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Introducing Whisperpurr (Whispurr)

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  • Jim Sinclair
    In late 2006 the people living in the house next door to me skipped out on their lease and disappeared, leaving five cats locked inside the vacant house. The
    Message 1 of 4 , Mar 23, 2014
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      In late 2006 the people living in the house next door to me skipped
      out on their lease and disappeared, leaving five cats locked inside
      the vacant house. The landlord's maintenance crew went into the house,
      found the cats, and chased them outside. I was able to save four of
      them. As with all incoming rescue cats, I quarantined them for two
      weeks and had them treated for parasites and tested for FeLV and FIV.
      All tested negative. Whispurr was sneezing and had orange and green
      drainage from one eye. This was diagnosed as an upper respiratory
      infection and treated with antibiotics. The symptoms cleared up.
      Eventually Whispurr and the other cats were released from quarantine
      and allowed to mingle with my established cats. Meanwhile I was
      frantically calling every cat rescue group in town, begging for help,
      because I already had six cats and could not deal with ten.
      Eventually, after I'd gotten all four abandoned cats vaccinated and
      spayed, a rescue group agreed to take some of them. Three of the new
      cats were afraid of my dogs and hissy and spitty with my other cats,
      so they went to the rescue. Whispurr made a big deal of showing me
      that she was happy to be here, she liked me, she liked the other cats,
      she didn't mind the dogs, and she seemed to be asking, "Please,
      please, please let me stay!" So I did.

      She was estimated to be between one and two years old at that time, so
      she's about nine now.

      Some months after her URI symptoms seemed to have cleared up, the
      goopy eye came back. After several recurrences of sneezing and runny
      eye, my vet tested her for Bartonella. She tested positive. Over the
      years she's had several courses of azithromycin and doxycycline when
      this has flared up. She's had chronic sneezing but usually no colored
      discharge.

      During the last few years she has also had several bouts of vomiting,
      diarrhea, and inappetence. In between bouts, she has an excellent
      appetite, normal stools, and no vomiting. That doesn't seem like a
      food allergy. She has been tested repeatedly for worms. Last fall I
      treated all the cats for worms even though the fecal test was
      negative, just in case.

      Recently Whispurr has been losing weight despite eating well and
      having no vomiting or diarrhea. In January I took her to the vet with
      muscle wasting sneezing, and a big bloated belly. My vet did a GI and
      chem panel, T4, SPEC fPL, cobalamin and folate tests, and abdominal
      radiographs because of the bloated belly. Her heart looked enlarged on
      the X rays, so the vet added a cardiac BNP test to the blood work.

      The radiologist's report on the January 15 radiographs:

      "The cardiac silhouette is increased in size on the ventrodorsal
      projection; however, on the lateral projection the cardiac silhouette
      is more normal in size.

      "On the ventrodorsal projection there appears to be enlargement of the
      atria resulting in a valentine shape cardiac silhouette.

      "The pulmonary vasculature is normal in size with no evidence of
      cardiac decompensation.

      "The trachea and bronchi are normal.

      "The esophagus is mildly distended with fluid with this change most
      dramatic on the right lateral view.

      "The stomach is greatly distended with gas and fluid occupying the
      cranial half of the abdomen.

      "Small bone dense foreign material is present in the stomach.

      "The small bowel is gas- and fluid-filled.

      "There are distended segments of small bowel and the amount of
      distension could suggest partial obstruction.

      "Heterogeneous material is present in the small bowel which has the
      appearance of ingesta; however, foreign material cannot be excluded.

      "Abdominal detail is decreased due to lack of abdominal fat; however,
      a small amount of peritoneal fluid cannot be completely excluded.

      "Liver volume appears normal.

      "The spleen and kidneys are not well visualized due to the overlying
      bowel and poor abdominal detail.

      "Radiographic diagnosis: Mild cardiomegaly. Severe gastric distension
      with small bone dense gastric foreign material. Poor abdominal detail.

      "Comments: The greatly distended stomach would be consistent with
      significant gastric disease and compatible with a pyloric outflow
      abnormality. Because of the mild distension of the small bowel and
      gastric foreign material foreign body obstruction will need to be
      considered especially if vomiting is part of the clinical signs.
      Follow-up radiographs will be important to monitor the digestive
      tract. Further assessment of the digestive tract with a barium series
      or an ultrasonographic examination should be warranted to evaluate for
      possible causes of the gastric distension. A small amount of
      peritoneal fluid cannot be completely excluded, and if peritoneal
      fluid is documented clinically abdominocentsis to obtain fluid for
      analysis would be indicated. An abdominal ultrasonographic examination
      is recommended to evaluate intra-abdominal structures possible cause
      of clinical signs which are not well visualized radiographically.
      Because of the mild cardiomegaly assessment of the heart
      untrasonographically will need to be considered especially if a heart
      murmur or cardiac arrhythmia is present."

      At that time the vet did *not* hear any murmur or abnormal heart
      sounds, so our primary concern was with her digestive tract.

      On blood work, she was anemic with RBC 5.44 (7.12-11.46), HGB 7.8
      (10.3-16.2) and HCT 22.5 (28.2-52.7). SPEC fPL and T4 were both fine.
      But she was badly deficient in cobalamin (<150 [276-1425]) and folate
      (3.1 [8.9-19.9]) "consistent with proximal small intestinal disease,"
      and her BNP was very high at 1500 (0-100).

      As the heart sounds at that time were normal, the radiographs showed
      only "mild" cardiomegaly, and the vitamin deficiency and muscle
      wasting were severe, my vet said it was possible the high BNP and
      cardiomegaly were part of muscle tissue being broken down because of
      the intestinal disease. She recommended weekly injections of vitamin
      B12. A few weeks later we saw a different vet in the same practice for
      a follow-up and that vet recommended adding a weekly B complex
      injection, as she suspected thiamine deficiency as well. So Whispurr
      has been getting weekly B12 injections for two months now, and B
      complex injections for about a month and a half.

      Meanwhile I started giving her CoQ10 and nattokinase right away.

      On February 6 I noticed her right eye had a white film on it. I took
      her to the vet, who diagnosed a melting corneal ulcer and referred us
      to an ophthalmologist. The vet said this corneal ulcer appeared to be
      caused by trauma, such as getting scratched in the eye, and was not
      related to Whispurr's other problems. However, she said that with
      Whispurr's overall poor health, she would have a very high risk of
      death from anesthesia if surgery needed to be done to remove the eye.
      At that appointment, for the first time, the vet did note a heart
      murmur.

      The next day, February 7, I drove Whispurr 90 miles to see a
      veterinary ophthalmologist. He confirmed that she had an infected
      melting corneal ulcer. But he said it looked like the kind of thing
      that is caused by herpes. So now I don't know whether the ulcer is
      unrelated to Whispurr's other issues, or is part of some chronic
      infection.

      Whispurr was prescribed a potent antibiotic to be dropped into her eye
      every hour, and a corneal repair gel to be administered twice a day.
      On the night of February 9 she was not eating and seemed to me to be
      in significant pain, so I took her to the ER. At that visit they
      confirmed that she was in pain and dispensed buprenorphine to use as
      needed. They did *not* hear a heart murmur that night, but did note an
      arrythmia, as well as generalized muscle wasting and unkempt coat.
      There was no abdominal distension at that time.

      To everyone's surprise, Whispurr responded well and her eye is
      healing. She has resumed eating, and grooming herself, and has a nice
      coat again. Last week the vet said we can stop the hourly antibiotic
      and she does not appear to need the buprenorphine anymore.

      But her abdomen was distended again. She has gained over a pound since
      January 15, and it does not seem to be muscle mass that she's gaining.
      Her muscles are still wasted. And while last time the vet could
      palpate her intestine easily and they felt "doughy" (consistent with
      intestinal disease), this time she said she could not really feel the
      intestine because there seemed to be so much fluid in the abdomen. She
      said with the heart murmur, "split" heartbeat (whatever that means?),
      and now fluid in the abdomen, all after she's been getting the B12 and
      B complex injections all these weeks, Whispurr should have an
      echocardiogram and be evaluated by a cardiologist.

      And the rest, I posted here in the other thread about where to get an
      echocardiogram: Cornell doesn't have an available appointment until
      mid-May, the specialty hospitals in Rochester and Buffalo don't have
      cardiologists, the one in Latham could see her in April, but so could
      the one in Michigan where I was planning to go next month anyway, so
      we are going to Michigan early (hopefully Thursday of this week) and
      Whispurr will see a cardiologist there.

      That brings us to Friday, March 21. I emailed my vet an update about
      the cardiologist search, and asked if Whispurr would benefit from
      furosemide to reduce the fluid buildup while waiting for the
      cardiology appointment. She said that would be reasonable, but she
      would recommend drawing a sample of the fluid for analysis first. I
      took Whispurr back to have the fluid drawn. The vet said it was clear,
      free-floating abdominal fluid with hardly any cells in it. She also
      tested her liver enzymes and they were fine.

      Starting Friday evening Whispurr has been getting 6.25 mg (half a 12.5
      mg tablet) of furosemide twice a day, and is continuing to get the
      CoQ10 and nattokinase in her breakfast, and the corneal repair gel in
      her eye twice a day.

      Jim Sinclair jisincla@...
    • Elfinmyst
      Oh Jim I remember you. It keeps happening, we keep getting more heart babies. I think they are sent to us. If anyone can help whispurr it s you. I think the
      Message 2 of 4 , Mar 23, 2014
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        Oh Jim

        I remember you. It keeps happening, we keep getting more heart babies. I think they are sent to us. If anyone can help whispurr it's you.
        I think the lasix is a good plan, fuid in the body is more likely right sided heart. Let us know what the ultrasound says

        Lyn
      • Jim Sinclair
        Lyn, and others, how common is heart disease in cats? I keep seeing people here who have multiple heart kitties. If it were just me, it would be easy enough to
        Message 3 of 4 , Mar 27, 2014
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          Lyn, and others, how common is heart disease in cats? I keep seeing
          people here who have multiple heart kitties. If it were just me, it
          would be easy enough to think I must be doing something wrong to give
          my cats these problems, but so many other people seem to have multiple
          cats that have the same problems. Is it really more common than anyone
          suspects?

          I intended to leave for Michigan today, but things needing to be done
          first are not done yet, so now I'm aiming for Sunday morning
          departure. That means we are still at home in New York.

          About the fluid buildup, which I have not encountered before: After
          being on furosemide (half of a 12.5 mg tablet twice a day) since
          Friday night, so five and a half days, Whispurr's belly does not look
          any less swollen. I have sent an email to my vets, asking if she
          should be on a higher dose, and/or if she should have some of that
          fluid drawn off before we leave on the long trip (which is bound to be
          somewhat stressful even for a travel-experienced cat like Whispurr).
          Any thoughts about that? Last Friday the vet offered to try to draw it
          off, but we decided to try the furosemide first because there are
          risks associated with removing the fluid (especially late on a Friday
          afternoon shortly before the clinic would close). Whispurr does not
          currently seem to be in distress. She eats, she purrs, she grooms, she
          cuddles, her breathing is good. Would it be more risky to set off on a
          10+ hour road trip with her like this, or to get the fluid drained and
          then set off on a 10+ hour road trip a couple days later?

          Jim Sinclair jisincla@...


          On Sun, Mar 23, 2014 at 7:28 PM, Elfinmyst <elfinmyst@...> wrote:
          >
          >
          >
          > Oh Jim
          >
          >
          > I remember you. It keeps happening, we keep getting more heart babies. I think they are sent to us. If anyone can help whispurr it's you.
          > I think the lasix is a good plan, fuid in the body is more likely right sided heart. Let us know what the ultrasound says
          >
          > Lyn
        • Mary Sue Rubin
          Hi Jim, My tiny little Devon Rex Esther, diagnosed with RCM and CRF with ascites in Feb. 2013, was prescribed 5 mg furosemide twice a day to begin with. Due to
          Message 4 of 4 , Mar 27, 2014
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            Hi Jim,

             

            My tiny little Devon Rex Esther, diagnosed with RCM and CRF with ascites in Feb. 2013, was prescribed 5 mg furosemide twice a day to begin with. Due to an error with the vet writing the wrong prescription, and me not noticing for about 4 weeks, Esther was getting 10 mg twice a day. Within two weeks of starting the furosemide, Esther’s ascites was resolved. She looked pregnant, but she never seemed bothered by it before it resolved. She never had a problem with fluid on her lungs and she never had more fluid problems as long as she lived, which was 13 more months. After the first month she was maintained on 5 mg furosemide once per day, changed to 5mg or 10 mg on alternating days about 10 months later. I hope this helps.

             

            I am sad to report that Esther died this past Saturday. She was 19 and lived more than twice as long as the vets had expected. She threw multiple blood clots within a 1 ½ hour period, at home and at the ER (at 2am, of course). These were not to her back legs. Given the results of the x-rays (no fluid anywhere) and consultation with the vet and cardiologist to discuss prognosis and possible next steps, I decided to let her go. She was alert in between these events, but each one was terribly painful for her (and me) and the vets said they would likely continue overnight. I decided to set my needs aside, which was not easy, and let her go in between these events while she wasn’t in severe pain. She died peacefully wrapped in a warm blanket in my arms. My house seems so empty, even though I have two other cats and a dog. I think she might have been having these for a few days, when I was gone from the house. I knew she was a little off, though I couldn’t put my finger on it, so I had made an appointment for Monday to take her to the vet. She was eating well and fairly active, but she had been urinating in an area away from her box. She did this prior to her original diagnosis so I knew something was wrong.

             

            This list has been invaluable to me during this past year. I’ve learned so much information that I hope I never need to use again, but if I do, I know where to go. I’ll probably stay on the list for a while and then take a break from the daily posts. Thank you all and best of luck to all of you and your wonderful cats.

             

            Mary Sue

             

            From: feline-heart@yahoogroups.com [mailto:feline-heart@yahoogroups.com] On Behalf Of Jim Sinclair
            Sent: Thursday, March 27, 2014 1:48 PM
            To: feline-heart@yahoogroups.com
            Subject: Re: [FH] Re: Introducing Whisperpurr (Whispurr)

            About the fluid buildup, which I have not encountered before: After
            being on furosemide (half of a 12.5 mg tablet twice a day) since
            Friday night, so five and a half days, Whispurr's belly does not look
            any less swollen. I have sent an email to my vets, asking if she
            should be on a higher dose, and/or if she should have some of that
            fluid drawn off before we leave on the long trip

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