Question on HCM diagnosis

hvcubed

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This may be kind of a long story, but I wanted to see if anyone has ever had a similar issue with their cat. Our two and a half year old generic tabby cat was recently diagnosed with hypertrophic cardiomyopathy (enlarged heart). To start at the beginning, I left for work on a Friday morning, came home late Friday night and couldn't find the cat. I eventually figured out she was hiding under the bed, which she does occasionally, and also saw a full litter box. I didn't think anything of it since she was fine when I left in the morning and went to sleep. The next day I get up and she's sitting in my bathroom just staring off into space. I chalked it up to just her odd behavior and let her be. Later in the day I noticed heavy abdominal breathing. Her normal vet was closed for the day, so I just kept an eye on her. About 11pm that night, I see that she's flaring her nostrils while she breaths and call a 24hr vet. The vet says that she should be okay through the night and I can bring her in in the morning.

Since her normal vet is closed Sundays, I called her backup vet that we use. Once I described her symptoms, they said to bring her in immediately. The vet looked at her and said that she needs oxygen and informs me that when cats get like this they can go from bad to really bad quickly and pass away. He suggests that we give her some oxygen for 45 minutes and then he'll take a look at her. He suspected a fluid build up and also gave her a shot of lasix to help her pee and release some of the fluid. At this point, i'm beside myself since 2 days before this she was running around and was her old normal self.

The vet then comes back and says that he suspects an enlarged heart and that we can try to x-ray her but I should consider putting her to sleep because she's really having trouble breathing. He shows me her gums and they were turning blue. I decide to have the x-rays done since the doctor said that it'll tell us how bad the damage is. We got to play with her for a few minutes before the x-rays since he said there is a chance that she may stop breathing during the stress of taking them. During that time, I actually see her move around a bit and jump from a table to a chair. It was almost like she was trying to tell us there was some life left in her and to give her a chance. It was also the first time I saw any real activity since Friday morning. We get the x-rays taken and the vet says that the lungs aren't as filled as he thought and that it may be a bad respiratory infection. He prescribed a weeks worth of Clavamox and lasix and said to watch her behavior.

Over the two days we force fed her water and food and by Tuesday night she started to show signs of life. She usually sleeps in our bed, but since Friday she hasn't. On Tuesday night she jumped back into the bed as we were going to sleep. We decided to take her to her normal vet on Wednesday for a second opinion and he gave us a good sign saying that cats with bad hearts don't go from almost dying to running around over the course of a few days. He did recommend an ultrasound to rule out heart problems.

So we have the ultrasound performed and the cardiologist said it's an enlarged heart. The vet said to finish the antibiotics and ween her off the lasix. He also prescribed her Atenolol and Benazepril daily and a baby aspirin twice a week and said that in another 4-5 weeks we can do another ultrasound to see if her heart shrinks. The vet also wasn't sure what caused this. In the month preceding the episode, she figured out how to escape from the house a few times. The vet said she may have caught a lung worm while she was out. I also wonder if she ate a poisonous plant (we have birds of paradise and chrysanthemums growing around here, but I'm not sure that poison has a gestation period since it was about a week since she had gotten out last). Her blood and urine work were also inconclusive. I also contacted the person we got her from when she was a kitten (she was from a litter of 6 kittens). Neither the mother cat nor any of litter have had heart troubles either. And up until the initial Friday, she never panted or showed any signs of being sick. She's also been through a bunch of vet checkups and none of them have ever detected anything.

I'm actually included to think she had a really bad reaction to Advantage Multi. The cat occasionally stays at my girlfriends house (this is where she was escaping from) where she can get fleas from their dog. In the past I've given her regular Advantage and we've never had any issues. Since she got out this last time, I wanted to give her the Multi since she may have picked up worms. The regular Advantage uses imidacloprid where the Advantage Multi uses imidacloprid and moxidectin. I'm wondering if the moxidectin did it. The vet doesn't think so since he's never seen it before, but I don't know.

So I guess my question after this long story is what's next? This all occurred the first weekend in January. Now if you look at her, she looks and acts almost exactly like her old self. She runs around the place, climbs our window screens, has her 4 foot vertical jump back, etc. No real difference except that I can still see her doing the abdominal breathing (though not nearly as bad as when this initially started). I still have another three weeks before we go in for the follow up ultrasound so I guess i'll know more then. Has anyone else ever gone through something similar like this? I'm trying to stay positive since she acts (plays, eats, uses the bathroom) normally, but I don't think I'll be at rest until the next ultrasound.
 

farleyv

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Oh I am so sorry you are going through this. I always believe that body language is huge when trying to detect how an animal is feeling. Your girl sounds like she is feeling fit with all the activity.

What are the side effects of Advantage Multi? You should be able to find out online.

I will keep you all in my prayers for a good report next vet visit.
 

violet

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An excellent article for information
http://maxshouse.com/hypertrophic_cardiomyopathy.htm

Extremely important from the article

This may partially explain the frequent clinical observation that stress can precipitate pulmonary edema in a previously compensated cat with HCM.
So with this in mind, please, do everything in your power to keep her away from any and all stressful situations. If you ever have to leave for a day or several days, make arrangements for a sitter to come and take care of her. As a rule most cats feel safe and secure in their own environment but they can get terribly stressed if they have to stay somewhere else.

There are many things you can do to fight heart disease, so I'd like to recommend that, if at all possible, find a very good holistic vet who is knowledgeable about treating HCM and combine conventional and holistic treatment for best results.
One way to find holistic vets
http://www.holisticvetlist.com/
but you can also Google for even more.

You are fortunate to have a diagnosis because this will make a lifesaving difference for your baby. You can now treat and do all you can to slow the progression of the disease.
I urge you to keep doing the ultrasounds (with the best cardiologist you can find). Don't ever go longer than one year between two ultrasounds. And keep a close eye on kidney and liver function with regular blood work (very necessary with drug treatment).

This is also very important info from the article

Often cats with MCM (I think that should be HCM) remain asymptomatic unless their condition is complicated by severe left atrial enlargement, progressive myocardial failure, aortic thrombosis, atrial fibrillation, hyperthyroidism, anemia, fever, renal failure, tranquilizers or anesthesia, or fluid infusions. When the precipitating cause is reversible, the cat may stabilize spontaneously following the management of acute pulmonary edema.
Without complicating factors cats with HCM can survive for many years, so fighting HCM is a fight worth every effort. (One of mine was doing very well for several years after she was diagnosed.)
 

my4llma

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I don't have any experience with HCM. I'm so sorry you and your cat, are going through this.
 
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hvcubed

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farleyv - I checked Bayer's site for the side effects (http://www.bayerdvm.com/Resources/Do...-Cat-Label.pdf) and the only thing I found was a mention of respiratory infections. The reason it sticks out in my mind is that I gave it to her two days before all this started. It may be a coincidence, so I'm really not sure. I'm just trusting in her body language. She's acting like her old self and actually eating way more than she used to so I think she's trying to gain back her lost weight.

Violet - Those articles were really helpful...thanks! We'll keep up the ultrasounds. A lot of the things I've been reading on the Internet say that if the heart reacts well to the medicine, then the disease is manageable. I'll check out the holistic vet as well. Did you have any recommendation on food? From what I can find on the Internet, it looks like low-sodium food is recommended. She eats either Halo Salmon or Wellness Core dry food and either Fancy Feast or Halo wet food (she's really picky). I was thinking of switching her over to Blue Buffalo dry food since it seems to be well regarded on this website.

My4LLMA - Thanks!
 

violet

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Yes, medications can be very helpful, even though they can also have side effects one has to be aware of and watch for. (Possible side effects of these meds include slowed heart rate, lethargy, low blood pressure, vomiting and diarrhea. Some, perhaps all, can also affect kidney function, so it is very important to regularly monitor the kidney values.)

I think, if you don't have to make a special effort to (at least temporarily) restrict sodium intake, any good-quality canned cat food should be all right to feed.

I have this article on low sodium diet
http://www.soyouwanna.com/low-sodium-diet-cat-7867.html

My cat loved this food (yours might not care for it at all), I'm just including the link so you can take a look at the info on it
http://www.onlynaturalpet.com/produc...od/131250.aspx
(I could buy it locally, never had to have it shipped.)
 
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