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13yo RCM - lasix not working

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  • mainecoonkatze
    Hi, I ve been a member of this group sadly for many, many years. 12 years ago September 1st, an adopted stray -- Kitty -- gave birth to four beautiful kittens
    Message 1 of 7 , Aug 27, 2013
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      Hi,

      I've been a member of this group sadly for many, many years. 12 years ago September 1st, an adopted stray -- Kitty -- gave birth to four beautiful kittens on my bed, all of whom would turn out to have congenital heart disease. Three have since passed, the third one passing just last year. They all had HCM.

      In April this year, Kitty began having difficulty breathing, and given the family history, she was put on furosemide, which worked for a while.

      About 3 weeks ago, it stopped working. She was tapped twice in 8 days, each time over 200ml. $3000+ later, she was diagnosed by an expert with RCM, and her furosemide dose was doubled to 40mg daily. To work in with my schedule it is given as 1 x 20mg dose and 2 x 10mg doses. She also gets 1 x Fortekor (benazapril).

      She's still eating, drinking, exploring outside, so she seems happy, but her breathing definitely still isn't right.

      I seem to recall something called Spironolactone. Does that work with RCM kitties? Can it be given with Lasix/Furosemide? Is there anything else we can try?

      3 years ago I lost my grandmotherly aunt. 2 years ago I lost my dad. 1 year ago I lost my grandma. Less than a year ago I lost my mum. Kitty helped me through all of this. Even now, she sleeps in my bed, her head on my pillow, me the big spoon, her the little.

      Any advice would be recommended!

      Thanks,

      Catie, Kitty, and Tuppenny.
      Topsy-Angel, Buttons-Angel, Patch-Angel, Claude-Angel
    • elfinmyst
      Hi Catie Yes, you can use the two together. I would ask for it straight away. Also ask about vetmedin (pimobendan) or atenolol or about increasing Fortekor as
      Message 2 of 7 , Aug 27, 2013
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        Hi Catie

        Yes, you can use the two together. I would ask for it straight away. Also
        ask about vetmedin (pimobendan) or atenolol or about increasing Fortekor
        as it sounds like she needs something to help her heart work properly.
        Usually when heart failure occurs again, they try adding a new medication. She
        also needs a potassium supplement on that dose of lasix.

        Trixi at her worst had
        fortekor a day
        vetmedin twice
        atenolol 5mg twice
        spiro 8mg twice
        lasix 5mg every 4 hour.
        kaminox (potassium supplement)
        plavix quarter tab daily.


        Lyn:)

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

        [Non-text portions of this message have been removed]
      • mainecoonkatze
        Hi all, I spoke with the vet again today and she s going back in for bloods tomorrow. I m fairly confident that her current problems are due to overmedication
        Message 3 of 7 , Aug 29, 2013
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          Hi all,

          I spoke with the vet again today and she's going back in for bloods tomorrow. I'm fairly confident that her current problems are due to overmedication with furosemide combined with no potassium supplementation. She's been weak, lethargic, off her food (and that's HUGE -- she's a MASSIVE eater) and just plain miserable. When asleep, her breathing's perfect, but if she has to walk even a few steps, she's exhausted!

          I got permission to cut her furosemide back just for today, so I had dosed her at 7.30am. She was sick and miserable until about 3pm, when she went outside and walked/sat in the backyard for about 90 mins. This is roughly the time when I would have remedicated her, but I held off, because she hadn't been interested in the world around her all day. About 4.45pm onwards to now (almost 7pm) she's been eating, alert, and happy and purring. I am going to have to redose her, because she does have the heart disease, but to me this pretty much conclusively proves that the further we got from the last dose, the more her potassium levels recovered and the better she felt.

          The vet hospital I take her to hasn't prescribed spiro for cats, only dogs -- spiro is really uncommon in Australia with cats, Vetmedin is unheard of, and Atenolol isn't given to HCM/RCM cats at all once they're symptomatic.

          But I'm going to ask for her furosemide to be cut back, spiro to be added, and also potassium supplementation, that's after her bloods have been taken.

          Wish us luck!

          Catie and Kitty, and Tuppenny, her last surviving daughter, who is starved for attention until this is all sorted!
        • elfinmyst
          Hi Catie I think you are onto something with the potassium. Spiro is not as bad for potassium so hopefully you will get a balance. Vetmedin is called
          Message 4 of 7 , Aug 29, 2013
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            Hi Catie

            I think you are onto something with the potassium. Spiro is not as bad for
            potassium so hopefully you will get a balance. Vetmedin is called
            pimobendan if that helps.

            Lyn:)

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

            [Non-text portions of this message have been removed]
          • r schu
            We just started supplementing May with tumil k, potassium gluconate, as her lasix was doubled, her fluids reduced to none, and I m restricting the renal kibble
            Message 5 of 7 , Aug 30, 2013
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              We just started supplementing May with tumil k, potassium gluconate, as her lasix was doubled, her fluids reduced to none, and I'm restricting the renal kibble (that also has potassium) as kibble can dry them out.  So far so good, but 1/2 tsp of the gel is alot to get in her, so I'm thinking of switching to the powder when this runs out.  A week after starting tumil k her potassium was up, but still well within range.

              -Lee and May
              ========================
              Hi all,

              I spoke with the vet again today and she's going back in for bloods
              tomorrow. I'm fairly confident that her current problems are due to
              overmedication with furosemide combined with no potassium
              supplementation. She's been weak, lethargic, off her food (and that's
              HUGE -- she's a MASSIVE eater) and just plain miserable. When asleep,
              her breathing' s perfect, but if she has to walk even a few steps, she's
              exhausted!

              I got permission to cut her furosemide back just for today, so I had
              dosed her at 7.30am. She was sick and miserable until about 3pm, when
              she went outside and walked/sat in the backyard for about 90 mins. This
              is roughly the time when I would have remedicated her, but I held off,
              because she hadn't been interested in the world around her all day.
              About 4.45pm onwards to now (almost 7pm) she's been eating, alert, and
              happy and purring. I am going to have to redose her, because she does
              have the heart disease, but to me this pretty much conclusively proves
              that the further we got from the last dose, the more her potassium
              levels recovered and the better she felt.

              The vet hospital I take her to hasn't prescribed spiro for cats, only
              dogs -- spiro is really uncommon in Australia with cats, Vetmedin is
              unheard of, and Atenolol isn't given to HCM/RCM cats at all once they're
              symptomatic.

              But I'm going to ask for her furosemide to be cut back, spiro to be
              added, and also potassium supplementation, that's after her bloods have
              been taken.

              Wish us luck!

              [Non-text portions of this message have been removed]
            • r schu
              From what I ve been told by our cardiologist, the kidney can develop a sort of tolerance to lasix.  Though sprio is not as strong a diuretic, it is potassium
              Message 6 of 7 , Aug 30, 2013
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                From what I've been told by our cardiologist, the kidney can develop a sort of tolerance to lasix.  Though sprio is not as strong a diuretic, it is potassium sparing from what I've heard, and our cardiologist says it works in a different part of the kidney tubules.

                Has anyone also heard this?

                -Lee and May
                ==========
                Hi Catie

                I think you are onto something with the potassium. Spiro is not as bad for
                potassium so hopefully you will get a balance. Vetmedin is called
                pimobendan if that helps.

                -Lyn

                [Non-text portions of this message have been removed]
              • mainecoonkatze
                So I got her bloods back, and EVERYTHING was within normal limits.  Even the potassium.  So it's not that. Problem is, that so long as her
                Message 7 of 7 , Sep 1, 2013
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                  So I got her bloods back, and EVERYTHING was within normal limits.  Even the potassium.  So it's not that. Problem is, that so long as her breathing is within normal limits, and her bloods are within normal limits, and her X-rays are clear, it makes it very hard for the vets to know what to treat. Having said that,  she has had two good days yesterday and today.  Eating, drinking, purring, , no nausea, and just generally interested in life.  The three things that were different about those two days are  (a) it was slightly warmer - beginning of Spring in Australia - so I wasn't running the heater that makes that weird plastic smell (b) I gave her two x 20mg lasix doses, rather than 4 x 10mg doses, and  (c) she refused point-blank both days to take her Fortekor (benazapril). No idea which of these caused the improvement.  Her GP has put an email into the cardio vet because he needs advice about introducing Spiro, it's not commonly given to cats in Australia, it's more a doggie-drug. But it's been nice to have two full consecutive days with sunshine and a happy cat :) Catie, Kitty, Tuppenny Topsy-Angel, Buttons-Angel, Patch-Angel, Claude-Angel --- In feline-heart@yahoogroups.com, <rschu92@...> wrote: From what I've been told by our cardiologist, the kidney can develop a sort of tolerance to lasix.  Though sprio is not as strong a diuretic, it is potassium sparing from what I've heard, and our cardiologist says it works in a different part of the kidney tubules.

                  Has anyone also heard this?

                  -Lee and May
                  ==========
                  Hi Catie

                  I think you are onto something with the potassium. Spiro is not as bad for
                  potassium so hopefully you will get a balance. Vetmedin is called
                  pimobendan if that helps.

                  -Lyn

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