a cat with a serious heart issue will think the cost of the ultrasound and consult would be well worth it,
                > but for an otherwise healthy cat, and an owner who is out of work, this seems a bit excessive to me
                > if there are other less expensive ways to rule out serious heart disease
                >
                > Now the owner is even more upset, because she's worried the cat is in pain from her teeth (the vet never said that not all cats get FORLs, she made it sound like she probably has them- which is why I am calling her an alarmist)
                >
                > now she's worried her cat is going to up and die suddenly (which is what the vet said could happen- without treatment and even WITH treatment)
                >
                > I'm not thrilled that the vet upset my friend this way but aside from that
                > isn't there a bit more to go on for suspecting heart disease than what this vet found in this healthy asymptomatic cat?
                >
                > What led you or your vet to think that your cats had heart disease, if you don't mind my asking?
                >
                > thanks for your time in reading this rather long post. Looking forward to any suggestions or advice you can offer.
                >
                > althea
                >





                [Non-text portions of this message have been removed]
              • elise eisfelder
                What about a radiologist that is not a cardiologist but exclusively does US? Would that be good enought? Elise [Non-text portions of this message have been
                Message 7 of 11 , Aug 1, 2012
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                  What about a radiologist that is not a cardiologist but exclusively does US? Would that be good enought?

                  Elise

                  [Non-text portions of this message have been removed]
                • Carol
                  You asked about the stethoscope - I got our at a (nurses) uniform store, had no idea a uniform store carried that kind of supplies. The first one we got was
                  Message 8 of 11 , Aug 1, 2012
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                    You asked about the stethoscope - I got our at a (nurses) uniform store, had no idea a uniform store carried that kind of supplies. The first one we got was $6 and I couldn't hear her well, then I got a $15 model and it is fine. Mellie's vet is the one who told me where to get it.

                    Regarding a radiologist - I've learned to ask if a specialist is board certified so you need to ask if the radiologist is a board certified radiologist. When we were making the initial appt with the cardiologist I asked if we could just bring the locally performed echo information for the cardiologist's review, we were told if the echo was done by either a board certified radiologist or a board certified cardiologist then that would be fine. I called the local office and asked if he was board certified - no but he'd taken many classes. That means nothing when it comes to such things.

                    A few years earlier Mellie's sister had been diagnosed with chronic renal failure. Her regular vet had done an xray to diagnose complete intestinal blockage prior to doing emergency surgery on her. During the surgery he saw one kidney smaller than the other. In time her bloodwork showed her with crf. I wanted to know why she had developed this - oh how naieve I was back then! We took her to a local clinic for ultrasound to see if she had polycystic kidney disease as, being persian, her breed was prone to that. No, she didn't have pkd. Still on my search we took her to Ohio State Univ. veterinary medical school/hospital and took the initial xrays with us.. They took one look at the xrays and immediately pointed out about 8 or 9 stones in her kidneys, bladder, and one ureter! Strange as her regular vet had not seen the stones on the same xray and the other vet had not seen stones on the ultrasound he performed. I asked the OSU vets about that and was told general practice vets can read xrays,etc. to diagnose broken bones but when it comes to other problems to seek out a board certified vet. And to think, all our local vets graduated from that same OSU medical school.

                    carol

                    --- In feline-heart@yahoogroups.com, elise eisfelder <eeisfelder@...> wrote:
                    >
                    > What about a radiologist that is not a cardiologist but exclusively does US? Would that be good enought?
                    >
                    > Elise
                    >
                    > [Non-text portions of this message have been removed]
                    >
                  • elise eisfelder
                    Thank you, Carol for your reply. Max had an US done by a Board Certified Radiologist back in 2002 as he had a heart murmur. His heart was normal and the murmur
                    Message 9 of 11 , Aug 1, 2012
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                      Thank you, Carol for your reply. Max had an US done by a Board Certified Radiologist back in 2002 as he had a heart murmur. His heart was normal and the murmur insignificant. My vet is a Board Certified Internist and he doesn't think anything as changed since then. Max is now almost 15 and may have primary high blood pressure. I asked if it could be heart related and my vet said no. He doesn't feel it's CRF based upon slightly elevated BUN but no change in creatinine (1.4) and his free T4 was good so he isn't hyper-t. So he's on amlodipine and since it started his appetite has tanked. I lowered the dose from 1/4 and 1/5 and all was well until yesterday. Now I don't know if he's have a pancreatitis attack or what's going on. I was just wondering if it's necessary to do another US if the murmur hasn't changed according to my vet.

                      Elise

                      [Non-text portions of this message have been removed]
                    • Carol
                      Elise, you are so fortunate to have board certified vets in your area. We have to drive almost 3 hours to see one and our local vets mostly say to not waste
                      Message 10 of 11 , Aug 2, 2012
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                        Elise, you are so fortunate to have board certified vets in your area. We have to drive almost 3 hours to see one and our local vets mostly say to not waste the time and money. However, we've found too many local vets to be in error with their diagnoses - therefore, I always encourage people to go that extra step. Thank you for clarifying about your vets.
                        There is a blood test for pancreatitis plus there is a group for such kitties. Perhaps it would be worth a visit to the group? Has the blood test been done? I believe if it fPLI or something like that.

                        carol
                        --- In feline-heart@yahoogroups.com, elise eisfelder <eeisfelder@...> wrote:
                        >
                        > Thank you, Carol for your reply. Max had an US done by a Board Certified Radiologist back in 2002 as he had a heart murmur. His heart was normal and the murmur insignificant. My vet is a Board Certified Internist and he doesn't think anything as changed since then. Max is now almost 15 and may have primary high blood pressure. I asked if it could be heart related and my vet said no. He doesn't feel it's CRF based upon slightly elevated BUN but no change in creatinine (1.4) and his free T4 was good so he isn't hyper-t. So he's on amlodipine and since it started his appetite has tanked. I lowered the dose from 1/4 and 1/5 and all was well until yesterday. Now I don't know if he's have a pancreatitis attack or what's going on. I was just wondering if it's necessary to do another US if the murmur hasn't changed according to my vet.
                        >
                        > Elise
                        >
                        > [Non-text portions of this message have been removed]
                        >
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