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Isabella not good. HCM on top of kidney failure.

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  • madsongstress
    Hey all, I just spent half the day at an emergency vet. They drained 80mls of fluid off her lung and abdomen but it wasn t IN her lungs so we are safe from
    Message 1 of 2 , Dec 13, 2012
      Hey all, I just spent half the day at an emergency vet.
      They drained 80mls of fluid off her lung and abdomen but it wasn't IN her lungs so we are safe from congestive heart failure for now.
      Her HCT had dropped to 17% so we have started Epogen and now I could kick myself for not starting it last week when her crit was at 21 when I had the chance. I feel like the anemia was straining her heart and brought this on!
      Her BUN was off the charts again but her Creat had come down to 8 at least so that's something. And they said she looked great and was feisty.
      We go in for a full cardiac ultrasound with a real specialist tomorrow morning and maybe then I'll know more, but I am devastated because I realize it will be hard to hydrate her from now on and I could use some advice.
      I don't want to keep having to tap her chest and what if next time its in her lungs! Then I feel like we're done and I'll have to say goodbye.

      I am so tired, hungry and devastated right now.
      She is 18 1/2 but I don't want her to suffer, struggle to breathe or have a heart attack!

      This is very similar to how we lost her sister 2 1/2 years ago so I am in major panic mode.

      Any purrs most appreciated!
      Michelle
    • June Jeffrey
      Hello Michelle,   I m so sorry this has happened to Isabella and know how woried you must be.  Have attached a link to some information about pleural
      Message 2 of 2 , Dec 13, 2012
        Hello Michelle,
         
        I'm so sorry this has happened to Isabella and know how woried you must be.  Have attached a link to some information about pleural effusion in cats which may be of help:
        http://www.petplace.com/cats/pleural-effusion-in-cats/page1.aspx
        and to dealing with heart problems and CRF:
        http://www.felinecrf.org/heart_problems.htm
        I have a close friend who has a heart/kidney kitty, who also has congestive heart failure. She provided the following information:
        •Giving fluids to kitties with kidney and heart issues can be tricky and really is a delicate balancing act.•Often, fluids are given along with a low-dose of a diuretic (like Lasix/furosemide). But this is something that is disputed even between veterinarians.
        •If fluids are given, low volumes given more frequently may be helpful. For instance, if you're giving subcut. fluids, cut the total fluid dose (calculated for a cat with kidney disease but no heart disease) by 25-50% and divide it up into two doses rather than one.

        Her kitty is given MINIMAL subq fluids - 25 to 50ml a day. She is also given Lasix to counteract the fluid build up. If she gets in worse CHF the Lasix is increased a little and she holds off on the fluids. She has been in this balancing act for the last 10 months and most of the time is really okay. It's really hard, but not totally impossible to treat both.
        It is also advisable to ensure blood pressure is being monitored. Hyper or hypo-tension can both cause further issues with the heart and kidneys.

        She asked her vet for more information to understand the Lasix/SubQ fluids dynamic and forwarded this to me (I now have two CRF kitties with whom my vet has detected heart mumurs and I wanted some information to be "forwarned, forarmed" so to speak):
        "Lasix works to pull fluids out of the system in the hopes that it will control the build up of fluids around/in the lungs and/or in the abdomen, but in doing so it can also diminish the kidney's ability to process/make urine. This fluid buildup is not really part of the "hydration loop" anymore because it is pooling outside of the blood supply so it is entirely possible to have a kitty with excess fluids pooling and yet still be technically dehydrating. This is the tricky balancing act, as I understand it."

        Her vet requested she does two things: encourage more drinking/fluid intake orally and really monitor urine volume output. She doesn't actually catch each pee, but writes down each time she pees and whether it is a "normal" (for her) amount. If kitty's volume decreases or if she stops taking in water then my friend has to call her vet and they discuss whether to add any subQ's...but this is only done in very small doses (approx 25ml x 2 for one day) and then they see how kitty is doing.
        Could you maybe try to get Isabella to drink more/and or mix in more fluid with her food?  Getting the fluids orally isn't as hard on the heart at when they're directly injected under the skin. Giving IV fluids or subQ's, the fluid goes directly into the tissues, and that can overload them quicker. Giving more fluid orally, going through the digestive system, the body takes what it needs at a slower pace. There are about 118 ml of fluid in a 1/2 cup, so you can see that if 100ml a day were needed to maintain hydration it could be spread out throughout the day to get that 100ml's of fluid into the kitty. You can make homemade chicken broth, just chicken and water boiled into broth, and offer this to drink when cooled or mix into food.
        My friend was also able to syringe small amounts of water or broth into her kitty when she couldn't give her subq's. The assisted feeding group  http://pets.groups.yahoo.com/group/Feline-Assisted-Feeding/%c2%a0 gives more information on syringe feeding and how to do it safely.
        I know this is a really difficult situation but hope the information you are getting will help you and your vet find the very best way forward for Isabella.
        Do let us know how Isabella is doing.
        Sending you both prayers and best wishes,
        June, Freddie and Daisy and Angels Felix, Smudge and Fleur
         

        ________________________________
        From: madsongstress <madsongstress@...>
        To: feline-heart@yahoogroups.com
        Sent: Friday, 14 December 2012, 0:04
        Subject: [FH] Isabella not good. HCM on top of kidney failure.

         

        Hey all, I just spent half the day at an emergency vet. They drained 80mls of fluid off her lung and abdomen but it wasn't IN her lungs so we are safe from congestive heart failure for now. Her HCT had dropped to 17% so we have started Epogen and now I could kick myself for not starting it last week when her crit was at 21 when I had the chance. I feel like the anemia was straining her heart and brought this on! Her BUN was off the charts again but her Creat had come down to 8 at least so that's something. And they said she looked great and was feisty. We go in for a full cardiac ultrasound with a real specialist tomorrow morning and maybe then I'll know more, but I am devastated because I realize it will be hard to hydrate her from now on and I could use some advice. I don't want to keep having to tap her chest and what if next time its in her lungs! Then I feel like we're done and I'll have to say goodbye. I am so tired, hungry and devastated right
        now. She is 18 1/2 but I don't want her to suffer, struggle to breathe or have a heart attack! This is very similar to how we lost her sister 2 1/2 years ago so I am in major panic mode. Any purrs most appreciated! Michelle


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