Re: [FH] Hypertrophic Cardiomyopathy
- Hi Karen -- please don't get scared or overwhelmed by what Joanne wrote here. It sounds like your kitty has very mild HCM. I would suggest you talk to the cardiologist about putting him on atenolol -- but that is probably all he needs right now. His diagnosis is almost the same as my Tigger got at 5 months of age. Tigg started on atenolol right away, and he is now 8 1/2 and has no sign of any problem. NOT every kitty develops fluid on the lungs, and I believe prophalactive lasix or prescription blood thinners would be a mistake. He may never get fluid and never need lasix. It's hard on the body, and totally unnecessary at this point. Just watch his breathing -- if his resting breaths per minute approach 30, talk to the cardiologist -- if they go to 40, that is an emergency. But supplementing ith CoQ10 or natto is fine, etc. Each cat is different.
It is good that you found this early -- and in such a mild stage. He might never need any more meds. But I'd want him on atenolol if he was my kitty. Many cats with HCM never go on to have any problems with it, live a full life and die of something else entirely. But it is a terrible disease that can turn on a dime. So just keep and eye on your little guy, but treat him as normally as possible -- he doesn't know he's sick. Be prepared to run to the ER if needed -- know where it is and the hours, etc. But like my Tigger, maybe nothing will ever happen. So treat your kitty normally, don't hover -- he will pick up on your stress. Just keep calm and carry on --- we will all help you!
take care -- Michelle & Tigger Too in Toronto
----- Original Message -----
From: joanne marbut
To: Karen R ; firstname.lastname@example.org
Sent: Monday, February 18, 2013 2:25 PM
Subject: Re: [FH] Hypertrophic Cardiomyopathy
I have a blog and a Facebook page for HCM if you'd like to read either. You can find links and search for info in the blog.
Your cat should have meds. Trouble is without meds now to prevent symptoms, symptoms of the growing disease could suddenly appear causing an emergency situation. I suggest you discuss with the vet the need for lasix-a diuretic used to keep away congestion which the HCM heart can cause; Plavix for thinning blood, preventing clots, helping heart pump better; atenolol and enalapril which in their own ways helps lower heart rate, lower blood pressure; and spironolactone that helps to maintain potassium levels the kidneys need but the body will excrete due to frequent urination while the cat takes lasix. You might eventually need to give a potassium supplement if the blood work (if the cat's on lasix) shows a decline in potassium. A human supplement will do. Just cut into 1/4 pieces (I use Sundown.) When on heart meds, you should give a good vitamin supplement for cats (I use Excel vitamin paste). And COQ10 is perfect for assisting the heart. I use
Nature Made, pierce, and mix into food. There are many variations sold in stores.
Meanwhile, you need to monitor the cat's breathing rate, signs for distress, keep him cool/warm as needed, keep him away from noise, decrease stressful situations, etc. The progression of the disease can be managed with meds and careful monitoring. The cat should see the cardiologist 4-6 months apart or as needed and as the disease progresses, the cardiologist should see the cat every 3 months or so.
With a strict schedule of meds and good monitoring and good vet care, your cat will live (and it does depend on the severity of the disease at this point in time and how quickly it progresses) 2-5 yrs or longer. My cat's HCM was discovered at 8 months and was very advanced, not mild at all, unlike your kitten. She will be 4 yrs old in March. We are just now beginning to see drastic progression of the disease. She is now seeing the cardiologist every 2 months and has had an increase in lasix.
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- Sorry, I forgot to add the Wikipedia links to earlier posts:
>________________________________[Non-text portions of this message have been removed]
> From: joanne marbut <jomarbut@...>
>To: mary beth fitzpatrick <marybethfitzpatrick@...>; Joanne Haeussinger <chmiss01@...>; "email@example.com" <firstname.lastname@example.org>
>Sent: Monday, February 18, 2013 9:52 PM
>Subject: Re: [FH] Hypertrophic Cardiomyopathy
>Atenolol slows the heart rate thereby lowering blood pressure, easing the work the heart does, etc. It's good for preventing heart attacks, CHF, etc. It does this in a number of ways due to the fact that it's a beta blocker. Read the Wikipedia page.
>> From: mary beth fitzpatrick marybethfitzpatrick@...>
>>To: Joanne Haeussinger chmiss01@...>; email@example.com
>>Sent: Monday, February 18, 2013 4:33 PM
>>Subject: Re: [FH] Hypertrophic Cardiomyopathy
>>Very interesting all the sharing. Thanks, Karen, for getting all of us in gear.
>>Karen's question about whether her little one does not need Atenolol has me wondering about the use of Atenolol in general.
>>When is it necessary and when not? When Lahri was diagnosed in '06 with "Mild focal concentric hypertrophy of the septum (maybe) secondary to mild early hylpertrophic cardiomyopathy, systemic hypertension, or hyperthyroidism," the highly respected cardiologist wrote, "The changes are so mild that treatment with Atenolol or anticoagulants is not recommended at this time." After an echo months later, she wrote: "The mild concentric hypertrophy is not secondary to systemic hypertension or hyperthyroidism, and is due to mild hypertrophic cardiomyopathy." She still prescribed no meds. Two more echos in '07 got him to "Static mild hypertrophic obstructive cardiomyopathy with no progression over the past year of monitoring" and even " mild risk of sudden death is present" but still with no meds. Toward the end of '08, she said: "Mild progression in the HCM to mild-moderate severity with upper mild severity of SAM obstruction" and did presribe Atenolol.
>At this time, she also found hyperthyroidism and prescribed Methimazole. When she saw "Marked reduction in left ventricular hypertrophy on the methimazole and atenolol, with no appreciable wall hypertrophy . . and only subtle papillary hypertrophy, mild diastolic dysfunction, and no SMA at this time on Atenolol [and] suspect[ed] a ,majority of the improvement is due to the control of the hyperthyroidism, although it is possible the atenolol could have contributed," she found it "not . . . necessary" to continue the Atenolol. By June 2010, her conclusion was "Equivocal to mild HCM" and "No specific cardiac medications are now needed." He's been doing fine without any heart medication since that time. (I say 'fine' here also with the admission that, for financial reasons, we stopped getting him echoed. We did just find out through HEMOPET that his hyperthyroidism now requires more Methimazole,. which he's now getting.) Anyway . . . just
>wondering at all the posts implying Atenolol is desirable, if not necessary, even if a cat is presenting with only mild HCM.
>>Maybe I'm asking too much here. Sorry, if that's the case. Just let me know. The posts just have me wondering if maybe, though Lahri seems to be doing so well, he still needs Atenolol . . . and maybe, at least for the sake of the prescription, I need to get him back to the cardiologist somehow.
>>mb and lahri
>>----- Original Message -----
>>From: Joanne Haeussinger
>>Cc: joanne marbut ; feline-heart
>>Sent: Monday, February 18, 2013 12:42 PM
>>Subject: Re: [FH] Hypertrophic Cardiomyopathy
>>Michelle and I have similar experiences in which both our Tiggers were caught early and mine only takes Atenelol. Lasix is only for when they go into failure (like my Twix did last year), and so your baby kitten may not need any other meds for quite some time. I'd follow the instructions of your cardiologist, and if you're interested in adding other supplements, consult him/her first. But, please don't worry too much. You're lucky you caught it early. :)
>>Blessings to you and your little one!
>>Joanne, Twix, Tigger and Tagg
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