9/11- Frosty restrictive cardiomyopathy

http://www.felinediabetes.com/FDMB/...ital-still-poor-appetite.202927/#post-2252219

He was basically in heart failure last night from all the extra fluids, so they did an echo which showed restrictive cardiomyopathy - the worst kind a cat can have. I did a little reading and it says average survival from diagnosis is 2 months.

they are going to tap his chest to get excess fluid out and then will put him on Lasix and another medicine at home that I don’t know bc we don’t use it in humans. I’m concerned about the lasix because he was dehydrated with signs of possible kidney problems when he first came in, so I’m worried it can make that worse.

They wanted to start him on an ace inhibitor, but apparently it interacts with his Vetoryl. So he can’t have both, and both are needed to treat his diseases. There is no alternative medication to give for restrictive cardiomyopathy in cats apparently. Either way, from what I’ve read it doesn’t matter bc there really is nothing we can do to stop it from progressing.

He is also at a high risk of throwing a blood clot which can go to his legs and cause paralysis, or less likely a stroke.

I looked through his old labs and his PSL was high in May, so he did have pancreatitis back then. They said they can do the SNAP FPL test in the hospital, but I’m not sure it’s really going to change anything. I told them just to do it bc it’s like $28.

After they do the thoracentesis tonight I’m going to take him home. I made an appt to follow him up with an IM doctor on Thursday but unfortunately our IM doc is away.

When I called, the response I got from the receptionist was “uhhh well if your doctor wants him to be seen this week, dr Pintar can see him, but he doesn’t know anything about this case.” First of all, a**hole, he’s not a case. He’s a patient or cat or whatever u wanna call him, but not a case. I would never call my patient a case!

And second of all, I asked her, “ so what does that mean? I see patients all the time who I don’t know anything about and I review their record and talk to them and formulate a treatment plan. are u saying he doesn’t feel comfortable seeing him? Bc I can try to call another hospital then .”

She’s like “I never said that he wasn’t comfortable I was just telling you that... and she repeated the same thing over again. She also added that he only had a half hour to see him. UGHHHH

I was like “well then I don’t understand why ur telling me this then. Dr Demarco, his partner, is away. So I can’t see her, right? She has seen frosty many times, I know she has notes about him in his chart. Also my vet is sending you guys some of his records from his hospitalization . And I left a message for dr Pintar earlier today to call me back so I can also fill him in about the case. Is he not going to get good care of him? Does he not feel comfortable treating him? Bc I will take him somewhere else .”

People who can’t think for themselves or have no people skills or empathy SHOULD NOT WORK that job! I really want to talk to the doctor before I bring Frosty in because I truly now do not feel confident that he can help us. But our local vet didn’t want me to wait longer than a few days before seeing an internist, so it’s not like I can wait til our doctor returns. But now he has a laundry list of problems that I am not even sure are all treatable and I need someone to sit down with me and outline some kind of a plan.

This really sucks. I wish dr. Demarco was in town because she would have helped us. This is literally hell.

 

So sorry Ana! No advice, just hugs.

 

I miss the days where I actually cared about his blood sugar. None of that matters anymore. I might as well get rid of all his diabetic supplies bc none of it is gonna prolong his life.

 

@Wendy&Neko has a lot of experience with heart issues. Hopefully she can chime in here.

 

So sorry to hear this. I don't have experience with heart issues, but I wanted to tag @Doodles & Karen to see if she might be able to offer any advice.

 

wish I had answers for you. All I can say is bring him home, fuss over him, love him, keep him happy and comfortable until he tells you otherwise.

 

I guess there aren’t any answers. We are all gonna die right, sigh.

I’m not handling this well

 

I think most cats here have hypertrophic cardiomyopathy because it is common in Acro cats and I’m not sure if it’s common in Maine coons?

I honestly had to look up restrictive bc I never even see it in humans. It’s the worst one a cat can have (of course).

What really sucks is that enalapril which is one of the meds for this type of cardiomyopathy interacts with Vetoryl. Like, really? How do i get a cat with the most care disease (cushing’s) AND the most severe type of heart disease and we can’t even treat both?! Come ON!

I am still kind of mind blown over the fact that he has NO symptoms what so ever if any heart failure before he got pumped a ton of fluid into him.

Cats really do have 9 lives. I just don’t know what to expect from him.

 

Again, I'm no expert, but if they fluid load brought this on, maybe less fluid will keep it at bay. The question I would ask the vet who has been treating him is what to expect in terms of the heart issue with less fluid. It is my understanding you plan to do SQ at home. It would be good to agree on the max daily amount he can handle at home.

 

Ana I’m so sorry you guys are going through all this, sending many healing vines and lots of hugs

 

This sucks.
All I can send is huge hugs.
I hope you get to speak or see with someone sensible very shortly.

 

My heart absolutely goes out to you. I have been where you are at with some of my furkids and it is mind bending and heart wrenching at the same time. It is such bad timing you don't have your vet here...it sounds like you two work well together on getting a plan in place. Hopefully you can just see the replacement for now then circle back to your regular vet to get a long term plan in place.


Wendy and Karen can give some good advice on heart issues and what to watch for.

As for all the diseases thing..you treat the most pressing one. So you treat the heart if that is the one that is most life threatening. Then treat the diabetes. The cushings will have to be one that just sits on the back burner.

 

Cushing’s can’t sit in the corner. Without Vetoryl he had a fructosamine od 1245 and his sugars in 500s, and he has skin tears from which he will die right away, and it is painful. He also couldn’t walk. He HAS to stay on Vetoryl. He gained a pound after being on it for 4 months, and gained strength in his legs it’s not even a negotiation .

He never showed any heart symptoms until he got all this fluid. Either he gets Vetoryl or he tries being on both but he is not stopping Vetoryl. That has been his lifeline this whole time. He would be dead without it.

 

Ana, I am so sorry. If you've read any of my life with cats posts some are about Noah's family; mamma, papa and his three brothers all diagnosed with cardiomyopathy. There are different variations, ours were the ever expanding heart valve kind. It is NOT what took each of them before their time but that sick and helpless feeling in the pit of your stomach brings back painful memories. Right now I want to give you a politically incorrect bear hug and bake you some cookies. Maybe some cheap red wine too.
"Broken heart syndrome may be caused by the heart's reaction to a surge of stress hormones. The condition may also be called takotsubo cardiomyopathy". "The overall in-hospital mortality rate of the 45 patients with both tako-tsubo cardiomyopathy and severe heart failure was 20 percent". Those are human statistics and wildly inaccurate.
Almost everyone, including me, has a story of an elderly relative whose spouse has passed and shortly thereafter they themselves pass.
Now I will sincerely offer you a little rainbow of hope. Noah was diagnosed years ago, our last yellow and white cat, born upstairs. Along with his severe dental issues, an enlarged heart that has torn through the cardiac sac, his love of dog food and cheese, a morbid fear of travelling and the endless staring into the fridge Noah is just, well, Noah. He is 15 years old and has surprised ever medical expert. He doesn't need or want to be poked, prodded or shaved for another ultrasound. Every time we think he'll have a cardiac event in the car he comes back home like the little trooper he is. When we boarded him in May he came back home safe and sound in my arms.
After all you and Frosty have been through maybe some higher power will cut you some slack.
We all care for you Ana and for Frosty as well. Emojis don't quite do it but this is for both of you.

 

I will try to stop in later with something useful to say. I am presuming he will be on Plavix (chlopidogril)? Maybe Vetmedin (pimomedin)? I balanced heart and kidney issues for 7 months.

Cats are very tough. Neko went off her food, with no previous other symptoms, then got the dual heart failure//heart block/small cell lymphoma diagnosis. Why can't they talk! Neko went out of heart failure (also rare but in a good way), once fluids were stopped.

For now, thinking of you. I am busting my DM out of the hospital, more later.

 

Oh Ana, I'm so sorry. I have no experience with heart issues so I have no advice except to take him home and love him.

 

Then you balance the best you can.... The order may be wrong but the idea is the same...deal with the most life threatening first then go from there...

 

I asked about a blood thinner for possible blood clot but they said no. Not sure why. I’ll discuss this further with the IM vet (who doesn’t wanna see us) on Thursday.

 

@Noah & me (GA) Dr. Demarco (his IM doc) was just telling me on Saturday that in her experience with 4! Cushing’s cats, none of them died due to the tumor growing and causing problems. It was always “something else.” So I can’t say that he won’t die from the cardiomyopathy, because this IS his “something else.” I mean, there’s also pancreatitis, possible? Kidney disease, and diabetes... but they can’t all be NOT the thing that kills him. Ya know?

When I first adopted Frosty, I was hoping to give him 5 years. When we heard about Cushing’s, I figured maybe 2. Now I just want him to make it til January to celebrate our 1 year anniversary.

I just brought him home and put him upstairs where he eats. He took a few bites, then ran downstairs to the kitchen and is currently laying on the kitchen floor.

I wish he would come lay on the couch with me. He doesn’t even wanna eat but he’s still hanging out in the kitchen! I don’t understand this cat.

I have now offered him hard boiled eggs, chicken salad, and even some of my pretzel, he didn’t want those. I’m not sure how I’m gonna give him his cerenia and lasix tonight since he’s not eating. Ugh. Thankfully that’s a few hours away...

 

Doodles had advanced HCM and recurring CHF. They told me he had 2 months and with heart meds he lasted a year after the dx. He was on Enalapril (understand Frosty can't have it) and a high dose of Lasix...60mg a day and sometimes more as needed. His kidneys somehow tolerated that large of dose but he was only 8 yrs old. Heart trumps kidneys, it has to. Like others have said, it's possible the fluids caused the CHF and I know of a few kitties here that by stopping the fluids CHF stayed away with a low dose of lasik. Wendy's Neko was one of them. I was in constant contact with Doodles cardiologist and often had to take him in for xrays and echo's. His appy was never great but did get better on the heart meds. They never put him on Plavix or other blood thinners either. It was a constant worry wondering if this was the day. We believe Doodles also developed asthma toward the end so he really was having trouble breathing with coughing etc. I waited until Doodles told me he had enough and helped him cross peacefully. Hopefully you can go see the doctor of choice and get a handle on everything that's going on with your sweet boy.

 

So sorry you and Frosty are having such a tough day. My prayers and thoughts are with you Ana

 

Ana, I am so sorry. There are medications that will help since his kidney values are decent. I wasn’t that lucky and lost Max three days after he was tapped. He had advanced kidney failure by then and couldn’t get lasix. Frosty is a candidate for vetmedin and lasix. I feared this when his breathing was mentioned but he very likely will have quality time left with you. You have options.

 

Sending prayers.

 

Dear Ana, I'm sorry that I don't know anything about Frosty's issues that might be of help, or comfort, to you. But please know that we are thinking positively and hoping that you will get some good advice from the IM vets. Sending many vines and prayers for your boy, and many hugs to you.

 

Hi Ana,
I don't usually write on post's because I feel like a)what do I know? and b)in a weird way I feel like I'm intruding on your privacy.
I'm so very sorry for your heartache, you are doing everything you can to do what's best for your baby. Unlike you I am not in the medical profession but I have had a much loved cat with a heart condition. Our baby TG (Tough Guy) lost an eye in an accident and we took him home being told that minus the eye-he would live a normal life. That night his lungs filled with fluid and he was essentially drowning. The ER gave him a large dose of Frusemide to empty his lungs, oxygen tent and a diagnosis of congestive heart failure, they gave him a 10% chance of making it through the night, so suggested we 'let him go'. A week in the hospital and his regular vet released him saying we might have 3 days, 3 weeks or if very lucky 3 months with him but that was about it. We took him home and loved him to bits, appreciating every day. He went from an active cat to a much quieter life because he exhausted easily. We had a couple of close calls with him (when my daughter rescued a kitten who REALLY wanted to PLAY (enter Tucker)) and his lungs would fill up. TG didn't have a complicated history of medical challenges but as long as his lungs were kept clear using the diuretic he had a decent quality of life. I just wanted to share this with you because those 3 days? They turned into 5 years. I did have to help him cross the bridge at the end and it was broke my heart, but I'm glad we gave him those extra years when the ER told us we should let him go. I hope Frosty also surprises everyone, but just remember that you are doing everything you can and Frosty knows that.

 

I don't have advice for you Ana. I have been following you and Frosty since day 1. You are in my thoughts and I hope you can spend some quality time with Frosty and make him feel better. You have given him a loving and comfortable home, when he was going to die in the snow. In his soul, he knows you are doing your best.

 

, Ana.

Don’t give up hope....our babies are little fighters and I’m sure he wants to make the anniversary mark with you as well.

 

Another late night thought - is there a cardiologist at the vet hospital? Neko's IM vet was good, but got the cardio vet (my Dr. Marco) involved in decisions about treatment and medications involving the heart. Heart issues can make them nauseous, having Cerenia or ondansetron may help his appetite. Maybe even both, they target different nausea receptors.

Sending healing vines for Frosty.

 

Hi Ana ...if Frosty is not eating...it likely means he is in big trouble...heart disease can cause severe nausea....I know this from experience as do many ppl here who have answered you...my biggest worry for you and Frosty is that his heart condition may cause him to throw a clot which can result in an extremely painful condition called arterial thrombosis...I think that is the name...meaning a pulmonary embolism thrown from Frosty's heart which can lodge itself in the artery that leads to his back legs...this would be very painful...it might be prudent for you to have buprenephrine on hand should this happen...a strong injectable painkiller that could alleviate some of Frosty's pain until you can get him straight to an ER ...should Frosty begin showing signs of extreme pain (they will be obvious) ..it is imperative that you have a very strong painkiller on hand ...I say this not to ALARM you but to keep you prepared in case of this particular emergency so as to reduce Frosty's suffering and of course as his loving mama ...yours....Allison

 

Alarm wouldn’t quite cover the sheer panic im feeling after reading this. I know about the risk, and I do have bupe but I’m out for work 12 hours a day. Now I can’t breathe myself bc I’m thinking of him possibly being in pain while I’m at work.

 

I’ll talk to them about it tomorrow. I’m sure they have a cardiologist. I’m just worried they will want to put him on enalapril instead of the Vetoryl. That’s not gonna work. Our local vet agreed that Vetoryl is an important piece of his plan and she felt the most important part of the cardiac treatment is lasix and that other med I can’t remember.

I can’t feel my legs though right now thinking about him having a possible clot in his legs. I just can’t

 

Those of you with experience with feline cardiomyopathy- do you know why they don’t put cats on anticoagulation?

Also, I wonder if i should give him enalapril for NOW to see if his heart function improves, and if it does then stop it and start Vetoryl? Or give them every other day? Idk. I gotta pick this doctors brain tomorrow.

I honestly almost brought frosty in their ER overnight bc his breathing looked bad at around 4 am. I slept another 2 hours and he looked better this morning. I gave him his lasix and I see him walking around in the room now. He even jumped up on the window and watched me leave for work, and then jumped down to greet the pet sitter who came to check on him. He ate a bunch of treats from me overnight and this morning but didn’t want his FF.

While I slept though I had horrible dreams of taking frosty to the vet and telling everyone to say goodbye to him bc i didn’t know if it was gonna be the end. In my dream my dad was yelling at me for adopting a sick cat bc what did I think was gonna happen. Totally realistic too. I probably feel him judging me from afar

 

Regarding pets and "It's always something". After losing eight cats and a dog along with poking, prodding, ultrasounds, needle biopsies, enemas and plain old misdiagnosis we finally got the last piece of news about Noah. All his teeth needed to come out but there was only a 10% chance he would survive general anesthesia. We love our vet but after all we've been through she almost seemed flippant when she said "If I were you guys I would go for it". It's not a $2 lottery ticket!
There is no cure for Noah's ailments. I should be giving him ASA but he reacts so badly I'm literally afraid he'll have a cardiac event scruffing him and pinning him down to force the oral meds into him. I'm not exaggerating when I say his transdermal BUPE prolonged if not saved his life.
Ana, I know I'm way over here and I wouldn't dare put my hand on your shoulder and tell you either "Everything will be fine" or "You'll know what to do". If things look really bad there is the option of just taking him home and medicating him, even if he's not in pain, so that he may calm down and be a bit less aware of his physical symptoms. When we rushed Zoe from our regular vet to emergency she was given a moderate dose of morphine because she was panicking. That was made worse when we were sent on our way with an oxygen bottle and mask.
I'm not qualified to advise this but you could set up a small oxygen tent for Frosty. A simple note from your vet and a sheet of plastic over a large carrier is all it takes. It may not help long term but it can't hurt and it's your right to ask.
I'm here for you Ana and for Frosty too. We all are.
From me, Cynthia and all the boys.

 

Sorry for the double post and I know I've said this before.
Noah's teeth were the last in a long list of his problems and that was years ago. Things are not as good as they could be but he eats, no bowel problems and the BUPE doesn't interfere with is vision, balance or interaction with the other cats or the dog. He's not stoned, he's pain free and I've even seen him picking at the dog's kibble. He is behind on blood panel work but our vet trusts us and Noah trusts us. Tickling his ears with BUPE is now the worst part of his day.
Why companies develop pain medication then have doctors fearful to use bothers me greatly.

 

love light and healing

 

I’m so glad you posted, obviously you know a lot, and no intrusion at all. I am posting to get some info from people who have gone through this.

Did your cat ever need to have fluid drained from his lungs or belly, or did the lasix take care of it? If it was the lasix, how long did it take for the fluid to even out and the breathing to get better?

Interestingly, none of the vets have proposed possibly putting him down. I don’t even care about the money as much as I care about doing the right thing. Right now he’s still obviously having trouble breathing which really worries me. I hope that tomorrow the doctor can adjust his medicine, or we can get a cardiologist involved if needed.

If he gets worse in the meantime, I’m gonna have to take him to the big hospital with the EM doc emergently. That’s my backup plan. But I don’t wanna torture him either if he isn’t recovering. I want him to recover and be comfortable, but I just don’t know which way this is going to go.

It sucks that I’m at work right now and can’t keep an eye on him. We have the nest camera set up, but he must be sleeping under the desk because I can’t see him. this really sucks.

 

Hi There. I'm so sorry you are going through all of this and have had to go to work, you must be so distracted. I know what you mean by the struggle to breathe, it is very upsetting! When TG got too stressed (Tucker chasing him or when he was put in the car) he would open mouth breathe and it freaked me out. He had 4 or 5 'events' that sent him off kilter over the years the required a trip to the ER. He would get admitted to an oxygen tent and be given a higher dose of the lasix than we were ever allowed to give him at home. Those were the only things they ever did for him and once his breathing improved he would be allowed to come home. At one point about a year before we lost him he was dragging his head and weaving when he walked. I was super scared and rang the vet in the wee hours of the morning, waking her up. She said to crush up a potassium tablet and get it into him because the lasix can deplete that level. Within a few hours he had righted himself. We didn't have any trouble with his kidneys so if he did have a bit more fluid in his lungs and was breathing hard, I gave him an extra squirt of lasix to clear his lungs. Frosty is very lucky to have you, you are his best advocate and friend.

 

It is an ongoing moving target sometimes with the Lasix or other meds. You can monitor by counting his resting rate when he's sleeping. If more than 40 breaths per minute there's an issue. I counted Doodles RR at least 3 times a day and kept good records. We didn't run off to the ER unless I got multiple readings in the 50's but would often make a call to the cardiologist, take him for an xray and adjust meds. At times we'd dose the Lasix every 8 hrs for 3 days to knock down the fluid but some need their chest tapped. I think once you see the appropriate vet you'll get a better picture of what the best course is for you and Frosty.

It can deplete potassium but I would only add under your vets care. Electrolyte levels should be monitored through BW regularly when on these meds. Glad it help your boy but one must be careful not to jump the gun unless directed by the vet/ cardiologist. Also, typically if a cat is eating enough the potassium levels will be fine especially on a low dose of lasik but again ECID of course. Since Doodles was on 60mg-90mg a day they had no idea why his kidneys tolerated and his electrolytes remained normal. We believe he became Lasik resistant just like he became insulin resistant.

 

I am of no help, but just to let you know, I am sure each and every one of us know that awful ache right in the pit of your stomach, you are going through. We are here.

 

Yes, frosty is already getting K supplements because his levels were very low while he was in the hospital.

He is also on Cerenia 1/2 pill daily

Plus lasix BID plus that other heart med that’s not enalapril, I’ll never learn it’s name (there’s no comparable meds in humans)

He’s off his Vetoryl right now which makes me worry because cushing’s will also drop his k levels.

I hope they check his kidney function and electrolyte levels tomorrow at the vet.

I’m worried about the condition I’m gonna find him in when I get home tonight. I really hope he’s doing better. I appreciate the advice about counting his breaths - I knew 20-30 is normal for cats but didn’t realize that up to 40 is ok under certain circumstances. I’ll try to count tonight and I’ll also try to weigh him so I can track if he’s losing fluid or not. I also have him confined to one room so i can track how much he has peed.

The pet sitter came by twice today to check on him, and both times he greeted her and was affectionate. He nibbled on the food a few times but hasn’t made any significant progress. I’m happy he’s at least eating a mouthful here and there, that is such a relief so we aren’t worried about his liver being in jeopardy.

The pet sitter said his breathing didn’t look abnormal and he looked comfortable. I don’t know if I’m just overly paranoid? He definitely looked like he was short of breath to me and working to breath. But at the same time, the vet did discharge him ... so he can’t be that bad? Maybe I’m comparing him to a human patient? I don’t even know. It doesn’t look normal to me for sure. I REALLY hope that maybe he’s getting better. I just want him to pull through this. UGH.

Yeah the feeling in my stomach is nauseating. I’m one of those people who can’t eat when they’re upset or stressed so i just feel sick. I wanna go home and cuddle on the floor next to my fur baby.

 

A pain free cat is not necessarily a happy cat but pain affects so many things and can certainly affect appetite, then metabolism, then proper digestion of meds.
This is Noah's BUPE. "Bupernorphine 0.16mg/0.1ml TD. Apply 0.05ml every 12 hours".
It comes from a compounding pharmacy so some advance notice is needed. It's the consistency of toothpaste in an easy to measure syringe and is applied to the inner ear on the backside of the supplied tiny "spoons". There is a waxy buildup so alternate ears and just clean the ears with a damp paper towel. I'm supposed to wear latex gloves but I don't. You can vary the dose to 3 or 4 times a day as long as the daily dose remains the same. No refrigeration necessary and roughly a 3 month expiration date.
Be kind to yourself Ana. You need to be healthy to take care of a cat. I wish I had more for you, not feeling so hot myself.

 

Everyone here on the board is sending prayers and hugs...if not good advice...we're all thinking of you and Frosty.

 

ECID in respiratory rate. Neko was getting into distress over 26 breathes per minute. I knew what "normal" was for her, high teens, low 20's and anything out of that range set off my alarm. Course she had bradycardia and second degree heart block to complicate things, IM vet had put her back on a tiny amount of fluids every other day, so I was on alarm mode, turned out they drained something like 150 ml from her. And in the process, poked a hole in her lungs and she had air in the chest. Back to ER from home and 2.5 days in an oxygen tent. She got bolus shots of Lasix, cause her kidneys could not take anything but tiny amounts every other day. Her kidneys were already iffy before the heart issues started. In spite of all this, she was affectionate when I reached in the oxygen tent and we gave each other eye kisses. She came home to no more fluids ever.

I had a previous kitty that had a stromboembolism two days before his echocardiogram. Misdiagnosed at first by not the regular vet. Sent home in pain until the next day. We made the tough decision that day. Now I always want Plavix. Don't want to see that again.

How much Cerenia is he on? What does Frosty weigh? Pills come in different sizes. Vet's seem to really underdose the nausea meds. One of my greatest regrets, found out later I could have substantially increased the dose of both the Cerenia and the ondansetron.

Neko was not on enalapril, but rather already on benazapril for her kidneys. It did double duty for the heart.

I hope by reading these stories you realize that no two are the same. Frosty may be like none of these or some of these. You are doing the right thing by becoming educated on kitty heart issues. I still have the voice recordings of my sessions with Neko's cardiologist.

Above all, there is hope and love going your way.

 

You have a hug Ana and make sure you take care of you so you can continue the wonderful love and care you give your Frosty.

 

Ana, I don't know what led me to look in on the forum today. And I know you don't know me at all, but having recently lost my girl to an unusual heart condition, I felt I had to add at least a few comments to try to help you figure all this out.

Generally, they do if there's a clot risk. I'm not sure why they're not doing that for Frosty. Are they maybe worried that if there's a skin tear from the Cushing's it will cause excessive bleeding?

The one with no comparable human equivalent is pimobendan (Vetmedin). It's commonly used for heart disease in both cats and dogs and supports the contractility of the heart muscle.

My Regan had ARVC (also incredibly rare in cats, although rather more common in dogs and also extremely serious - that is what she died from). She also had Bowen's disease (also very rare in cats). Trust me - I'm convinced that some of us get the super-special ones because they choose us to take care of them because they know we can and will. She could not take enalapril - we tried her with it but it dropped her blood pressure life-threateningly low in the first 24 hours and we never dared to put her back on it as it took 4 days of hospitalization to get her stable enough to come home. However, despite the dire warnings from the ER that she probably only had 24 hours left, she had 4 good months at home. No, of course it wasn't enough - but it was more time than we'd dared hope for and for that I'm grateful. So if 24 hours can turn into 4 months, 2 months could turn into quite a long time yet.

Regan had fluid drained twice. Once when she was first diagnosed (her condition had previously been thought to be non-problematic VPCs and she was only diagnosed after she went into CHF). And again a second time about a week later while her lasix dose was still being calibrated. Lasix alone is pretty good at clearing fluid inside the lungs, but if the fluid is in the chest cavity and there is a substantial amount, then it usually has to be physically drained. Once the fluid is gone, lasix is pretty good at keeping it down once you find the right dose (which doesn't always happen at the first attempt).

The level of supplementation may well need to be increased to offset the potassium loss from the lasix. You will want to re-check the level after about a week or so on lasix, and again fairly regularly after that especially after any lasix dose changes.

Regan also could not go safely above 26. Her rate wasn't above 35 at rest on either of the occasions she had fluid drained. The only real answer is to learn the "normal" for Frosty and know that if he goes higher than that, you may need to give extra lasix and/or get him to the vet (an extra lasix dose can often buy you the time to get to the vet if a cat is in CHF-induced respiratory distress).

General advice - heart disease takes priority over kidneys, diabetes and just about anything else. The exception I would make to that, as you've already mentioned, is the Vetoryl for Cushing's as a skin tear can prove fatal just as quickly as heart disease. When Regan had her low blood pressure incident, she went into AKI. Her creatinine was over 11 at one point - from a cat that had always had the kidney values you'd expect from a young adult cat, even at 15 years old. It came back down within about 3 or 4 days, back to her usual 0.8-1.0. With the high doses of lasix she needed, it went back up a couple of weeks later to 1.5. I had a long discussion with our vet about it and they confirmed my feeling that lack of ability to breathe will take a cat out much, much faster than cumulative kidney damage. I know kidneys are always a concern with cats, but with the sort of diagnosis you've just received, I would be significantly less concerned about kidneys than heart.

You're already dealing with so very much for Frosty that this just feels so unfair - I do understand and sympathize with you. But remember, Frosty chose you because he knows you're strong. He knows you will fight for him every step of the way. He trusts you to advocate for him with the vets and to do everything you possibly can to maintain his quality of life for as long as possible. And just from reading your comments, I know his trust is well-placed.

 

That receptionist was rude and not taking account that it was a REAL PERSON on the other line. You hit the nail on the head when you said no empathy. Ugh.....

I am so sorry you are going through this. This really sucks. I hope those meds he will be on, and removing the extra fluids will at least help with pain and appetite? I just hope he becomes comfortable at some point, and will definitely feel better once he is at home. Try to take it one day at a time the best you can... although I know first hand that is way easier said than done. So lets make it, hour by hour. Much love to you, Ana.

 

well said <3 <3