I was not aware of that latter point but it was just going to be a
serum ammonia test to see where she is at.

Just on the heart murmur. I contacted the rescue centre where we got
MAGI and on her file they had a note about the murmur which was
actually detected in June of 2002 and in her file there there was a
note referencing it and describing it as a "Grade 2-3, early systolic
audible, L&R in all valves." Does that mean anything to you Phil? It
is a previous baseline which I can take to the other (commercial) vet
prior to another test.

I got all of that documentation photocopied and to tell the truth it
is a horror story for her. She is actually very lucky to be alive. At
one point they record her as having gone into full status and this not
being resolvable by diazepam. They note that she became blind and it
is true to this day that from our observations she still has damaged
eyesight. I'd always believed her to be slightly cognitively damaged
and reference was also made to her being possibly brain damaged and
that this was a possible source for her seizures.

Apparently she was quite a violent cat when she was young and I wonder
at the back of my mind whether her previous owners were physically
abusive. No mention of that is made in the documentation but she was
quite aggressive when we got her and it took awhile for her to settle.
We gave her LOTS of space and got out of the way when she walked down
the corridor!!! ;-)

Of course now she has calmed down more or less completely and has
recently made moves to jump onto the bottom of the bed and sleep with
us. I think she realises that she is safe with us and that we do
genuinely care about her welfare. The worst I get is the odd gentle
nip (for her) to let me know I've to behave myself.

Kelly, in another thread, was asking about the life span of PSS cats
and I note tonight from the original documentation a quote ... "Magi
can continue on antibiotics and lactulose indefinitely however as you
are probably aware medical management for hepatic encephalopathy is
not normally successful long term." This quote would argue the case
for surgical intervention as you can see.

She was never ultrasounded as this was (of course) too expensive for
the rescue centre to pursue. I did speak to the commercial vet and he
was confident of being able to perform such surgery but in the absence
of knowing whether she has an intra or extra hepatic shunt a decision
would be very difficult.

An outside of the liver shunt suggests a possibility of a successful
operation - I would not want to risk her life if the shunt was
internal (though I have to admit I'd need to study this in detail).
But to tell the truth Phil, now this issue of a murmur has appeared
I'd be very wary of going down the surgical line.

We'd have to think deeply about that. The cost would not be an issue
since we have taken her in (and gladly too) and have a responsibility
for her.

We tried the low-protein food but MAGI was not having any of it!!! We
give her regular cat food and high protein turkey or chicken or ham -
all contraindicated but when the other cats are getting this stuff we
don't leave her out. I try to avoid having the other cats know that
MAGI  'is different' - but of course they are not stupid and know she
is not the same. I never intervene in the cats play even when it gets
a bit rough but I do freak inside a bit when BISCUIT hits MAGI on the
side of the head. Mind you BISCUIT is so skittish it doesn't take much
to distract her.

The lactulose is the core of her treatment and there is no doubt it
works - something so simple and readily available! I identified at the
time around ten distinct approaches to treating the problem but the
lactulose has always been the mainstay. At the moment she is on
antibiotics, SYNULOX 50mg x twice daily (gets the last one tomorrow
morning) so I'll be given her some pro-bacteria supplements to
replenish the friendly flora 'n fauna in her gut.

I also add anti-oxidants to her food (like Vit.E) as I would imagine
ammonia and products of digestion to be very seriously oxidising and
hence more damaging to her circulation and organs.

Other than the regular seizures she does have ongoing 'twitching' and
'jerking' through the day. Some days worse then others but we use
these as a guideline to back off on the amount of protein she is
getting or to increase the amount of lactulose. If that twitching gets
very bad we give her extra Pheno which does seem to help but we have
to watch that as we don't want to risk over-sedating her too much with
it.

I was not immediately aware of this either but of course it makes
sense as this ammonia has to be dealt with somehow by the body.

She was born around June/July of 2002 so she is almost three. We got
her June 19th last year when her original owners surrendered her to
the Celia Hammond Rescue Centre - the workers and volunteers there are
wonderful people!!! All three of our cats are from there.

The commercial vet felt she was fit enough for surgery though he was
quite surprised to see a PSS in such good condition and with good
bodyweight - and this after nearly a week of the cold and minimal
eating. He complimented us on her care which kind of relieved me we
were obviously doing it right overall - apart from indulging MAGI's
sheer love of 'meaty bits'. I do see a point in the future where, when
she gets older we may have to stop doing that.

Hope this info is of use to you Phil, you have given me quite a bit of
advice already to run with - just hope MAGI will run with it too!!!

Iain.H

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Not only that but it puts your cat at risk if it were to need any type
of anesthesia or sedation.  I'd definitely get a better diagnosis.

-L.

Phil, do you think murmurs can cause arrhythmia?

MAGI does tend to eat white meat more than red meat so anemia is
always possible. It never occurred to me until you mentioned it but I
will be looking into it. I just have not told MAGI yet ;-)

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