Re: Moe Bad News
- Hi, thanks for all the suggestions, Moe is still hanging in there so thought I should give an update.
Moe saw his regular cardiologist tues 6/18. Had blood work done, what is amazing he had a tremendous drop in his numbers: BUN 97 down from 173, creatinine 3.9 down from 6.6 and phos 6.3 down from 6.9. Vet says he crashed from that 1/4 BID increase in lasix. I told her I haven't gone back to the 1/2 BID but probably 3/8 BID (break off small corner of the 1/2 tab). Lungs remain clear, so said to continue but watch breathing. I know kidney values are still way up there but Moe continues to eat and feel relatively well most of the time.
But she reviewed his chest xrays again, no fluid but suspicious dark area left middle lobe. I think I left this out of the original posting, kidney issue took over. This showed up on the 6/7 visit when he was so congested. On 6/7 she started him on clavamox in case this was an infection but that was the week he crashed and wasn't eating so stopped after 5 days. Then all the kidney stuff arose.
On 6/14, day of 'off the wall' kidney stuff, stand in vet also took another set of films which I found showed the same mass. Vet isn't sure what it is but said looks like middle lobe of lung has collapsed. On 3 sets of xrays, 1st set area looked diffuse then was consolated on the other 2. These were all taken a few days apart.
Anyway she wanted him on a course of antibiotics and started baytril. Well seems Moe is one of the rare cats that have GI issues, he threw up about 40 min after dose, tried after meal and empty stomach and twice a day instead of once, all had vomiting after 40 minues (was in gelcap). She wanted to start on doxycyline which also has GI issues and I said no.
My feeling is right now, he is eating and seems stable, why make him feel crappy again. His congestion is pretty much gone, still giving 1000mg lysine daily. Added 1/4 pepcid once a day and getting 1/6 cyproheptadine twice a day.
Has anyone had dealings with a lung mass/collapsed lung/???. Could it be related to that congestion, maybe due to herpes???
He goes back in July 2 for a quick film to see if clearing. She mentioned that if he was a younger cat, they would scope. Ah, that is not going to happen.
Oh did ask about the spiro and benazapril but for now she doesn't want to change anything. The spiro is more potassium sparing which isn't an issue and was told can have more GI side affects. Also both benazapril and enalapril raise creatinine values.
Anyway keep Moe in your prayers, just taking it day by day.
--- In firstname.lastname@example.org, "tafoster4000" <tafoster4000@...> wrote:
> Need some help with Moe and kidney/heart issues. Moe turned 18 on June 1st. He is a cornish rex.
> History on Moe: Dx hyperthyroid in Feb 2012 (apathetic), started on 1.25mg felimazole twice a day. Also got 100ml subq at vets for lack of eating/drinking. This put him in congestive heart failure. Spent all of Leap Day in ER. 100mls of fluid was pulled off of pleural cavity and ECHO showed severe restrictive cardiomyopathy. Prognosis poor, maybe a few months.
> He was put on a ton of meds in addition to his felimazole: Lasix, pimobendan, enalapril, Plavix and potassium. Also was getting AlOH in food along with miralax, B vitamins and cosequin. His Lasix started at 1 12.5mg tab twice a day which was lowered to 1/2 tab or 6.25mg twice a day in Feb 2013.
> During this time his kidney values were staying in the 40's and creatinine low 2's until 1st of year when BUN went to mid 50's and creat 2.5. This was when his Lasix was lowered and started azodyl. His Bun dropped to 46 (10-30) in April and creatinine to 2.2 (0.3-2.1).
> Over the last 3 weeks he wasn't eating as well and didn't seem to feel that good. Got a full blood panel done on 5/20 and Bun was now 55 (14-36) and creatinine 2.5 (.6-2.4). T4 level has remained in high 1's, low 2's.
> Saw his cardiologist on 6/7, she took chest xrays and mini ECHO. Left atrium was still enlarged slightly more than last ECHO 2 months ago. She also thought he might be showing some signs of CHF so raised his Lasix to 3/4 tab twice a day. Also his breathing rate was up to 40 and had been last few days. Moe also had nasal congestion probably a herpes flare so upped his lysine. No blood work done then. She was leaving for conference and not back to next week but wanted FU call Monday. Called and discussed basically no change other than breathing rate seemed to be lower. She wanted me to have a FU with another cardiologist today (Fri 6/14)
> During these last few days Moe still not eating much and definitely feeling unwell at times. He was also drinking lots of water.
> Then today had blood work done, his BUN jumped to 173 and his creatinine to 6.6 Also phosphorus upped from high 4's to 6.9. Talk about being in shock.
> Vet said Moe was `dry' and gave him 70mls of subq fluids and told no Lasix tonight or tomorrow and start back at 1/2 tab twice a day on Sunday. Asked about subq's at home but said no because of severe heart issue. Was told to monitor his eating and get him to drink as much as possible and to come back on Tuesday when his regular cardiologist is back.
> So I'm not sure what else to do, this 70mls of fluids isn't much but again 100mls sent him into CHF. Was told IV fluids not an option. He eats only wet food with as much water as I can add, about 100mls a day. What I can't understand is why this happened so suddenly. The vet today said it was because of the extra 1/4 tab Lasix BID. Since no blood was done last Friday, don't know if BUN/Creatinine had been creeping up and the extra Lasix threw him into a crash.
> He did eat all his breakfast when he got home and ate most of his dinner so he is feeling better. Just can't my head around that huge increase in numbers.
> Also his electrolytes are all normal, which I thought might be increased if he was really dehydrated.
> So that is Moe's long story. I had actually thought of letting him go this morning when I saw those numbers, but vet kept telling me to NOT look at the numbers and that Moe didn't look that bad and to lower the Lasix and see what happens in a few days.
> Has anyone had those high kidney values come down without fluids? In a catch 22 situation with heart and kidneys. Hum should have asked about spiro.
- Hi Taca
It's horrible balancing so many issues, I know. I have known two cats with
shadows on their lung xrays. One sadly had a tumour, but I assume the vet
would recognise that right away. The other was a very strange case. Seven
months before he had a car accident and we didn't know at the time had torn a
small hole in the diaphragm. The hole had enlarged over time and the
intestines had passed into the chest cavity and caused the lung to collapse.
This showed as a shadow. We didn't have surgery because he was a very old cat
and had HCM and kidney and other issues. Shadows can be infections as well.
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