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My Bob, a 15 year old CRF kitty -- diagnosed with HCM today

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  • Karen
    I don t know what to do right now. I m spinning in circles, looking for the slightest bit of hope to cling to. My boy, my Bob, the four-legged love of my life
    Message 1 of 9 , Mar 26, 2013
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      I don't know what to do right now. I'm spinning in circles, looking for the slightest bit of hope to cling to.

      My boy, my Bob, the four-legged love of my life was having trouble breathing on Sunday, and we took him to the emergency vet, where they did an x-ray, showing that he had so much fluid his heart and lungs were pushed back as far as they could go. The doctor estimated that he was only using about 20% of his lungs, poor boy. They drained as much as they could, which turned out to be 350ml of chylious fluid, and there was quite a bit she said she didn't want to risk going after while he was in crisis. As you can imagine, having that much fluid removed made him feel worlds better. But the vet wasn't very hopeful for his long-term prognosis, although she recommended that we have an ultrasound performed to see what we are dealing with.

      We did that today, having been referred to a cardiologist. She came back into the room and was quite visibly upset at what she'd found. Her words were "severe dilated cardiomyopathy," and "atrial fibrillation," although I have to be honest and say that I didn't hear much of what she said because I was having a mild fainting spell myself (it happens sometimes).

      She said she could make out a moderate-to-severe amount of fluid as well, although how much of that was left by the previous doctor, and how much was new is unknown. She came up with a list of very aggressive treatment options. We opted to have them drain him again, and took home some pimobendan and a very small dose of furosemide, but wanted to hold off on any of the other medicines until we had a chance to get our minds together. We don't want any heroics at the cost of Bob's comfort.

      Bob was diagnosed with CRF last April, but one whose numbers have come down dramatically under treatment by a holistic vet in the area (azodyl, rehmannia, epakitin, renovast, and sub-Q fluids). His initial diagnosis was from a local vet who was quite brusque and unwilling to consider even azodyl as it was "scientifically unproven." I fired him, partly for that, and partly because he also wouldn't even consider letting us do sub-Q at home, saving Bob unnecessarily stressful trips to his office where they left him in a cold room and then dropped loud metal objects outside, making even this generally cool dude very upset.

      When I found Bob's current vet, I was nearly out of hope and she calmed me down and then got to work helping Bob, using chinese herbs and other things. Since then, Bob's weight has remained the same, but his creatinine and BUN have come down dramatically. So much so, she says that if he'd presented with his current levels but otherwise healthy, she'd just monitor him.

      Anyway... I know this is a long post. I don't know exactly what kind of question to ask or what answer to hope for. I guess I just want some reassurance that we're doing the right thing, and possibly some ideas of other things to try.
    • CHRISTINA FELTY
      My sympathies out to you to get such a diagnosis. I am new to heart problems myself with my somewhat newly diagnosed BoBo (HCM). My vet said out of a scale
      Message 2 of 9 , Mar 26, 2013
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        My sympathies out to you to get such a diagnosis.

        I am new to heart problems myself with my somewhat newly diagnosed BoBo (HCM).

        My vet said out of a scale from 1-5 with 5 being the absolute worst, BoBo's ultrasound was a 3.5. I told her I liked that number better than a 4 or a 5.

        We have had to juggle different meds. He is on pimobendan (vetmedin), furosemide and enalapril. I can say with this current combination (12.5mg furosemid 2x daily, 1.25mg of enalapril 1x a day, and 1.25mg of vetmedin 2x a day) he is doing super awesome. He is back to his bossy, assholish self (he is not an angel at home when he is completely healthy) and even comes up stairs to say hello to me.

        The drugs have been WELL worth it and his improvement has been night and day.

        Good luck

        Christina


        On Mar 26, 2013, at 9:33 PM, Karen <krprice@...> wrote:

        > I don't know what to do right now. I'm spinning in circles, looking for the slightest bit of hope to cling to.
        >
        > My boy, my Bob, the four-legged love of my life was having trouble breathing on Sunday, and we took him to the emergency vet, where they did an x-ray, showing that he had so much fluid his heart and lungs were pushed back as far as they could go. The doctor estimated that he was only using about 20% of his lungs, poor boy. They drained as much as they could, which turned out to be 350ml of chylious fluid, and there was quite a bit she said she didn't want to risk going after while he was in crisis. As you can imagine, having that much fluid removed made him feel worlds better. But the vet wasn't very hopeful for his long-term prognosis, although she recommended that we have an ultrasound performed to see what we are dealing with.
        >
        > We did that today, having been referred to a cardiologist. She came back into the room and was quite visibly upset at what she'd found. Her words were "severe dilated cardiomyopathy," and "atrial fibrillation," although I have to be honest and say that I didn't hear much of what she said because I was having a mild fainting spell myself (it happens sometimes).
        >
        > She said she could make out a moderate-to-severe amount of fluid as well, although how much of that was left by the previous doctor, and how much was new is unknown. She came up with a list of very aggressive treatment options. We opted to have them drain him again, and took home some pimobendan and a very small dose of furosemide, but wanted to hold off on any of the other medicines until we had a chance to get our minds together. We don't want any heroics at the cost of Bob's comfort.
        >
        > Bob was diagnosed with CRF last April, but one whose numbers have come down dramatically under treatment by a holistic vet in the area (azodyl, rehmannia, epakitin, renovast, and sub-Q fluids). His initial diagnosis was from a local vet who was quite brusque and unwilling to consider even azodyl as it was "scientifically unproven." I fired him, partly for that, and partly because he also wouldn't even consider letting us do sub-Q at home, saving Bob unnecessarily stressful trips to his office where they left him in a cold room and then dropped loud metal objects outside, making even this generally cool dude very upset.
        >
        > When I found Bob's current vet, I was nearly out of hope and she calmed me down and then got to work helping Bob, using chinese herbs and other things. Since then, Bob's weight has remained the same, but his creatinine and BUN have come down dramatically. So much so, she says that if he'd presented with his current levels but otherwise healthy, she'd just monitor him.
        >
        > Anyway... I know this is a long post. I don't know exactly what kind of question to ask or what answer to hope for. I guess I just want some reassurance that we're doing the right thing, and possibly some ideas of other things to try.
        >
        >



        [Non-text portions of this message have been removed]
      • Laurie Stead
        Karen, I am very sorry to hear about Bob s dx.  My Boo had a similar experience... had no idea she was ill until she was suffering CHF, and this is when they
        Message 3 of 9 , Mar 26, 2013
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          Karen,

          I am very sorry to hear about Bob's dx.  My Boo had a similar experience... had no idea she was ill until she was suffering CHF, and this is when they diagnosed DCM.
          Did they run a blood test for Bob's Taurine level?   DCM can be caused by low Taurine.

          I am very glad they put Bob on pimobendan.  It is very important to continue with the lasix (furosemide) so that fluid does not continue to build up.  Heart trumps kidneys and the diuretic is necessary.  I would also ask about Benazepril and Plavix. The right medications can make all the difference.  Boo at dx was given "a few months, at best" and I am happy to report she has been stable for 17mos!  It's a lot to take in when first diagnosed, completely understandable how you are feeling.  In time, the medication becomes part of the routine and the disease is not at the forefront of your every thought.  So hang in there, and keep us posted.

          Laurie and Boo




          ________________________________
          From: Karen <krprice@...>
          To: feline-heart@yahoogroups.com
          Sent: Tuesday, March 26, 2013 9:33 PM
          Subject: [FH] My Bob, a 15 year old CRF kitty -- diagnosed with HCM today


           
          I don't know what to do right now. I'm spinning in circles, looking for the slightest bit of hope to cling to.

          My boy, my Bob, the four-legged love of my life was having trouble breathing on Sunday, and we took him to the emergency vet, where they did an x-ray, showing that he had so much fluid his heart and lungs were pushed back as far as they could go. The doctor estimated that he was only using about 20% of his lungs, poor boy. They drained as much as they could, which turned out to be 350ml of chylious fluid, and there was quite a bit she said she didn't want to risk going after while he was in crisis. As you can imagine, having that much fluid removed made him feel worlds better. But the vet wasn't very hopeful for his long-term prognosis, although she recommended that we have an ultrasound performed to see what we are dealing with.

          We did that today, having been referred to a cardiologist. She came back into the room and was quite visibly upset at what she'd found. Her words were "severe dilated cardiomyopathy," and "atrial fibrillation," although I have to be honest and say that I didn't hear much of what she said because I was having a mild fainting spell myself (it happens sometimes).

          She said she could make out a moderate-to-severe amount of fluid as well, although how much of that was left by the previous doctor, and how much was new is unknown. She came up with a list of very aggressive treatment options. We opted to have them drain him again, and took home some pimobendan and a very small dose of furosemide, but wanted to hold off on any of the other medicines until we had a chance to get our minds together. We don't want any heroics at the cost of Bob's comfort.

          Bob was diagnosed with CRF last April, but one whose numbers have come down dramatically under treatment by a holistic vet in the area (azodyl, rehmannia, epakitin, renovast, and sub-Q fluids). His initial diagnosis was from a local vet who was quite brusque and unwilling to consider even azodyl as it was "scientifically unproven." I fired him, partly for that, and partly because he also wouldn't even consider letting us do sub-Q at home, saving Bob unnecessarily stressful trips to his office where they left him in a cold room and then dropped loud metal objects outside, making even this generally cool dude very upset.

          When I found Bob's current vet, I was nearly out of hope and she calmed me down and then got to work helping Bob, using chinese herbs and other things. Since then, Bob's weight has remained the same, but his creatinine and BUN have come down dramatically. So much so, she says that if he'd presented with his current levels but otherwise healthy, she'd just monitor him.

          Anyway... I know this is a long post. I don't know exactly what kind of question to ask or what answer to hope for. I guess I just want some reassurance that we're doing the right thing, and possibly some ideas of other things to try.

          [Non-text portions of this message have been removed]
        • elfinmyst
          Hi My Trixi had a heart attack and was given no chance, but drugs pulled her through, including pimobendan. Give it a try, if he is not uin discomfort then
          Message 4 of 9 , Mar 27, 2013
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            Hi

            My Trixi had a heart attack and was given no chance, but drugs pulled her
            through, including pimobendan. Give it a try, if he is not uin discomfort
            then there is nothing to lose. Cats can recover from heart failure and
            stabilise their HCM.The diuretic is essential.

            Watch his breathing, see what is normal per minute when he is asleep, and
            note how he breathes. Any increase in rate or change (double breaths,
            drawing stomach in, unable to lie down) are warning signs. Over 40 is an
            emergency, over 30 concern.

            It's scary at first, get as much information as you can. Keep us posted and
            ask all your questions.

            Lyn

            _www.myfurkids.co.uk_ (http://www.myfurkids.co.uk/)

            [Non-text portions of this message have been removed]
          • Karen
            Actually, I was confused about the acronym for his condition. It s not HCM, it s DCM. And I ve been lying awake all night doing Internet searches for as much
            Message 5 of 9 , Mar 28, 2013
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              Actually, I was confused about the acronym for his condition. It's not HCM, it's DCM.

              And I've been lying awake all night doing Internet searches for as much info as I can get. Some ideas I'm working on with the vet:

              - Taurine - While he's been on a raw beef diet (Nature's Variety) which has beef muscle and beef heart (both are high in taurine), we have been adding sweet potato to it to slow down the absorption of the protein to protect his kidneys. Now I have learned that high-fiber diets can slow the absorption of taurine. So we're starting him on a taurine supplement ASAP (500mg 2x day).

              - CoQ10 - We're giving him 50mg 2x day, to help boost his heart strength.

              - Mitochondrial Energizer - She's recommended that he start taking this supplement to protect his heart and kidneys from further damage and possibly strengthen them.

              - Blood Palace TCM - She is a Herbalist and Homeopathic doctor, with a specialty in Traditional Chinese Medicine for animals. My research on the scientific properties of Blood Palace is that it will act like a blood thinner, and make the platelets less sticky, making him less prone to clotting.

              This is all in addition to the Bemobanden and the Lasix, as well as his Azodyl, Pepcid AC, Rehmmania 8, Epakatin, Renivast, and Wen Dan Tang (TCM for hyperthyroidism).

              I'm feeling a bit more hopeful this morning. Most of what I've read about taurine-deficient DCM makes me think that he has a decent chance of improving, if we can just keep him healthy long enough for it to start to work. He's in good spirits and eating quite well. He seems to love the nutritional yeast I added to his food last night because it is a source of additional taurine. He's taking his pills like a champ, and his eyes don't appear to be sinking any more than they have been, making me think that the water in his food is helping to keep him hydrated just right. His breathing is slow and steady, with no catch. He's sleeping next to me and I count about 24 breaths a minute.

              Karen
            • tafoster4000
              Glad to hear Bob is doing better. Don t listen to vet s prognosis, my vet said she always gives sort of the worse case because she doesn t want to give false
              Message 6 of 9 , Mar 29, 2013
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                Glad to hear Bob is doing better. Don't listen to vet's prognosis, my vet said she always gives sort of the worse case because she doesn't want to give false hope if things go bad. She tries to be realistic. some cats do well on meds while doesn't work for others. In my case Moe had a very good reaction to his meds.

                My Moe, 17 yr old, was diagnosed last year in Feb with severe RCR (restrictive cardiomyopathy)after getting subqs at vet's office. he had just been diagnosed with apathetic hyperthyroid (my third apathatic hypert cat), so was given some fluids because he hadn't been eating nor drinking much. This threw him into congestive heart failure. Spent all of leap day in the ER. Had fluid taken from around his lungs and ECHO showed severe RCM. Vet said he was literally dying when I brought him in.

                Vet said he's probably been developing RCM over the years and the subqs threw his heart over the edge. She gave him a few months because the ECHO was so bad.

                Went home with lasix (12.5mg 1/2 tab twice a day)but on 5 day recheck he was developing fluid again, so upped to 12.5mg twice a day. Also added pimobendan, enalapril, plavix, potassium, CoQ10 this along with 1.25mg felimazole twice a day for his hyperT. Also getting AlOH, miralax, B vitamins and lysine in his food. Gets 1/6 or less of cyproheptadine for appetite as needed.

                He is on a grain free high protein canned food diet. I add between 50-100mls of extra water to his food daily. He does get a few grain free crunchies for lunch with added water. His kidney values are creeping up, so added azodyl 2 months ago and lowered his lasix to 6.25mg twice a day.

                He is still doing OK, he goes in next week for a 2 month FU after reducing his lasix.

                Taca

                --- In feline-heart@yahoogroups.com, "Karen" <krprice@...> wrote:
                >
                > Actually, I was confused about the acronym for his condition. It's not HCM, it's DCM.
                >
                > And I've been lying awake all night doing Internet searches for as much info as I can get. Some ideas I'm working on with the vet:
                >
                > - Taurine - While he's been on a raw beef diet (Nature's Variety) which has beef muscle and beef heart (both are high in taurine), we have been adding sweet potato to it to slow down the absorption of the protein to protect his kidneys. Now I have learned that high-fiber diets can slow the absorption of taurine. So we're starting him on a taurine supplement ASAP (500mg 2x day).
                >
                > - CoQ10 - We're giving him 50mg 2x day, to help boost his heart strength.
                >
                > - Mitochondrial Energizer - She's recommended that he start taking this supplement to protect his heart and kidneys from further damage and possibly strengthen them.
                >
                > - Blood Palace TCM - She is a Herbalist and Homeopathic doctor, with a specialty in Traditional Chinese Medicine for animals. My research on the scientific properties of Blood Palace is that it will act like a blood thinner, and make the platelets less sticky, making him less prone to clotting.
                >
                > This is all in addition to the Bemobanden and the Lasix, as well as his Azodyl, Pepcid AC, Rehmmania 8, Epakatin, Renivast, and Wen Dan Tang (TCM for hyperthyroidism).
                >
                > I'm feeling a bit more hopeful this morning. Most of what I've read about taurine-deficient DCM makes me think that he has a decent chance of improving, if we can just keep him healthy long enough for it to start to work. He's in good spirits and eating quite well. He seems to love the nutritional yeast I added to his food last night because it is a source of additional taurine. He's taking his pills like a champ, and his eyes don't appear to be sinking any more than they have been, making me think that the water in his food is helping to keep him hydrated just right. His breathing is slow and steady, with no catch. He's sleeping next to me and I count about 24 breaths a minute.
                >
                > Karen
                >
              • Karen
                Thanks for that. I understand why they do it, but it s still quite frustrating. I ve been doing a lot of reading, and keep coming across sites that say
                Message 7 of 9 , Mar 29, 2013
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                  Thanks for that. I understand why they do it, but it's still quite frustrating.

                  I've been doing a lot of reading, and keep coming across sites that say something to the effect that cats with taurine-deficient DCM generally have a good prognosis, if they can get through the first 2-3 weeks of treatment. It could take as long as 6 months for a full recovery, or close, unless the disease has progressed "too far."

                  Now I'm curious to know whether Mr. Bob really is taurine-deficient, or if he's one of the very unlucky cats who develop idiopathic DCM. And if he is taurine-deficient, I want to know what "too far" means.

                  But... we had a good-ish day yesterday. He didn't eat or drink as much as I would have liked (or, as he'd put it, I didn't stop putting food and water in his face as much as he would have liked), but we gave him a very small amount (less than 50cc) of fluids last night and he perked right up. He ate all of his overnight food and took his pills and drank his tuna water this morning.

                  One day at a time, I guess.

                  Karen
                • Laurie Stead
                  Hi Karen. There is a blood test you can run to find out if Bob is Taurine deficient. Laurie ________________________________ From: Karen
                  Message 8 of 9 , Mar 29, 2013
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                    Hi Karen.

                    There is a blood test you can run to find out if Bob is Taurine deficient.

                    Laurie




                    ________________________________
                    From: Karen <krprice@...>
                    To: feline-heart@yahoogroups.com
                    Sent: Friday, March 29, 2013 1:17 PM
                    Subject: Re: [FH] My Bob, a 15 year old CRF kitty -- diagnosed with DCM today


                     
                    Thanks for that. I understand why they do it, but it's still quite frustrating.

                    I've been doing a lot of reading, and keep coming across sites that say something to the effect that cats with taurine-deficient DCM generally have a good prognosis, if they can get through the first 2-3 weeks of treatment. It could take as long as 6 months for a full recovery, or close, unless the disease has progressed "too far."

                    Now I'm curious to know whether Mr. Bob really is taurine-deficient, or if he's one of the very unlucky cats who develop idiopathic DCM. And if he is taurine-deficient, I want to know what "too far" means.

                    But... we had a good-ish day yesterday. He didn't eat or drink as much as I would have liked (or, as he'd put it, I didn't stop putting food and water in his face as much as he would have liked), but we gave him a very small amount (less than 50cc) of fluids last night and he perked right up. He ate all of his overnight food and took his pills and drank his tuna water this morning.

                    One day at a time, I guess.

                    Karen

                    [Non-text portions of this message have been removed]
                  • Karen
                    I have a call into the vet about setting him up for that, I just don t know how accurate it will be since we ve started giving him large amounts of taurine.
                    Message 9 of 9 , Mar 29, 2013
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                      I have a call into the vet about setting him up for that, I just don't know how accurate it will be since we've started giving him large amounts of taurine. But it's certainly worth checking, right?!
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