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Cat Forum / Health and Behavior / July 2005

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TK's HCM - An Update

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Nomen Nescio - 15 Jul 2005 06:50 GMT
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Well TK's been on the diltiazem for 2 months, now, after
being diagnosed with HCM. At that time, his heart murmur
was rated a 3 - 4. He needed some bloodwork, today, to
check the white count which was low normal a little over a
month ago and we decided, all things considered, to opt
for a full physical instead of just going in and having a
tech draw the blood.
When the vet listened to his heart, she was taking an abnormally
long time and then said "I'm going to get the electronic
stethoscope" and darted out of the room. My wife and
I just looked at each other thinking "Uh-oh, this may not
be good." The vet came back in with the new stethoscope
and listened, again, for an abnormally long time.
Then the result....."I can't hear any murmur on the left side.
There's a little noise on the right side, but I would barely
rate it a 1".
We both let out a sigh of relief.
The vet stressed the fact that you can only tell so much
by listening and TK's current condition MAY NOT be as
good as it might seem. But she did say that it's a pretty
safe guess to say that his condition has not significantly
deteriorated.
So, it seems like the medication is helping. If nothing else,
the diltiazem seems to be relaxing the heart muscle and
getting it to pump more normally.
And I thought I was noticing that he had a bit more energy,
lately.
We get the blood test results, tomorrow. Hopefully, the white
count will have moved more into the normal range.
But, right now, I would describe my feelings as "Cautiously
Thrilled".

My thanks to everyone who has offered their good wishes
in the past.
And a special Thank You to Phil P, , who went well out of his way
to help this ol' bonehead get a much better understanding of
Tk's situation.
Mary - 15 Jul 2005 08:07 GMT
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> We get the blood test results, tomorrow. Hopefully, the white
> count will have moved more into the normal range.
> But, right now, I would describe my feelings as "Cautiously
> Thrilled".

This is great to hear. Kudos to you for all your good care!
Nomen Nescio - 16 Jul 2005 04:39 GMT
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From: "Mary" <marys@catlover.com>

>This is great to hear. Kudos to you for all your good care!

If anyone deserves the Kudos, it's Dr. John Rush at Tufts.
I'm just glad we brought TK there instead of getting a local
vet to do the echo. Our Vet asked the local specialist who
would have done the echo about the medication TK was
prescribed 'cause she'd never even heard of it.......Neither
had the specialist.
And a word about Tufts........It's the best run, most competently
staffed vet clinic I have ever seen. From the girls at admission
to the pharmacy, everyone, without exception, seems to
know what they're doing. I just wish we lived closer 'cause I'd
never take TK anywhere else.
They even have 2 waiting areas....one for dogs, one for cats.
Karen - 15 Jul 2005 12:27 GMT
That is good to hear. Pearl was discovered to have Mitral Regurgitation. She
is on Enecard, lasix and a low dosage of prednisone for a cough. She is
finally perking up a bit. It really is awful when you know there is
something amiss with their heart. I know that I have found I just have to
take it one day at a time and be happy with how each day goes. I'm glad to
hear TK is doing better.
Nomen Nescio - 16 Jul 2005 05:10 GMT
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From: Karen <kchuplis@alltel.net>

>That is good to hear. Pearl was discovered to have Mitral Regurgitation. She
>is on Enecard, lasix and a low dosage of prednisone for a cough.

Sorry to hear she has developed some heart trouble. Did you
discover it during a normal physical, or was there an "event"?

>She is
>finally perking up a bit.

Great!

>It really is awful when you know there is
>something amiss with their heart. I know that I have found I just have to
>take it one day at a time and be happy with how each day goes.

I know exactly what you mean.

> I'm glad to
>hear TK is doing better.

Thanks.
My best wishes for Pearl.
Karen - 16 Jul 2005 21:26 GMT
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> Sorry to hear she has developed some heart trouble. Did you
> discover it during a normal physical, or was there an "event"?

She has always had a very ocassional cough, but three SUndays ago, she began
coughing every couple of hours. I thought maybe it was asthma, but her heart
is enlarged and they think that is causing the coughing. The nearest
cardiologist is several hours away and so we have to really on what we have
here as I will not subject her to hours of travel (she gets VERY upset just
going across town). I know pred is contradictory (at least anecdotaly) for
heart kitties, but when we try to go off it she coughs. But I am heartened
that the last three days she has been as perky as I have seen her in some
time, even playing a bit by herself which is nearly unheard of.

>> She is
>> finally perking up a bit.
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> Thanks.
> My best wishes for Pearl.

Thanks. Mine for TK. I'm glad you are near such a good facility.

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Phil P. - 16 Jul 2005 04:22 GMT
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>
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> I just looked at each other thinking "Uh-oh, this may not
> be good."

I think it means the murmur was *so faint* she could hardly hear it with an
acoustic
steth!

The vet came back in with the new stethoscope
> and listened, again, for an abnormally long time.
> Then the result....."I can't hear any murmur on the left side.
[quoted text clipped - 9 lines]
> the diltiazem seems to be relaxing the heart muscle and
> getting it to pump more normally.

I think the diltiazem is doing more than that!  I think it might be reducing
hyperthrophy.  Murmurs in cats with HCM usually develop because the
hypertrophied left ventricular walls interfere with the chordae tendinae or
valve leaflets.  So, my guess is the murmur disappeared or diminished
because the hypertrophy is diminishing.  Diltiazem is known for reducing
hypertrophy and left atrial dimensions in cats.

> And I thought I was noticing that he had a bit more energy,
> lately.
> We get the blood test results, tomorrow. Hopefully, the white
> count will have moved more into the normal range.
> But, right now, I would describe my feelings as "Cautiously
> Thrilled".

So am I!

> My thanks to everyone who has offered their good wishes
> in the past.
> And a special Thank You to Phil P, , who went well out of his way
> to help this ol' bonehead get a much better understanding of
> Tk's situation.

Thank you for the update!  You sure made my day!

Keep the faith!

Best of luck,

Phil
Nomen Nescio - 16 Jul 2005 08:30 GMT
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From: "Phil P." <phil@maxshouse.com>

>> So, it seems like the medication is helping. If nothing else,
>> the diltiazem seems to be relaxing the heart muscle and
>> getting it to pump more normally.

>I think the diltiazem is doing more than that!  I think it might be reducing
>hyperthrophy.  Murmurs in cats with HCM usually develop because the
>hypertrophied left ventricular walls interfere with the chordae tendinae or
>valve leaflets.  So, my guess is the murmur disappeared or diminished
>because the hypertrophy is diminishing.  Diltiazem is known for reducing
>hypertrophy and left atrial dimensions in cats.

Thanks Phil. I sure hope you're right! But I certainly can't
see a disappearing heart murmur as being a BAD thing.
I may be wrong, but I'm feeling very encouraged about
his condition.
TK's blood work came back, today, and the white count
has dropped back a little to the bottom of the normal
range. I little lower than the second test, and a little higher
than the first.
But in 3 tests, it seems to be fairly stable at the
low-normal range so the vet thinks this may just be
normal for this cat. We're going to check it again in a
few months, but no other tests seem indicated at this time.
So, all in all, I think my big ol' buddy is doing pretty good.
He's even lost 1/4 - 1/2 pound of the 3 pounds he should
lose. I just wish he wouldn't sneak up behind me and nip
my ankle when he thinks I've shorted him on the amount
of food that he thinks he should get.:)

Thanks again, for all your help, advice, and encouragement.
 
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