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Cat Forum / Health and Behavior / January 2004Help! cat w/enlarged heart, breathing difficulties
Hi, I'm hoping someone here might be able to give me some insight. OUr 8 1/2 year old cat had a bladder blockage four days ago, which came after a bout of diahrrea that lasted 3 days. He's had diahreea before and we didn't think too much of it, he gets stressed easily, he's also over weight and an overeater, usually it would go away in a day or so. This time it seemed worse, and he suddenly started straining at the litter box. Well, he's had UTIs before too, so I took him in immediately. He was blocked. They had to catheterize him with anaesthesia and keep him over night, gave him Amoxycilin and hill's s/d, and sent him home, but told me to watch in case he blocked again. he was fine the first day, but the second night he refused his food, and he seemed listless. I took him to emergency and they said he wasn't blocked, but suggested I get him tested for kidney disease because of the diarrhea he'd had. So, I took him BACK to our vet this morning, by which time his breathing seemed really laboured (he was still refusing food). They ran blood tests on him: nothing unusual. Xrays: fluid in his lungs, so maybe asthma, and also, what appeared to be an enlarged heart. They want to do an ultrasound tomorrow but sent him home with us to watch overnight. Diagnosis now, so far, is that he MAY have heart disease, or it MAY just be asthma, although he didn't respond fast to a cortisone shot. MY SUSPICION: this is a complication from the anaesthetic they gave him to catheterize him. It seems very strange he'd suddenly have these problems just after having been in for an obstruction. The vet's only suggestion was that maybe he got an infection and it went to his heart which is causing this. If this is an enlarged heart: what will I do? OUr vet is very unhelpful. Many thanks, very worried. > Hi, > [quoted text clipped - 26 lines] > suggestion was that maybe he got an infection and it went to his heart > which is causing this. Possible, however, unlikely. Your vet is suggesting bacterial endocarditis - which is bacterial invasion and colonization of the heart valves. Although CHF can develop from endocarditis, the process usually takes weeks to months. My guess is your cat has undiagnosed heart disease (HCM/CHF) and probably decompensated under the stress of the blockage, hospital stay and treatment. Fluid in the lungs with an enlarged heart are pathogenomic for CHF secondary to HCM - not asthma - although asthma may exist as a concurrent illness. > If this is an enlarged heart: what will I do? Consult a veterinary cardiologist. Many cats with CHF survive for years on a therapeutic plan consisting of furosemide (Lasix), nitroglycerin, low-dose aspirin, diltiazem, atenolol, or a combination of the medications. Your immediate concern should be reducing or eliminating life-threatening pulmonary edema. Go to http://www.acvim.org/Kittleson/search.htm and do a search for an Diplomate in the specialty of cardiology in your area. American College of Veterinary Internal Medicine Diplomates are about the best there is. OUr vet is very > unhelpful. I agree. My guess is he's trying to cover failing to diagnose your cat's heart disease at an earlier date which may have averted this crisis. > Many thanks, very worried. Keep the faith - just find a new vet *quick*! Phil >My guess is your cat has undiagnosed heart disease (HCM/CHF) and probably >decompensated under the stress of the blockage, hospital stay and treatment. >Fluid in the lungs with an enlarged heart are pathogenomic for CHF secondary >to HCM - not asthma - although asthma may exist as a concurrent illness. Thanks Phil. After the ultrasound, he was given a diagnosis of HCM. They have him on Diltiazem, Lasix, and baby aspirin, as well as amoxycilin for the bladder problem last week. I'm really at a loss here, and don't know what to do or what to expect; from everything I've read, he could last six months, 3 months, 9 months, maybe a year? My worry right now is that he is NOT eating. They've prescribed Hill's s/d for him but he won't eat it, not even mixed with his old food (science diet lite). I think he did eat some of our other cat's food (professional adult, chicken). We actually have 2 vets here, one who is kind of an a.s, another who is much nicer; the nicer one had said offhand that he thought it was more important for him to eat something than special diet food, but that the diet was important. I am worried about him getting obstructed again though because if that happens, I do not think he will survive catheterization. Is there some other food we might give him? Does this sound like a reasonable course of treatment, or should I still take him to a cardiologist? I am not under the illusion that he will live forever, and am even expecting the absolute worst, but want to exhaust all our possibilities before I resign myself. thanks. Well, this is very strange; after four days of medication, he is acting almost completely normal and back to the way he was before this happened. He's more acive, he's cleaning himself up, he's even reluctantly eating his perscription food although seems much more interested in the other cats food (which i'm keeping him away from). A good sign? I hope so. I'm also thinking of getting a second opinion on him. >>My guess is your cat has undiagnosed heart disease (HCM/CHF) and probably >>decompensated under the stress of the blockage, hospital stay and treatment. [quoted text clipped - 27 lines] > >thanks. > >My guess is your cat has undiagnosed heart disease (HCM/CHF) and probably > >decompensated under the stress of the blockage, hospital stay and treatment. > >Fluid in the lungs with an enlarged heart are pathogenomic for CHF secondary > >to HCM - not asthma - although asthma may exist as a concurrent illness. > > Thanks Phil. After the ultrasound, he was given a diagnosis of HCM. I was afraid that would be the diagnosis. Sometimes I'm happier when I'm wrong... > They have him on Diltiazem, Lasix, and baby aspirin, Excellent drug therapy! Hopefully, you'll begin to notice an improvement within a few days. I'm a very strong proponent of Diltiazem for cats with HCM - we've had nothing but spetacular results -- including even complete *reversal* of myocardial hypertrophy in several cats! Also, the lasix can be tapered and even discontinued in many cats on diltiazem. Cats are very sensitive to lasix, so the smaller the dose and the shorter the duration- the better. At the very top of diltiazem's list of accolades is the reported *decrease* in the incidence of arterial thromboembolism (saddle thrombus). Diltiazem is a calcium channel blocker that also has antiplatelet activity in cats and seems to interfere with the formation of clots. A contributing factor in the formation of clots is sluggish blood flow through an enlarged left atrium (kinda like how the flow of water in a stream slows down where the stream gets wider). Diltiazem also seems to have a positive effect on left atrial hemodynamics that further reduces the risk of thrombus formation. Arterial thromboembolism (AT) is the most devastating complication associated with myocardial diseases in cats. Many cats with HCM would live several relatively normal lives if the risk of AT can be reduced. Most cats don't actually die from HCM itself but from the complications associated with AT. Diltiazem has certainly reduced these risks and permitted many cats to live many happy and otherwise healthy years that they would not have without Diltiazem. I'm speaking from *direct*, *first hand* experience with many HCM cats we've managed with Diltiazem. > Does this sound like a reasonable course of treatment, or should I > still take him to a cardiologist? Absolutely take him to a cardiologist - his disease and therapy must be monitored. > I am not under the illusion that he will live forever, and am even > expecting the absolute worst, but want to exhaust all our > possibilities before I resign myself. > > thanks. I've seen HCM cats live good quality lives for many years with the proper treatment. Keep the faith - Phil http://maxshouse.com/hypertrophic_cardiomyopathy.htm My 2 1/2 yr old black long haired kitty, Bear started having problems like this in Sept. First he was so blocked the vet had a hard time getting him cleaned out and he was there 3 days. A week later I took him back but the vet didn't find anything wrong, a week later it was bladder infection. Then it was drooling. I mentioned then that he was breathing hard and fast sometimes. No comment from vet. Sun. morning Bear was watching me getting ready for church. I sprayed hairspray but away from him then chased him out of the room. When I returned from lunch he was having trouble breathing. I took him to the vet who gave him a shot and some pills. An x-ray showed an enlarged heart and ashma-like condition. By evening he was worse. The vet and I made a flying trip to the nearest large city to get help. The vet in back with oxygen and kitty. Bear died as I drove into the city limits. I have been bawling my eyes out ever since. I feel like I killed my precious Bear with hairspray1 circa Tue, 27 Jan 2004 06:33:42 -0600 (CST), in rec.pets.cats.health+behav, Teddy (teddybearranch@webtv.net) said, > Bear died as I drove into the city limits. I have > been bawling my eyes out ever since. I feel like I killed my precious > Bear with hairspray1 You didn't; feeling guilty is natural, but not necessarily rational. I'm sure you didn't kill your cat. Positive. Laura Thanks for your kind words. I am having a very hard time dealing with this. It helps to know others understand and are sympathtic. circa Wed, 28 Jan 2004 08:31:07 -0600 (CST), in rec.pets.cats.health+behav, Teddy (teddybearranch@webtv.net) said, > Thanks for your kind words. I am having a very hard time dealing with > this. It helps to know others understand and are sympathtic. We've probably all been where you are right now. It's horrible, and there's little to nothing that makes it better besides time. It is human nature to look for things we could have done differently when we lose a pet, even though the reality usually is that we did everything we could and then some. Just by the obviousness of your grief and the post you placed that started this thread, it's very, very clear that you loved your cat dearly and that you went way over and above the call of duty in trying to save him. You have *nothing* for which to blame yourself. Sometimes these things just happen. :-( The pain *will* lessen over time. You'll never stop missing him, but you will be able to remember him without that horrible stabbing pain every time you do. Until then, unfortunately, the only thing you can do is to remind yourself of all the things you did to try to save him, and know that it was his time no matter what anybody did. Laura > circa Wed, 28 Jan 2004 08:31:07 -0600 (CST), in > rec.pets.cats.health+behav, Teddy (teddybearranch@webtv.net) said, [quoted text clipped - 18 lines] > > Laura Yes. And when it is time (you will know when) save another sweet little cat that needs a home. Or two. They still need you. >MY SUSPICION: this is a complication from the anaesthetic they gave >him to catheterize him. It seems very strange he'd suddenly have these >problems just after having been in for an obstruction. The vet's only >suggestion was that maybe he got an infection and it went to his heart >which is causing this. If your cat received a lot of fluids prior to being x-rayed, that could show up as a mildly enlarged heart, or that's what our vet told us with our cat. However, with the other symptoms you describe I think Phil is likely right and it may well be a form of cardiomyopathy. >If this is an enlarged heart: what will I do? OUr vet is very >unhelpful. > >Many thanks, very worried. Well, if it is a heart problem you can look on the bright side and consider that catching it early greatly increases your cat's chances of living a long and healthy life, with proper treatment. You really won't know what to do next until you have the ultrasound. Good luck.
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