Summer is here even if not officially and we must prevent our cats from breathing hot, humid, muggy, stale air in order to prevent congestion. The air in your home affects how they breathe and if they become congested and how well they deal with congestion. Give your cats good air to breathe indoors: get rid of humidity in the house with dehumidifiers (stand alone units or attached to the automatic A/C unit) Keep the temps inside cool, not hot nor too cold. Run fans-maybe buy some of the "whisper quiet" fans. Run stand alone room units that exhaust through window screens (no need to remove the screen) or buy those you insert into an open window. If you have an automatic A/C in your home, set it for 70-74 degrees or whatever works to keep the air cool but not cold, and not hot and stale. And don't let the cat stay in the sun for too long. Even heat can trigger stress and stress triggers congestion. And keep them indoors as much as possible. Good luck!
I began this blog in March 2014 when our cat suddenly developed symptoms of heart disease after dental surgery in February. Unfortunately, the disease took him August 9, 2014. Now that he has passed, there isn't much more to add to the blog but I will post something from time to time. Please read the corresponding blog "Cat Living with HCM" and the Facebook pages Cats Living with HCM and the Feline Moderator Band Facebook page.
Friday, May 30, 2014
Torsemide Works Well for a Cat While Other Cat Needs More Lasix
Cooper is doing well after a week of torsemide. At the request of the cardiologist, we decreased his med to 2mg four times a day (QID). Breathing rate is about an 8/15. Myrna has needed 5mg extra of lasix at some point during the day for some of the last few days (but not all.) Her breathing rate has been 10-12/15 and that's when she received extra lasix. She's stressed by the air conditioners and the fans going, storms we've had. When it's cool during the a.m. and evening, I turn the fans off and give her a break.
Cats Are Like Babies-They Cannot Sustain Injury or Illness On Their Own Without Medical Care
The other day I picked up something someone was giving away for free. They had a kitten with them which they had recently acquired. The kitten was 8 weeks old and the cutest little thing. It had just hurt its front leg a couple hours before I came over. The daughter was carrying the thing because it could not walk. I looked and saw the paw was swollen at the joint and asked if that was the hurt leg and it was. I felt the head and it felt very warm. I suggested the ER and soon because the leg was noticeably swollen and the body felt very warm and feverish (but because it was begin carried it could have picked up body heat.) We had a discussion about cats in general because they have six and I have seven. I mentioned that I was used to dealing with a variety of issues. They had a friend coming over in a few hours who is a vet tech who was going to look at it. Then she said she'll take it to the vet tomorrow if the friend says it needs the vet.
At this point, there was little I could say. Pointing out that the leg was swollen and the kitten possibly feverish and needing the ER wasn't enough to compel the lady to leave NOW for the ER. I didn't think it would work to tell her that by the time she takes it in-say she calls in the a.m. and they say they'll see her at 1 p.m.-the poor kitten would have been suffering, in pain, unable to walk, and possibly feverish for 24 hrs. What person in their right mind lets an animal suffer for 24 hrs?
And it bothered me all the rest of the day. And then it dawned on me-would she let her baby do the same thing? Would she be so calm, so seemingly unconcerned and lacking in a sense of urgency to get care for a baby if a baby were just as sick? Probably not. And that's what I should have asked: how long would you let a baby go with an injured, swollen limb, possibly feverish? 24 hrs? 12 hrs? 5?
Because cats are like babies, and I don't mean because we treat them as our children. They are physically too small to handle what most adults or even children can handle. Constant vomiting and diarrhea-what might be a normal course of illness in a child will weaken and debilitate a cat. A child can take all sorts of meds for such an illness but not a cat. Lethargy, an unwillingness to eat or drink are normal for a sick person. They have reserves in large bodies before needing to see a doctor. But not a cat. One day without food and water and the cat will not rebound on its own without vet care and may have its life in danger. A broken, sprained, swollen and painful limb injury? Who in their right mind would let a child sit around without seeing a doctor? Almost no one I'm sure. A cat would need care immediately as well.
And yet we treat our pets as if they are full grown adults, able to withstand not eating and drinking; withstand fevers; withstand constant vomiting and diarrhea; and withstand the inability to breathe. Some HCM owners ignore their cat's pain, crying out, inability to breathe, panting, breathing fast, discomfort, hiding, lack of drinking and eating, etc. And why? Because they think the cat can deal with it, that it will pass, that surly it can't be that serious, and that maybe the cat doesn't need the vet or that it can wait a day or two until the vet is available. And of course, there is the cost of care to consider.
But put it in perspective: the next time your cat is sick, think of it as you would a baby, a child under the age of one. Just how long would you let a baby be in pain, unable to breathe, have a swollen leg, have a fever before seeking medical care? Five minutes? 30 minutes? One hour? If we are not going to let a baby suffer without care then we can't let the cat suffer. Because a cat's body is just about as small, weighs almost the same as a newborn, and cannot sustain illness or injury and rebound on its own anymore than can a baby.
At this point, there was little I could say. Pointing out that the leg was swollen and the kitten possibly feverish and needing the ER wasn't enough to compel the lady to leave NOW for the ER. I didn't think it would work to tell her that by the time she takes it in-say she calls in the a.m. and they say they'll see her at 1 p.m.-the poor kitten would have been suffering, in pain, unable to walk, and possibly feverish for 24 hrs. What person in their right mind lets an animal suffer for 24 hrs?
And it bothered me all the rest of the day. And then it dawned on me-would she let her baby do the same thing? Would she be so calm, so seemingly unconcerned and lacking in a sense of urgency to get care for a baby if a baby were just as sick? Probably not. And that's what I should have asked: how long would you let a baby go with an injured, swollen limb, possibly feverish? 24 hrs? 12 hrs? 5?
Because cats are like babies, and I don't mean because we treat them as our children. They are physically too small to handle what most adults or even children can handle. Constant vomiting and diarrhea-what might be a normal course of illness in a child will weaken and debilitate a cat. A child can take all sorts of meds for such an illness but not a cat. Lethargy, an unwillingness to eat or drink are normal for a sick person. They have reserves in large bodies before needing to see a doctor. But not a cat. One day without food and water and the cat will not rebound on its own without vet care and may have its life in danger. A broken, sprained, swollen and painful limb injury? Who in their right mind would let a child sit around without seeing a doctor? Almost no one I'm sure. A cat would need care immediately as well.
And yet we treat our pets as if they are full grown adults, able to withstand not eating and drinking; withstand fevers; withstand constant vomiting and diarrhea; and withstand the inability to breathe. Some HCM owners ignore their cat's pain, crying out, inability to breathe, panting, breathing fast, discomfort, hiding, lack of drinking and eating, etc. And why? Because they think the cat can deal with it, that it will pass, that surly it can't be that serious, and that maybe the cat doesn't need the vet or that it can wait a day or two until the vet is available. And of course, there is the cost of care to consider.
But put it in perspective: the next time your cat is sick, think of it as you would a baby, a child under the age of one. Just how long would you let a baby be in pain, unable to breathe, have a swollen leg, have a fever before seeking medical care? Five minutes? 30 minutes? One hour? If we are not going to let a baby suffer without care then we can't let the cat suffer. Because a cat's body is just about as small, weighs almost the same as a newborn, and cannot sustain illness or injury and rebound on its own anymore than can a baby.
Monday, May 26, 2014
Feline Heart Meds Website Information
http://www.fvmace.org/FVMA_83rd_Annual_Conference/Proceedings/WHAT'S%20NEW%20IN%20MANAGEMENT%20OF%20CHF.html
http://bigheartsfund.org/resources/cardiac-medications/
http://bigheartsfund.org/resources/cardiac-medications/
Saturday, May 24, 2014
Torsemide and Feline Moderator Band Cardiomyopathy
Cooper's doing better. Breathing rate 10-11. Used the litterbox three times. No gurgles. Handling all that diuretic well. Even ate. His next dose will be 1/4 Torsemide at 8 p.m. and we'll give another 1/4 about 11:30 p.m. We'll see how he does tomorrow but for now we will give 1/2 dose in the morning and take it from there. Thanks for your prayers! What a pain is congestion to get under control. Of all the issues we've ever had with Myrna, she eventually stabilized, and we've had some scary moments with her. But his problem beats all of it. We can't get him to be stable for very long.
Torsemide for Cats May Not Be Working for Cooper Today
Torsemide may not work for Cooper. He was fine yesterday at 8/15 but this a.m. he was at 12/15. Gave 1/4 Torsemide as directed at 8 a.m. but breathing increased. Was at 15/15 by 1. We have another dose before 2 p.m. but then I heard gurgles so we injected him with .3ml lasix. Cardio's on vacation but is able to text. She said the Tor dose and injection together should be fine and to wait to see how quickly it acts. It's been an hour and although he's used the litter box, I'm not sure it's easing the breathing. He may need the ER. Will let you know.
Friday, May 23, 2014
Feline Moderator Band Use of Lasix: Cooper Back to Cardiologist for Oxygen and Lasix Due to Congestion
Cooper has been struggling all week with congestion and we've struggled to figure out the correct dose of lasix needed, timing of doses, and when he needed an injection to overcome the congestion. We communicated daily and sometimes often during the day with the cardiologist to get input. We had a protocol, a method, a process to follow. We knew what to do when, how quickly to respond to an increase in breathing, and how quickly to text the cardiologist to alert her of a new issue. And still, we all struggled to meet his needs.
Katharine Hepburn had an appointment for Thursday due to a gallop murmur (and an earlier post noted the cardiologist heard a mild murmur and saw no signs of heart disease) and Cooper already had the same appointment made in March because this was to be a checkup. But he had just been to the ER a couple weeks prior and everyone expected that he would recover and not need to be seen at this time. But we kept the appointment just in case. Despite recovering from the ER, despite trying a new drug (spironolactone/hydrochlorothiazide) and having it upset his system (nausea, diarrhea) and dropping the drug and bouncing back quickly from it, and despite an even breathing process, and despite controlling for heat, cold, and not allowing him to be in the sun for prolonged periods or in any open window at any time, he still developed congestion. And we couldn't get rid of it.
So, Thursday, Katharine, Cooper, and I went to the cardiologist. They took xrays which showed congestion in the right lung and only slight congestion in the left. They were going to give him a lasix injection but then he suddenly couldn't breathe well and was making gurgling, panic noises.
They put him in the oxygen cage and gave him lasix IV injections. They kept him from 1:30 until 6:30. He quickly responded to the use of oxygen and lasix which was an excellent sign. They weaned him off oxygen and his breathing rate dropped to 8/15, and we finally went home at 7 p.m. As of today, his breathing is still at 8.
The cardiologist has taken him off of lasix and given him a new loop diuretic to try. We will begin using it today. He will get the med twice a day and three times if needed. We will know after a day or two if the med is working to decrease congestion and we will know in 3-5 days if the med does or does not upset his stomach. In between doses, we can give injections as needed, which we would more likely consult with the cardio about the dose before giving an injection. The new drug is called Torsemide. It stays in the body and works in the body longer than furosemide (lasix.) In human patients it is shown to have a greater decrease in recurrence in congestion. But it can also deplete the body of electrolytes via extraction of fluid, leading to many adverse side effects. It can also deplete the kidneys of potassium and can cause stress on the kidneys. We will give 1/4 of a 10mg pill. He will go from 80 to 100 mg of lasix to 5mg of Torsemide a day.
She also suggested we use a potassium supplement called Tumil-K (we will use Sundown potassium, and Gerber baby sweet potatoes also as a potassium source.)
The cardio and I had separately come to the conclusion that trips to the vet were becoming stressful for Cooper and counterproductive-although he needed oxygen and IV lasix this time-and that going forward, Cooper will see the cardio or vet only when necessary and not for checkups.
By the way, they know when he's feeling better when he hisses and growls at them!
Here are her notes:
"Despite continued increases in his cardiac medication doses, Cooper has again relapsed into congestive heart failure. He is receiving extraordinary doses of lasix to try to maintain his comfort in breathing and we are having continued relapses in symptoms. Unfortunately, he did not tolerate hydrochlorothiazide well and that mediation had to be discontinued. I would now like to switch his lasix to a much more potent diuretic called torsemide. Torsemide functions very similarly to lasix. The risks of this medication include kidney failure and electrolyte depletion. The major benefit would be more steady control of Cooper's symptoms. Today's laboratory results indicate that Cooper is an acceptable candidate for this medication. To help prevent excessive potassium depletion, I would like you to begin supplementation with Tumil-K (potassium supplement.)
Katharine Hepburn had an appointment for Thursday due to a gallop murmur (and an earlier post noted the cardiologist heard a mild murmur and saw no signs of heart disease) and Cooper already had the same appointment made in March because this was to be a checkup. But he had just been to the ER a couple weeks prior and everyone expected that he would recover and not need to be seen at this time. But we kept the appointment just in case. Despite recovering from the ER, despite trying a new drug (spironolactone/hydrochlorothiazide) and having it upset his system (nausea, diarrhea) and dropping the drug and bouncing back quickly from it, and despite an even breathing process, and despite controlling for heat, cold, and not allowing him to be in the sun for prolonged periods or in any open window at any time, he still developed congestion. And we couldn't get rid of it.
So, Thursday, Katharine, Cooper, and I went to the cardiologist. They took xrays which showed congestion in the right lung and only slight congestion in the left. They were going to give him a lasix injection but then he suddenly couldn't breathe well and was making gurgling, panic noises.
They put him in the oxygen cage and gave him lasix IV injections. They kept him from 1:30 until 6:30. He quickly responded to the use of oxygen and lasix which was an excellent sign. They weaned him off oxygen and his breathing rate dropped to 8/15, and we finally went home at 7 p.m. As of today, his breathing is still at 8.
The cardiologist has taken him off of lasix and given him a new loop diuretic to try. We will begin using it today. He will get the med twice a day and three times if needed. We will know after a day or two if the med is working to decrease congestion and we will know in 3-5 days if the med does or does not upset his stomach. In between doses, we can give injections as needed, which we would more likely consult with the cardio about the dose before giving an injection. The new drug is called Torsemide. It stays in the body and works in the body longer than furosemide (lasix.) In human patients it is shown to have a greater decrease in recurrence in congestion. But it can also deplete the body of electrolytes via extraction of fluid, leading to many adverse side effects. It can also deplete the kidneys of potassium and can cause stress on the kidneys. We will give 1/4 of a 10mg pill. He will go from 80 to 100 mg of lasix to 5mg of Torsemide a day.
 |
| Cooper at the cardiologist |
She also suggested we use a potassium supplement called Tumil-K (we will use Sundown potassium, and Gerber baby sweet potatoes also as a potassium source.)
The cardio and I had separately come to the conclusion that trips to the vet were becoming stressful for Cooper and counterproductive-although he needed oxygen and IV lasix this time-and that going forward, Cooper will see the cardio or vet only when necessary and not for checkups.
By the way, they know when he's feeling better when he hisses and growls at them!
Here are her notes:
"Despite continued increases in his cardiac medication doses, Cooper has again relapsed into congestive heart failure. He is receiving extraordinary doses of lasix to try to maintain his comfort in breathing and we are having continued relapses in symptoms. Unfortunately, he did not tolerate hydrochlorothiazide well and that mediation had to be discontinued. I would now like to switch his lasix to a much more potent diuretic called torsemide. Torsemide functions very similarly to lasix. The risks of this medication include kidney failure and electrolyte depletion. The major benefit would be more steady control of Cooper's symptoms. Today's laboratory results indicate that Cooper is an acceptable candidate for this medication. To help prevent excessive potassium depletion, I would like you to begin supplementation with Tumil-K (potassium supplement.)
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