Concerned Venting

I haven't been on here lately, I apologize for not contributing more. Molly hasn't been doing well.

About 3-4 weeks ago, I noticed she would lie down on the floor and breathe rapidly (no panting) she would wag her tail aggressively, and then settle down for a bit. Sometimes she would jump in the bed with me in the morning, making sure to have her back against my leg, and she would do it again.

At first I thought it was a combination of being hot and constipated and thus uncomfortable. By the 3rd day I was really worried and luckily my boyfriend was off from work and we could help me take her to the vet (the vet was 30 mins away and my car doesn't have AC) They did bloodwork, but didn't notice anything wrong with her breathing. She suggested chest x-ray but It was expensive and I wanted to see if the bloodwork could help us. The next day they called me and told me that Molly had elevated kidney values, suggested a low phosphorous diet, and recommended we come back for a urinalysis. The urinalysis confirmed that molly did not have any signs of infection, and the vet recommended an ultrasound. The vet also did a fructosamine and saw that Molly's BG was running low - so they advised me to reduce the insulin down to 1 unit per day.

She was acting pretty slow and hiding with the reduction and food change, and after some low numbers I reduce her dose down to .75 units. At this point I decided it would be best to find a closer vet - we had moved back in February but I still continued going there because I really liked them. We now go to a vet that is within walking distance.

I scheduled an ultrasound with the new vet and they confirmed she had mild kidney disease. They also didn't notice anything wrong with Molly's breathing, but checked her blood pressure for hypertension and her levels were all within healthy range. I accepted that and hoped that maybe her new diet would make her feel better.

She had 2 really good days in a row where she was acting like herself, eating normally, following me around, just being the great affectionate kitty I love so so much. But they she started having breathing problems again, being more withdrawn, hiding, barely talking to me. My boyfriend noticed two days again when she was walking to "fun time" (test, dinner, and insulin time) that she had a slight limp. I was absolutely concerned about that but with her current BG numbers it didn't seem like neuropathy. I thought maybe she had slept awkwardly or hurt it jumping.

The next day (yesterday) she is still limping (but only occasionally - not every time she walks, although she is barely walking) hiding, and just seeming generally unwell. I called the vet and explained everything - at first they suggested a chest X-RAY and a closer examination of her hind legs, but then they decided that I should do a curve. They we bring Molly in for a quick wellness check and to compare my monitor to theirs, they again did not notice anything wrong with her breathing. They told me to call if it gets worse.

It was worse today. It breaks my heart that she is feeling so bad and I feel like nothing I do can help her. I noticed this morning that her meow was raspy. She ate maybe half of her breakfast on her own. She would not come out from under the bed, even with her favorite treats. She makes small jumps occasionally but it seems like her back legs are in pain. I had to spoon feed her the rest of her breakfast. It almost seems like its hard for her to keep her head up. I called the vet again explaining how unwell Molly seems, how her numbers today were higher than they have been in months, and I asked if we could do more testing. They asked if I wanted to drop her off for another BG curve tomorrow! I am waiting for the vet to call me back now.

I am thinking it could be low potassium levels? that is a best case scenario at this point.

I just needed to vent and talk about this. I am so sad and I worry that I am losing her and there is nothing I can do to help. I am sorry for the long read, if anyone has been through something similar or has any advice or really anything to add at all, please let me know.


Thank you for reading

Here are some videos of her

https://photos.app.goo.gl/7WKMmRdo4nFjEmJo8

 

The breathing issue makes me think you should have done the X-ray t see if she has an enlarged heart. Do you have or can you get and post a copy of her labs. You can test at home so don’t waste your money on a curve. Sorry she is not well.

 

Thank you for your response
I will ask for a copy of her labs once the vet gets back to me. I was thinking the same thing about the curve! I think I will ask for the chest x ray and perhaps more labs.

 

Count her respiration while she is sleeping or at least at rest. I suspected Max had an issue but was told Max was okay. It turned out he did have CHF and by the time he was diagnosed CKD had advanced despite many sets of labs and vet visits. My vet actually was suspicious like I was but the radiologist who examined the X-rays was wrong. Any coughing? It sometimes happens but not so much with cats as with dogs.
Tell them to email the labs. I just looked at your ss. No curve needed. FD is not the reason for this I’m pretty sure.

 

I agree 100% with tiffmaxee having just gone through similar issues with Minnie. The X-ray should show if there’s an enlarged heart, cardiomyopathy or any other heart issue. If it does, and electrocardiogram would be advisable.

Do you know how to count the resting breathing rate? Wait till she’s been asleep for at least 15 minutes then count for 15 seconds and multiply the number you get by 4 to get the per minute rate. It should be between 20-30. Minnie’s was over 30 so I rushed her to the vet and they had to give her oxygen and did all the mentioned tests.

Sending good thoughts and keep us posted!

 

I have no advice but wanted to send positives and prayers for Molly. My Waldo had RCM and with proper medicine lived anther 2 years. Keeping you both in thought and prayer.
jeanne

 

I counted her respiration and it was 12 breaths in 15 seconds so... not good - although I'm not sure if I would consider it to be resting. No coughing at all. The vet called me back and we discussed her diabetes, she thinks Molly is going into remission and I should reduce or eliminate her insulin and see how she does. The vet also said that she didn't see any clinical signs and saw nothing with her labs that would cause her breathing, and of course I forgot to ask her. They are closed now. She seems to think all of Molly's issues are due to having low blood sugar. I mentioned a chest X-ray and the vet made it seem like it wouldn't be necessary. Should I try to get her seen tomorrow?

 

I haven't caught her sleeping since she has only been sleeping under the bed. I counted breathing rate a few minutes ago and it was 12 breaths in 15 seconds. The vet didn't seem to think that a chest x-ray is necessary. Should I call and make her an appointment for a chest x-ray tomorrow? Should I see an emergency vet? She came out from under the bed on her own and is sitting on her recliner now, it makes me feel a little better that she came out to say hello.

Thank you for your thoughts and advice

 

Thank you so much. I am hoping whatever she has can be treated.

 

I would have never known Waldo had RCM without a chest xray. If its the cost thats stopping you I totally understand otherwise I cant see what an xray would hurt.

 

She seems to be sleeping or attempting to sleep and I counted 9 breaths in 15 seconds. Definitely not good, but better than before.

 

BTW Molly sure is a cutie pie.

 

I really hope the vet is able to squeeze her in tomorrow

 

We all do.

 

Thank you She is the sweetest girl

 

Awwwwwwwwwwww look at those eyes...

 

Normal respiration is 20-40 do that sounds good. I wouldn’t rush her in but would keep an eye on it. Rent vet to check when sleeping or totally relaxed.
As for remission let me look at the ss again. Be right back.

 

You are jumping around with the dose too much. I don’t think she’s ready to stop insulin. The dose is based on his lie it takes her and not the preshot. I’d stick with .75 and grab some mud cycle tests like you gave been doing. A drop under 50 would call fir a reduction. She’s adorable.
What do you think.?

 

The vet wanted me to stop or reduce to .5 tonight and I agreed with her initially but it just didn't feel right, I know I am jumping around too much with the numbers. I felt that it would not benefit her to stop right now I gave her and so I gave her .5 with dinner. It is a little weird to me to see how high today's numbers were compared to how they have been - and its after today's numbers she wants to lower the dose. I know I need to get her chest X-Rays.

 

So stick with the .50 for 6 cycles unless she drops under 50 and see how she does. You can always go back up if she’s too high. What do you think?

 

You said she’s not panting, right? I guess it’s up to what you’re comfortable with since you know her best. And your finances as well. I myself would have a hard time sleeping not knowing if her breathing would get worse. That’s what happened with Minnie the second time and I took her in to the vet who squeezed me in. The first time she was panting so clearly couldn’t breathe and I rushed her to the ER at 3 am. An X-ray is the basic test you should run to rule out basic heart and lung issues that could be causing the breathing problem. I don’t understand why your vet would not think that’s necessary, but then again we’ve seen our share of not so great vets around here. I’m sorry I’m not answering your question but the only thing I can do is tell you what I would do

 

I’m sorry but normal resting breathing rate that is consistently above 30 is abnormal. I’m sadly an expert now and I’ve had that conversation with my internal medicine vet many times, especially after the second rushed visit. I’d definitely have the X-ray done tomorrow.

 

Thanks for catching my typo. I meant to write 30.

 

That sounds like a good idea. Thank you!

 

You know I have had a hard time sleeping worrying about her im worried about the cost of the emergency vet being even more expensive. no she is not panting at all, she panted very briefly after we got back from the vet tomorrow but we walked back home in 90 degree weather. I put her in an air conditioned room with lots of water and she stopped quickly. Two different vets said they didn't notice a breathing problem when they examined her (both multiple times). One said it could be anxiety - but if it was anxiety I think it would be worse at the vet if anything! And they both initially recommended chest x-rays before focusing on other issues.

I have to be assertive when I call in the morning! I have to go to work my 2nd job (to afford Molly's needs at this point lol) but I can drop her off in the morning and have my sister or boyfriend pick her up when she's finished.

 

Phew... if anyone knows about typos it’s me ha!

 

How is Molly doing today?

 

Not well. The vet was able to do chest x Ray's today even though they usually dont do it on the weekends and I am grateful for that.

Molly has a moderate enlarged heart and a few other possible conditions I can't recall at the moment, the vet is sending her home with a copy of the results but I'm not with her at the moment they recommended a echocardigram which I would like to do, but the vet bills are really adding up and I don't how much more I can afford.

The vet was able to get a closer look at her teeth and noticed she had a front canine that wiggled and looked like it was infected and had an abscess (these aren't the formal words and I apologize - I was very emotional on the phone call) she prescribed molly antibiotics and a pain reliever. We are going to start taking them tonight and on wednesday we are going to evaluate her condition and decide where to go from here.

I am a wreck. I feel so bad for molly and I wish I could have intervened earlier. I just want her to be comfortable. I'm not ready to lose her.

 

Awwwwww sending positives and prayers for Molly.
You sound like you could use some chocolate. This takes a toll on hoomans too. Wednesday seems like miles away sigh

 

An electro would be the next step after the X-ray to try to determine the reason for the enlarged heart. There are meds that she can go on for that too. Minnie is on one of them called pimobedan that works on the heart muscles. I’m very sorry to heart that, but the abnormal breathing does usually point towards a heart issue. Did he give her oxygen while she was there? Any fluids in the heart in the X-ray?

The good news is that the tooth can be removed but it may be tricky with the heart issue. I’m not sure what your financial situation is, but I did wreck up quite a debt with Minnie this year. One thing that did help was opening a Care Credit line to pay for all the vet bills and it gives me a year to pay back with no interest. Just thought I’d mention it.

sending good thoughts and if you want to post any of the results, I’m sure there will be members here who can help you interpret them

 

I’m glad you did the X-ray. Are the kidney values still sooner high? The echo really needs to be done as giving fluids would be a big issue. While waiting and deciding next steps try to add as muchwater
as she will take in her food. I’m so sorry.

 

I was about to say that. The furosemide Minnie is on is the diuretic that saved her life with the cardiomyopathy. My vet prescribed it right away before the electro. It may be worth asking about it because you could start giving it to her at home. It’s either in pill or liquid form. I get Minnie’s 60ml bottle from CVS and it’s $8.99. It makes her drink a ton and pee a ton so the fluids are pulled away from the heart

 

By the time Max was diagnosed it was too dangerous for him to get furosemide because of his kidneys. I would not start it without an echo.

 

Has blood pressure been measured?

 

How is Molly doing today?

 

Sorry for the late reply! She is doing much better with the antibiotics and pain reliever. She is eating and not hiding as much, as well as following me around and some meowing at me like she usually does I have counted her breathing and it is still high, but lower than before (an average of ~32 breaths per minute I am estimating) She is plopping down less and is much more active, and it seems like she is sleeping better. I know we have a long way to go but it makes me happy to see her doing better.

 

Once Molly has finished her course of antibiotics we are going to schedule an echo, The vet did not mention giving her oxygen, and I don't think there was fluid in the heart but there might have been some in the lungs. will copy what the results say:

"
FINDINGS:
The cardiac silhouette is moderately to severely enlarged given patient age, and is particularly wide on the ventrodorsal projection. The pulmonary vessels are unremarkable without evidence of distention. A mild diffuse unstructured interstitial pattern is present throughout the lungs. Moderate pericardial fat is present ventral to the cardiac silhouette on the lateral projections. The trachea is unremarkable with no evidence of narrowing. There is no evidence of pleural effusion.

Small round mineral opactities are present adjacent to the caudal aspect of each scapula glenoid, consistent with ununited separate center of ossification.

The cranial abdominal structures within the field of view are unremarkable.


CONCLUSIONS:
1. cardiomyopathy indicative of acquired cardiomyopathy, in cats the most common cardiomyopathy include hypertrophy, restrictive, and undifferentiated.

2. The diffuse increased opacity throughout the the lungs is likely at least partially secondary to underexposure, however pulmonary edema indicative of left heart failure cannot be excluded. Pulmonary fibrosis (which can lead to pulmonary hypertension) also cannot be excluded. "

I did actually open a care credit account as soon as the vet suggested kidney disease. It is getting quite expensive but I'm going to do everything I can. The vet also mentioned that removing the tooth may not be a good idea right now until we can get more information on her heart.

Thank you for your help

 

Yes blood pressure has been measured and is within normal ranges.

 

I am definitely concerned about treating one thing and worsening another whatever makes Molly comfortable and can extend her quality of life is what i'm looking for at this point. From my understanding Molly is still in the early stages of kidney disease.
I'm not sure exactly how to interpret these numbers (aside from glucose) but I hope someone here can help:
"Today's Abnormals are:
ALB 4.4 (range 2.2-4.4)
GLU 168
BUN 36 (range 10-30)
Cre 3 (range 0.3-2.1)

 

I've already been adding lots of water to her food with miralax but I think she can handle some more, especially with her tooth. I bought her a fountin as her last vet suggested to encourage water intake but she has no interest in it! I will probably just give that one to my parents' cats.

 

I wouldnt get rid od that "Fountain" too soon. Let it become part of the fabric of the house. Zoe absolutely ignored her water bowl for years. Now all of a sudden I'v caught her talking some drinks. In other words let it grow on her. jmuo

 

Great news Jackie! The tooth was probably painful and it’s what was making her not eat

you’re right the heart rate seems on the okay side and I’m happy you’re going to do the echo. Cardiomyopathy is what Minnie has and it’s treatable with the 2 meds I mentioned so maybe ask your vet about them next time you talk.

I’m not an expert on the lab works but tagging @Marje and Gracie understands that language better. There’s a tab for lab works in the spreadsheet so if you want to add that in we can then all see it anytime.

Keep us posted and I’ll continue sending positive healing thoughts to Molly

PS - I totally get it. I don’t even want to think about how I’m paying the care credit back

 

Tagging @Wendy&Neko for you. Wendy, please read post #37 regarding cardiac findings. ty

 

It looks like kidney disease stage 2 or early 3 BUT it could be better when retested after everything else settles down. My vet never relies on one set of labs. It sounds like she’s feeling better which is always a good sign and willingness to eat is a good indicator.

 

Thank you Red!

 

When I first got the fountain she was scared of it, she wouldn't eat near it and actually jumped when she got to close! She is getting used to it but I don't think she realizes she can drink from it

 

Yes I am hoping the stress of all the things that she is going through is increasing her levels, poor Molly

 

She still takes some "bribing" If she doesn't finish her food I put some on a spoon and she seems to want to lick it off of the spoon (or the floor..or my computer.. or the rug ) I am really hoping it is something treatable! I wish we didn't have to wait to be diagnosed, I will continue to post about her condition. I really appreciate all of the support

I am trying not to think about my balance on carecredit right now either! I am worried enough about Moll haha

 

If she acts or seems to be nauseated, post here because there are anti nausea meds that help. Minnie was on it for 2 years and it’s the only way she would eat. Also, with the antibiotics probiotics are important to replenish the good bacteria in the gut so she doesn’t feel like not eating.

Take the victories, one day at a time my friend!

 

Bobo will only drink from the water fountain in the kitchen and will not touch any of the water bowls I have for Minnie inside and outside. I mean he’ll come back up and inside to drink from the fountain instead of going for his sister’s bowl that is 2 steps from him

 

I had to balance heart and kidneys for a while with Neko. For the longest time it was just mild hypertrophic cardiomyopathy, and mild kidney disease and I didn't do anything but make sure food was low phosphorus and add plenty of water to the food. Then the kidneys got worse, the vet suggested adding fluids, which led to a heart failure incident and a heart block/myocarditis diagnosis. The main symptom was lack of appetite. At the same time she got a small cell lymphoma diagnosis, but I digress. That just a added an abdominal ultrasound to the bill with the echocardiogram. Treating the heart without damaging kidneys or vice versa, is a balancing act. Heart beats kidneys - always. Neko went on pimomedan (Vetmedin) and chlopidogrel (Plavix) for her heart. She was already on benazapril for her kidneys - sometimes heart diagnosis get that too. With luck and a strong willed cat, Neko got over her heart incident. The vets were amazed. Fluids were completely stopped.

At this point I had an internal medicine vet and cardiologist vet working tag team to find the right combination to balance heart and kidneys. We did try adding a very small amount of fluids back after several months, and unfortunately got another failure incident. Which I found out at home by seeing her resting heart rate (doesn't have to be sleeping), went from 20-22 to 26. It was that subtle a change. She did get some bolus Lasix (furosemide) at the vet, and a micro dose to go home with. It helped the heart, hurt the kidneys.

Sorry for the long story - I am glad you are getting an echo, hopefully buy someone with a cardiology specialty. It makes a big difference.

 

Minnie is on all those heart meds too, but she doesn’t have the kidney issues which I’m sure explain the high doses of furosimide for the last month or so.

thank you Wendy! I’m sure she’ll feel better hearing that it’s manageable

 

I would need to see her entire panel to tell you anything on the labs but, if her creatinine is 3, it’s way too soon to start fluids even in a cat with no heart issues.

It is definitely a balancing act between heart and kidneys and you might find that you will not be able to give her fluids at home even as her CKD progresses. Just keep adding water to her food and making water available to her to let her keep up as much as she can on her own.