Cat Forum / Health and Behavior / January 2008
Bullwinkle's Echocardiogram - not good
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cindys - 10 Jan 2008 20:51 GMT Bullwinkle had his echocardiogram today, and the outcome was the worst possible scenario. Apparently, both of his ventricles are enlarged and not emptying completely. I think the atria are enlarged too. The veterinarian saw what she described as something "cloudy" or "smoky" which can be a precursor to clot formation. I was advised to add diltiazem and low-dose aspirin to the current regimen of Enalapril and Lasix. Overall, the prognosis is very poor. I asked her how much time he had left. She guessed maybe a month or so. And that is assuming he doesn't throw a clot, which is a high possibility. The irony is that Bullwinkle looks great, he's eating well, seems to have energy, is conducting his normal life, which makes me glad.
Alex, in the meantime, rarely leaves his corner. He had been rejecting most food. I really thought it was time....but then I decided to try Pepcid and that did improve his appetite. (I hadn't been giving him Pepcid because he's already getting aluminum hydroxide - Maalox-- to bind phosphorus). But Pepcid has a different mechanism of action, and it made a difference, so he's been a little more alert and more interested in eating in the last couple of days. Nevertheless, he stays in his corner and gets up only to eat a little, drink, or go to the bathroom. He's barely grooming, but he doesn't seem to have any pain. I have scheduled him for an echocardiogram for next week. I'm wondering if that even makes sense at this point.
Next month, we are planning a short (5-day) family vacation. Our vet has offered to let us board Alex and Bullwinkle with her (even though our vet generally doesn't accept animals for boarding). I've been told that sometimes she actually takes sick cats home with her so she can watch them better. But the way things are going, I don't know if we'll still have either Alex or Bullwinkle by then. Best regards, ---Cindy S.
mariib - 10 Jan 2008 23:08 GMT >Alex, in the meantime, rarely leaves his corner. He had been rejecting most >food. I really thought it was time....but then I decided to try Pepcid and [quoted text clipped - 15 lines] >Best regards, >---Cindy S. re Alex's lack of appetite - have you tried Periactin (cyproheptadine) as an appetite stimulant? It does work - I was using this for my almost 20 year old Tigra in 2004 & 2005 when she was failing & sometimes didn't show any interest in food. I have no idea if there's any contraindications according to whatever medication Alex is already taking. To keep Tigra eating, my vet prescribed 1/4 to 1/2 of a 4 mg Periactin tablet & about 20 minutes after being pilled, she was always hungry enough to come for food. It was easy to divide the pills with a pill splitter.
Here's Tigra when she & Gingy were both about 7-1/2 years old - Ginger lived until 2002 when he was 16, Tigra until late 2005 when she was almost 20. It's hard when they're getting older & aren't well. Good luck with your cats. M. http://pets.webshots.com/photo/2202574600050028271gmiQZN
Gary Brown - 11 Jan 2008 21:30 GMT >>Alex, in the meantime, rarely leaves his corner. He had been rejecting >>most >>food. I really thought it was time....but then I decided to try Pepcid and
> re Alex's lack of appetite - have you tried Periactin (cyproheptadine) as > an I will echo the cypro. If you are that concerned it is worth a try. If he has a bad reaction you can stop. 1/8 of a 5mg tablet worked for Snowy. He also gets Pepcid.
Gary
PET ADMIN - 12 Jan 2008 01:27 GMT > >>Alex, in the meantime, rarely leaves his corner. He had been rejecting > >>most [quoted text clipped - 8 lines] > > Gary Pepcid works, huh? I had someone say it was not good for them. Is there a chance of a reaction with it - hopefully nothing like a seagull or crow would have of course!
Troy www.petadministation.com Good luck
cindys - 13 Jan 2008 01:45 GMT >> >>Alex, in the meantime, rarely leaves his corner. He had been rejecting >> >>most [quoted text clipped - 16 lines] > there a chance of a reaction with it - hopefully nothing like a > seagull or crow would have of course! ------- I've never heard anyone say Pepcid is bad for a cat. I have given it to more than one cat and a dog too on the advice of more than one veterinarian. My current vet told me to give Alex the Pepcid every day from now on, even if his appetite is good. The dose is 2.5 to 5 mg for a cat, not more than that. But I am not a veterinarian. Obviously, you should ask your veterinarian before giving your cat any medication. For Alex, it's worked like magic. He had barely eaten in a few days. I gave him Pepcid in the morning, and by the afternoon he was eating with a hearty appetite. This happened a few days ago. I have been giving him Pepcid every morning since and he has been eating like a hungry cat, even returned to his old habit of going over to his plate, putting his paws on it, looking at me and purring. He hadn't done that in weeks. Good luck. Best regards, ---Cindy S.
blkcatgal - 13 Jan 2008 14:47 GMT My vet also has recommended giving my cat Pepcid when he (the cat) has a stomach upset. The normal dosage is about 1/4 of a 10 mg pill a day. Make sure that you use regular Pepcid, NOT Pepcid Complete. There is an ingredient in Pepcid Complete that is not good for animals.
Cindy, I'm glad to hear that the Pepcid has jumpstarted Alex's appetite. I hope he continues to eat with a hearty appetite.
S.
 Signature **Visit me and my cats at http://www.island-cats.com/ ** ---
>>> >>Alex, in the meantime, rarely leaves his corner. He had been rejecting >>> >>most [quoted text clipped - 31 lines] > Best regards, > ---Cindy S. cindys - 13 Jan 2008 16:49 GMT > My vet also has recommended giving my cat Pepcid when he (the cat) has a > stomach upset. The normal dosage is about 1/4 of a 10 mg pill a day. [quoted text clipped - 3 lines] > Cindy, I'm glad to hear that the Pepcid has jumpstarted Alex's appetite. > I hope he continues to eat with a hearty appetite. -------- Thank you. Right now, both Alex and Bullwinkle are doing okay, even though they both seem tired. Alex is now dividing his time between his chair and the corner. This is good news as he hadn't been on his chair in days. Unfortunately, he hasn't been grooming like he used to. We think it's because he has arthritis in his back legs, and therefore he is unable to twist around to clean back there. He's been grooming his front half normally. Since he doesn't smell so good, we've decided we're going to give him a partial bath today (mostly to clean up his back legs). We are totally dreading this for both his sake and ours, but we have to do something because he smells like a latrine :-( Best regards, --Cindy S.
blkcatgal - 13 Jan 2008 16:57 GMT Cindy, Not sure how you were planning on giving Alex a partial bath, but you can get pre-moistened cat wipes at the pet store or you could use baby wipes. This might be better than trying to put Alex in a tub or something. I used the cat wipes on my cat Scooter (RB) when he began having problems using the litter box.
S.
 Signature **Visit me and my cats at http://www.island-cats.com/ ** ---
> >> My vet also has recommended giving my cat Pepcid when he (the cat) has a [quoted text clipped - 17 lines] > Best regards, > --Cindy S. cindys - 13 Jan 2008 17:50 GMT > Cindy, > Not sure how you were planning on giving Alex a partial bath, but you can > get pre-moistened cat wipes at the pet store or you could use baby wipes. > This might be better than trying to put Alex in a tub or something. I > used the cat wipes on my cat Scooter (RB) when he began having problems > using the litter box. ------- Thank you. What we were planning on doing is putting Alex in the bathtub (not filled with water), using a mild soap on his back legs and then rinsing by pouring some cups of warm water over his back legs. I have tried just wiping his back legs with some wet papertowels, but it wasn't enough. At least I don't have to be concerned that he's going to be licking anything off his back legs afterward as he apparently can't reach back there. (So, if we use soap, and there is a residue left behind, he's not going to lick it off and get sick). I do have baby wipes. I think we could try those first and see how we do before going to the soap and warm water. He's full of mats and knots, too. I try snipping out what I can, but he's always hated being brushed and groomed and fights. Until two years ago, it wasn't a problem because he was very good at keeping himself completely free from knots and mats. The last two years, he had more matting, and so we've had lion cuts in the spring. But now, I'm a little nervous about having him professionally groomed (due to the stress). Sigh. Thank you. Best regards, ---Cindy S.
mariib - 10 Jan 2008 23:08 GMT >Alex, in the meantime, rarely leaves his corner. He had been rejecting most >food. I really thought it was time....but then I decided to try Pepcid and [quoted text clipped - 15 lines] >Best regards, >---Cindy S. re Alex's lack of appetite - have you tried Periactin (cyproheptadine) as an appetite stimulant? It does work - I was using this for my almost 20 year old Tigra in 2004 & 2005 when she was failing & sometimes didn't show any interest in food. I have no idea if there's any contraindications according to whatever medication Alex is already taking. To keep Tigra eating, my vet prescribed 1/4 to 1/2 of a 4 mg Periactin tablet & about 20 minutes after being pilled, she was always hungry enough to come for food. It was easy to divide the pills with a pill splitter.
Here's Tigra when she & Gingy were both about 7-1/2 years old - Ginger lived until 2002 when he was 16, Tigra until late 2005 when she was almost 20. It's hard when they're getting older & aren't well. Good luck with your cats. M. http://pets.webshots.com/photo/2202574600050028271gmiQZN
cindys - 10 Jan 2008 23:26 GMT >>Alex, in the meantime, rarely leaves his corner. He had been rejecting >>most [quoted text clipped - 22 lines] > an > appetite stimulant? I tried that with Molly (of blessed memory). She was howling for hours. I understand that not every cat is going to respond the same way, but Alex's appetite has picked up since I reinstituted the Pepcid. I feel like it's a miracle drug.
>It does work - I was using this for my almost 20 year old > Tigra in 2004 & 2005 when she was failing & sometimes didn't show any > interest in food. I have no idea if there's any contraindications > according > to whatever medication Alex is already taking. Ciproheptadine IIRC is an antihistamine, so I don't think there would be contradictions, but I still don't think I would want to try that again after what happened with Molly.
>To keep Tigra eating, my vet > prescribed 1/4 to 1/2 of a 4 mg Periactin tablet & about 20 minutes after [quoted text clipped - 9 lines] > M. > http://pets.webshots.com/photo/2202574600050028271gmiQZN Thank you so much. Best regards, ---Cindy S.
mariib - 11 Jan 2008 00:46 GMT >>>Alex, in the meantime, rarely leaves his corner. He had been rejecting >>>most [quoted text clipped - 26 lines] >Best regards, >---Cindy S. perhaps the dose for Molly was too high, I was giving 1/4 of a 4 mg tablet. I had also used this same dose successfully for my gentle orange boy Ginger earlier in the battle to keep him alive with CRF. Neither of my cats responded with the howling you've described with your Molly. I do regret now that I pushed my Ginger too hard & too long, & should have let him go in peace much earlier than I did. But I did learn & won't make that mistake again & I try tell his story whenever I can so others will feel strong enough to make the difficult choices when necessary. M.
cindys - 11 Jan 2008 16:04 GMT >>>>Alex, in the meantime, rarely leaves his corner. He had been rejecting >>>>most [quoted text clipped - 31 lines] > perhaps the dose for Molly was too high, I was giving 1/4 of a 4 mg > tablet. I'm not sure, but I do know that the howling is a common side effect of giving cats ciproheptadine. But it obviously doesn't happen in every case. From my reading on the internet, I knew this was a possibility, but Molly wasn't eating at all, so I went ahead with it. At least, when she started howling, I knew the reason. If I hadn't known this was a side effect of the medication, I probably would have had her in the veterinary emergency room. The howling did stop after a few hours, but while it was going on, I thought I would lose my mind (for Molly's sake, because I felt so bad for her).
> I > had also used this same dose successfully for my gentle orange boy Ginger [quoted text clipped - 6 lines] > enough > to make the difficult choices when necessary. It's always so hard to know when is the right time. With Alvin our dog, we waited too long, and I pushed him too, and I feel horribly guilty for that. So, with Molly, I didn't wait so long, and then I felt horribly guilty. She was really sick, but she was still walking around albeit she was wobbly. Shortly before it was time to take her to the vet for the final journey, she came upstairs for a scritch and jumped up on the bed for a nap. And she was still using her litterbox. Oh, didn't I feel guilty, even after the vet showed me how extreme her lab values were and even though the cat was visibly so sick. When we got to the vet, Molly was agitated and got feisty when they put in the catheter. That was when the vet explained to me that Molly wasn't thinking "I have another week or two of life left in me, and she's taking it away." Maybe she could have lived another week or two in that sick state until she died naturally, but she obviously wasn't going to get better. It's been over a year, and now I feel confident that I did the right thing at the right time, but at the time, I felt guilty for months.
Alex is sleeping in his corner all day, but his situation is much different from Molly's. He is now eating with a hearty appetite (since the Pepcid), and he isn't wobbly when he walks, and he is consistently going to the bathroom on the puppy training pads which I have set up for him in the hallway off the kitchen. He doesn't look like he's hurting or suffering. He mostly just looks like he's exhausted.
Bullwinkle is behaving totally normally, going up and down stairs with ease, eating voraciously, using the litter box, jumping on everyone's laps, tail up and in the question mark position (indicating contentment). Total bliss. Totally clueless about what is about to befall him. And when it happens, we will take him to the vet right away, but there will obviously be a time lapse, and he will suffer during that time, from a clot or respiratory distress. I am already crying thinking about it. Life is so unfair. Best regards, ---Cindy S.
yngver - 11 Jan 2008 18:05 GMT > Bullwinkle is behaving totally normally, going up and down stairs with ease, > eating voraciously, using the litter box, jumping on everyone's laps, tail [quoted text clipped - 5 lines] > Best regards, > ---Cindy S. Cindy, I'm very sorry to hear about Bullwinkle's diagnosis, but at least he is doing fine right now. Have you visited the feline heart group on yahoo? In addition to sharing tips on managing heart problems, the group can tell you of a number of cases of cats that were given a grim prognosis but survived for much longer than ever expected, years even. Who knows, Bullwinkle might be one of those cats who surprises the cardiologist. I hope so. -yngver
cindys - 11 Jan 2008 20:19 GMT >> Bullwinkle is behaving totally normally, going up and down stairs with >> ease, [quoted text clipped - 18 lines] > who surprises the cardiologist. I hope so. > -yngver ---------- I hope so too. I'll check out the heart group. Thank you. Best regards, ---Cindy S.
Phil P. - 11 Jan 2008 15:23 GMT > Bullwinkle had his echocardiogram today, and the outcome was the worst > possible scenario. Apparently, both of his ventricles are enlarged and not [quoted text clipped - 27 lines] > Best regards, > ---Cindy S. Phil P. - 11 Jan 2008 15:52 GMT > Bullwinkle had his echocardiogram today, and the outcome was the worst > possible scenario. Apparently, both of his ventricles are enlarged and not [quoted text clipped - 27 lines] > Best regards, > ---Cindy S. Hi Cindy,
I'm very sorry to learn the results of Bullwinkle's echo, I was really hoping the results would be much better.
Although I don't remember reading about Alex's problem, in their condition I strongly advise against subjecting them to the stress of boarding and being placed a strange environment with unfamiliar people. I'm afraid the stress might lead to decompensation. I don't think you'll ever forgive yourself if something happened to either of them while you were away on vacation.
Please reconsider your plans and postpone your vacation.
Best wishes,
Phil
P.S. Try warming Alex's food. Heated food is more aromatic and might stimulate Alex's appetite.
cindys - 11 Jan 2008 20:39 GMT >> Bullwinkle had his echocardiogram today, and the outcome was the worst >> possible scenario. Apparently, both of his ventricles are enlarged and [quoted text clipped - 40 lines] > I'm very sorry to learn the results of Bullwinkle's echo, I was really > hoping the results would be much better. Me too.
> Although I don't remember reading about Alex's problem In addition to his CRF (which you and I have discussed in the past), he now has a gallop in his heart (he has carried a diagnosis of nonspecific cardiomyopathy since he was a few years old, and it's always been stable, but now it's progressed). Alex will be 17 years old next month. I have him set up for (his third) echocardiogram next week. The last time he had an echocardiogram was a few years ago.
>, in their condition I > strongly advise against subjecting them to the stress of boarding and > being > placed a strange environment with unfamiliar people. I'm afraid the stress > might lead to decompensation. I know. Two weeks ago, Bullwinkle was given a clean bill of health. Even now, he doesn't have a murmur or any other symptom to indicate that he is sick at all. By his behavior, you would think he is the picture of health. His checkup two weeks ago included the full senior blood panel and urinalysis. The only thing the doctor found wrong was that his urine was a little more dilute than it should have been and his BUN and creatinine were approaching the high end of normal. She told me he may be exhibiting the beginnings of CRF (so what else is new?) and suggested that I supplement his potassium. But the blood draws and urine draws etc were very stressful for him. I went in the back and tried to comfort him while they were drawing his blood etc, but even at that, by the time they were finished, I thought he was going to lose it. It has been suggested to me that the stress of the blood draws etc could have set the wheels in motion and caused him to decompensate a week later (when he ended up at the veterinary emergency hospital).
> I don't think you'll ever forgive yourself if > something happened to either of them while you were away on vacation. You're right.
> Please reconsider your plans and postpone your vacation. We can't postpone. The plane tickets are nonrefundable. My family would simply proceed on without me. If Alex and Bullwinkle are still alive when the time comes, I will probably end up staying home. But the trip isn't until the middle of February. A lot can happen before then. Unfortunately, nothing good.
I just want to thank you again for convincing me to have the echocardiogram for Bullwinkle. It didn't reveal a treatable condition (which I didn't think it would, which is why I wasn't going to have it), but as depressed as I am, it is some consolation to at least have a clear picture of what is going on. That's why I've decided to proceed with the echocardogram for Alex. I don't expect anything treatable will be found there either, but there, too, it will give me a clearer picture of what we're dealing with. Best regards, ---Cindy S.
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