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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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