From a discussion with a reader and a good reminder for us all:
Your cat will need to see a cardiologist and you will depend on the cardio for guidance about most of the regular care of the cat. Shots, other wellness issues-the regular vet. But you'll need to coordinate care between the two. Always have copies of cardio visit sent to vet; and regular vet info sent to cardio. The cardio should be consulted before any annual shots are given to make sure he's up to it. The cardio should be consulted for any contraindications with any other meds the regular vet wants to give. The regular vet needs to know how is the cat doing and what meds the cat is on from the cardio and what issues to look for.
*DO NOT allow your cat to be given steroids at any time-pill, injection, or asthma meds as these cause complications with heart disease cats. They retain fluid and that is not what the cat needs. For all other issues, stick only to antibiotics. If desperately needed for an illness, must consult with cardio first.
Keep copies of all visits and test results. You'll need to refer to them, be up to date, for all visits with any vet. Keep a notebook about how your cat is doing and any issues or concerns you need to address with the vet.
Get organized for cat care. File box, files, pill cutter, pill containers, frig boxes on counter or in frig or pantry to contain meds, supplies, supplements, pills, etc. will make care faster and more organized space wise. Nothing rolling around and bouncing around. And that will keep you calmer. As your needs grow for more things for the cat, so will your need to organize it. Find what works for you.
Did he have an echo? That is the only sure way to tell if and what type of heart disease he has and how it is progressing. He should have one every 3-5 months depending on how he is doing; is he seeing an actual cardiologist? He should as that is the expert. He'll need an echo every time he ends up in the ER.
He should have blood work done every 3 or so months and always before he sees the cardiologist so that the cardio knows how the body is responding to heart meds.
Meds-Atenolol is a beta blocker to lower heart rate and to help lower blood pressure. He should have only about a 1/4 tab a day. Maybe later twice a day as the disease and heart worsen. Too much, and the rate is too low, he will be weak. Plavix-only needs 1/4 pill once a day. Maybe later twice a day. And maybe later also add in aspirin. (Aspirin is difficult as cats do not tolerate it well. But you'll use a buffered 80 mg every three days and no more often than that. It might cause gastro upset but in progressive HCM adding aspirin can be beneficial to preventing clots along with Plavix. We gave it on Wednesdays and Saturdays.) He should also be on Enalapril, an ACE inhibitor. It helps to reduce body's retention of sodium, therefore of water; and it keeps veins opened in case of a heart attack. There are other drugs he may need: Sprionolactone-a mild diuretic that helps save potassium; Isosorbide-to lower blood pressure but it changes the load on the heart (I can't recall exactly how it works, only know that Myrna was on it late in life.) There are other diuretics such as Torsemide to use later if needed.
The major med to use is a diuretic like lasix/furosemide. Talk to your vet now about getting this. A daily maintenance dose of 5mg will keep away congestion. Congestion in the lungs is an inability to breathe and get oxygen to the brain/body, making one weak. It is also painful as it feels as if one is drowning. It's not simply a cold as we think of it for humans. As congestion pops up, he'll need more of a dosage and more often during the day. The amount and number of doses will increase as the need increases.
You are treating not only the heart but the entire body. The heart disease will effect his liver and kidneys. Meds will also. You must be aware of needs for the entire body. He will need a good overall cat vitamin paste. He will need extra potassium when on lasix. We use Renal K gel and powder. As the disease progressed for Myrna, I also used Sundown potassium pills. She was near the end on mega doses of potassium. I also gave her kidney support goop and how I administered it changed over time. First, in her food; then she needed it by mouth via a syringe. I mixed up COQ10, vitamin C, E, Renal K powder, etc. with baby sweet potato (source of potassium) in a small dish, and gave her 3ml 2-3 times a day as the disease progressed. Then I added Nature Made iron pills cut into halves and gave them by mouth about twice a day. Iron is necessary for the production of red cells which the kidneys need. It was complicated because it caused gastro upset and I had to adjust the dose as needed. But her kidney values remained stable for the last year of her life after increasing. You can read more about it at the blog under the Med tab.
As the lasix works to get rid of fluid, the cat will drink a lot of water. The cat will at times become dehydrated. You must keep up the hydration. Lots of water bowls, add water to wet food, more wet food than dry. While the heart does not need liquid, the body does. It seems contrary but water is necessary for the overall health and particularly kidney function. As the lasix works, electrolytes will become depleted. That's why you will need the extra potassium. If the cat is not eating well, he will need some extra glucose. The cat won't need extra sodium and does not really need a salt free diet as the lasix is already getting rid of salt. But do cut back on treats and avoid crackers/chips, and table foods.
There may be times he won't eat and you'll need to feed by hand. That can be discussed later but you can read about it at the blog. I have many tricks and methods to suggest.
Learn to monitor the cat and how it is breathing and walking. If you see the cat lethargic, not interested in getting up or eating, go to the vet or cardio. If the cat has cold paws front OR back, go to the cardio or vet ER immediately. If the cat is lame, dragging a leg or legs, or is falling over, go to the vet ER or cardio immediately. If the cat vomits a lot and doesn't get up, go to the vet ER or regular vet immediately. If the cat is laying down and breathing hard and doesn't get up, the cat could be in CHF-congestive heart failure, or having a heart attack. Go to the vet ER or cardio immediately for care. If the cat isn't eating, but seems fine, skip the vet for now and read in the blog how to feed and what to feed by hand.
Learn to count the breathing to monitor for CHF or other heart issues-one up and down chest movement is one count. How many of those in 15 seconds? 6-10 is fine. 12 or more and the cat may need the ER. A cat's breathing fluctuates during any given time from really slow to really fast. But sustained, heavy breathing-not panting, not opened mouth-is an indication that something is wrong. Count the breaths and if you think it's high, count again after a few minutes of the cat being still. If you have a diuretic that you are giving, and you think it's breathing fast, give an extra 2-5mg of diuretic and see if the cat responds within an hour. If the cat does, then he's in CHF but responding and you can give more 2-5mg of extra lasix in four hours. But if the cat seems really bad off, meds also don't help, then rush him to the vet ER or cardio for oxygen and injected lasix and monitoring.
Find the closest cardio, regular vet, and one or two dependable ER or 24/7 animal hospital to have on hand to go to anytime you need the vet.
You can order a lot of supplements at Amazon, Entirely Pet, 1800PetMeds. Sundown potassium and Nature Made products are at the local stores. But shop for lowest prices-Kroger often has buy one/one free; Target has low prices.
And as for the meds, these should be available at the local human pharmacy. They are often cheaper than those from the vet. Kroger and Target had $4.00 generics and have lower prices on many of the meds you are using. Shop around as things change. Avoid Walgreens/CVS which are expensive.
There is a lot of information at the blog in tabs, categories, and as a word search you might find helpful.
But please do continue to feel free to discuss your cat with me and how you are doing. I'm here to help.
Good luck!
