Qbert has CHF

Status
Not open for further replies.

geojlc

TCS Member
Thread starter
Young Cat
Joined
Aug 2, 2015
Messages
23
Purraise
6
I am grateful to find this site.  I joined because my 11 month DSH kitten, Qbert, was diagnosed with CHF and HCM last week.  I'm at the anxious and lost feeling stage as I try to get up to speed and learn about everything.  I've had long term terminal maintenance cats before (mostly kidney issues), but this is my first experience with heart issues.  I'm pretty sure I'll get through this phase once we figure out the new "normal", but dang is it hard!  

I'm pretty lucky in that we think we caught the CHF pretty early.  One day I noticed he was breathing heavy, kind of like he'd been running or playing only while napping.  It was pretty hot outside, and figured that might be the cause.  Then, over the next few days, a whole bunch of other little things tripped my Something is NOT Right radar.  Rads showed fluid in the lungs and an enlarged heart, so they started Qbert on a diuretic (furosemide) and scheduled an echocardiogram.  The cardiologist found the HCM and put him on plavix (blood thinner) and taught me signs to look for that would indicate going to emergency.  (OMG, I'm so grateful I got pet insurance for him!!!)  We have another X-ray and blood panel test scheduled for Tuesday to see if the meds are helping with the fluid in his lungs.  I'm also really lucky that I have a very supportive vet and staff willing to work with us. 

The cardiologist said that if we can stabalize Qbert and if he (and particularly his kidneys) tolerates meds well, we might be able to look into long term maintenance steps. 

So far he is tolerating taking his meds ok, although the plavix requires something to hide the taste which he seems to hate.  Pill pockets torn in half to make a smaller bit are working for now,  We are struggling a bit with eating, although I'm finding he seems to prefer smaller, more frequent meals.  (Now to keep the other cats from turning this into a free food atm moment...)  I'll talk with the vet on Tuesday to see if she has any suggestions for food.  He has moments when he seems normal and playful and kitten crazy, and other moments when he just seems tired (sleeping more).  Since he started meds, he's gone back to mostly sprawling when he sleeps.

So that's the rambley bit.  I know CHF has a different progression in every cat, but would anyone be willing to share what kinds of things I should look for or that might happen as it progresses?  I'm trying to be philosophical and treasure the possibility of a long term journey with my baby but also cherishing the moments because I don't know how long we'll actually have.  I also fight my anxiety better when I learn things and understand what might happen (as opposed to all the worse case scenarios anxiety serves up constantly).   The internet is full of "these are the symptoms of CHF" and not so much "my cat has CHF, now what"

As a silly (because I need silly or I end up in tears again), furosemide, the diuretic, keeps making me think of Furiosa from Mad Max.  Then I go on to "My cat is so badass he takes Furiosa to get better!"  :-)

 
Last edited by a moderator:

Columbine

TCS Member
Veteran
Joined
Feb 27, 2015
Messages
12,921
Purraise
6,224
Location
The kitty playground
I'm so sorry you're having to deal with this disease - especially in one so young. I lost a cat to it early last year - he was 12, and only got treatment once his breathing was badly affected because the stress of pilling him outweighed the benefits in the early stages.

The appetite decrease is very common. It can often be made worse when breathing is laboured as the cat doesn't have enough breath to eat. Sometimes hand feeding can really help, as that way the cat can keep his head/neck in the optimum position for breathing.

Prednisone (steroid) is often used to reduce inflammation and make breathing easier. A useful side effect is that it can really boost appetite, so it's almost killing two birds with one stone. We found vitamin B injections useful as a mild pick-me-up/appetite boost when things weren't going so well too.

Cali had major breathing issues as he progressed, and we ended up treating him like an asthmatic - using an AeroKat chamber and inhalers for him. It made the most amazing difference - he went from death's door to almost his old self, and it gave him an extra 2-3 months of reasonable quality life.

Chf does not have a long life expectancy post diagnosis. Every cat will progress differently. Staying calm is so important, as is being prepared to really take time with feeding. I would regularly spend half an hour at a time hand feeding morsel by morsel, and would repeat the process many times a day. As Cali got worse, my life increasingly revolved around his feeding, his meds, regular vet visits (the contrary animal found going to the vet for an injection less stressful than taking a pill :rolleyes: ).

All I can say is be prepared, enjoy the good days, and be honest with yourself about his quality of life. We pushed on too long (my mother couldn't let go), and Cali went into respiratory distress whilst I was trying to give him his meds - he died before the vets were able to drug him. That last half hour haunts me, and I would hate another cat to have to go through that.

I hope this is of some help. Good luck with your boy. I hope you have a good long time with him :vibes:
 
  • Thread Starter Thread Starter
  • #3

geojlc

TCS Member
Thread starter
Young Cat
Joined
Aug 2, 2015
Messages
23
Purraise
6
Thank you so much!  I had a different cat go through liver issues from not eating last summer (he recovered and is doing fine!), so I'll definitely work on keeping him eating.  Those are good suggestions for feeding options.  I'll talk with the vet on Tuesday about eating and see what she thinks about B-12.  I know they are planning to do an electrolyte test along with the kidney function test.  My vet is good at working with me and answering questions, but I'm kind of still at the "I don't even know what questions to ask" phase.  

We have an aeroKat chamber for another cat who has asthma.  I tried using it initially before we knew what was going on, but the vet said to not use it, at least for now, because the albuterol can elevate heart rate.  That may change as things progress--it's good to know that it was helpful for your cat!

Thank you for being up front about most cats not having a long life expectancy.  That is painful to hear, but it also helps with learning what to potentially expect.  (which also helps me get to a calm place faster).  I've made quality of life decisions before.  It sucks big rocks through little straws, but I would hate more knowing that I made my cat suffer because I couldn't say good bye.  The vet and I will also be talking about these issues on Tuesday so i can make better decisions.  

And I am definitely enjoying his good moments!
 

Columbine

TCS Member
Veteran
Joined
Feb 27, 2015
Messages
12,921
Purraise
6,224
Location
The kitty playground
With the inhaler - we didn't use albuterol for Cali. I can't remember names, but we started with a plain steroid inhaler (orange), and then moved to an inhaler that was primarily steroid with a little bronchodialator added in (purple). Big difference from what my asthmatic pony uses - pure bronchodialator (blue).

Hope that all makes sense. The inhaler didn't replace the oral steroid - it just complemented it.

I'm dealing with a chf dog at the moment (after going through it with Cali, my heart sank to know we were going through it again). My vet said feed him what he'll eat - far better he's eating people food than starving in front of a bowl of dog food. I'm finding commercial raw food has made a HUGE difference to his appetite. It might be worth trying for your guy - he might love it too.

Another drug worth asking about is Vetmedin. It's designed for dogs, but is gaining a good track record with cats too. It's not appropriate for every case, but it can make a big difference if it is right. The downside is that it can reduce appetite, but it's possible to work round that with patience and imagination.

Good luck at your next vet visit. :vibes:
 
  • Thread Starter Thread Starter
  • #5

geojlc

TCS Member
Thread starter
Young Cat
Joined
Aug 2, 2015
Messages
23
Purraise
6
Well, Qbert had his appointment yesterday, and the news wasn't fantastic.  His lung fluid levels haven't really dropped, and are a little worse around his heart.  His blood pressure was also down to 80, which the vet said was because his heart probably isn't contracting enough to keep blood pressure up.  The vet called the cardiologist, and they decided to do a week of agressive treatment (increase furosemide to 3 times a day plus add Vetmedin twice a day to help the heart contract more strongly) and come back next week to see how he's responding.  I'm still waiting to hear about the blood work.

I asked about possibly doing a fluid tap, but the vet says that really is only an option if the fluid is around his lungs or heart.  Since his fluid is inside his lungs, a tap isn't an option.  

The good news is that the appetite stimulant is doing it's job and he's eaten a couple good meals already today.  Eat up buddy!  He also came up on the bed this morning and we had some lovely snuggles.  He's currently curled up by my foot and sleeping.

We're not giving up hope, but I'm also trying to be realistic about the possibility of making some hard decisions next week...

This waiting part is even harder than knowing your cat is in hospice and keeping her comfortable and feeling loved until it's time to say goodbye.  This is kind of like that, but with a tantalizing bit of hope that it might go away mixed with a dread that something sudden might happen and take the choice away.

I'm trying to be philosophical and balance the "it's not fair!" with "but we are here, and pitching hissy fits isn't going to help either of us."  Practicing self care helps.  Having friends to talk with helps a lot.  Having reasons to leave the house that I can't blow off also helps.  Helping a friend with kitten sitting some 4 week old foster babies this week is an amazing thing.  I had a kitten fall asleep in my hand last night while I was holding him!

So, that's where we are.  Here's to making it through another week with more good days than bad.
 

Columbine

TCS Member
Veteran
Joined
Feb 27, 2015
Messages
12,921
Purraise
6,224
Location
The kitty playground
:hugs: I'm so sorry the vet wasn't more positive. Sometimes it takes quite a lot of diuretic to get fluid to shift. :cross: that this increased dose helps. Vetmedin really can make a big difference. I'm glad you're trying it for Qbert.

I really understand the 'It's not fair' feelings. CHF is so cruel at any age, but so much harder to accept in one so young. For me, those feelings need to be put to one side for now - all your energy needs to be channelled into keep in things feeling as normal as possible for your boy. The calmer you can be for him the better. You're giving him a wonderful level of care, and I know just how much of a challenge that can be (especially when you're falling apart inside at the thought of losing him).

Just take things one day at a time. Come and vent here if you need to - sometimes hissy fits are necessary to maintain calmness and sanity during this time!

Mega vibes for Qbert :vibes: :vibes: :vibes: :vibes: :vibes: :vibes: :vibes: :vibes: :vibes: :vibes: :vibes: :vibes: :vibes: :vibes: :vibes: :vibes: :vibes: :vibes: :vibes: :vibes: :vibes: :vibes: :vibes:
 
  • Thread Starter Thread Starter
  • #7

geojlc

TCS Member
Thread starter
Young Cat
Joined
Aug 2, 2015
Messages
23
Purraise
6
Thank you.  Qbert and I both appreciate the mega vibes!  
 

blackmagik

TCS Member
Kitten
Joined
Feb 27, 2015
Messages
10
Purraise
5
Hi all,
I haven't been here for a while but I can tell you that Columbine has been very helpful with advice and comfort as I journey through the heart disease of my Baby Black Dot. Dot is doing remarkably well. She is 14 or 15 years old (feral) and was diagnosed in October 2014. Our story is on this site and I understand the anxiety and stress that comes to us treating this disease. At her last cardiologist visit in March 2015 I was told that Dot has the 'largest left atrium' she has ever seen.
After Dot was first diagnosed and I brought her home from a weekend in emergency, she behaved very anxiously.....flipping her tail and seemingly angry for several days. She hid. I cried.
There were several trips to emergency that first month. When I asked the prognosis, I was told that her heart would 'just stop' and I'd have maybe 6 months. No one told me that she could drown in her own fluids. I was just told to watch her breathing rate etc. not knowing that fluid build up would cause such suffering. Oh......I get it now.......and then her heart would 'just stop'.
Once Dot adjusted to the medications, she began to behave like her old self. Chasing birds and tormenting our other cat.
She hasn't required oxygen treatment since May and her blood work 'looks good'. (no problems yet with kidneys)
(I purchase an oxygen cage for pets, the larger size ($300) for her comfort, because I didn't want to pay the $1700 to just step inside an emergency clinic. I researched online, how to make my own oxygen cage, but I was so stressed and wanted one right away in the event she needed it in the middle of the night. You can make your own and purchase medical oxygen with prescription)
As we progressed through the months, Dot would require oxygen maybe once a week for about an hour, maybe two. Sometimes she would need it twice a week, sometimes every other week. The disease is so unpredictable and heartbreaking.....that I can't really tell you a schedule.
As I stated above, Dot hasn't needed oxygen since early May and her cardiologist is amazed.
Her medications are compounded and in February I also started giving her Cardio Strength (vetri-science) for cats.
I don't stress too much about Dot now. I know all her signals and messages. As much as I hate this disease, I can tell you this much.....I have never been so close or in-tune with any pet of mine as I have with Dot. This disease has cause me so much pain and anxiety but Dot knows what she needs and she tells me. All I can do is pay attention and understand and hopefully give her what she needs.
I'm probably not giving you newly diagnosed what you want or need, but I hope that my experience so far can give you hope.
I send my best wishes and comfort.:vibes:
 
  • Thread Starter Thread Starter
  • #9

geojlc

TCS Member
Thread starter
Young Cat
Joined
Aug 2, 2015
Messages
23
Purraise
6
Thank you so much.  I appreciate hearing your Dot's story, and I had no idea you could do an oxygen cage at home.  I don't know that I'm ready to look into that yet, but it is good to know it is a possibility!  

We have another check and X-ray next Tuesday to see if the fluid in his lungs is responding any better to the new meds.  Yesterday was pretty rough, but today has been better.  
 

Columbine

TCS Member
Veteran
Joined
Feb 27, 2015
Messages
12,921
Purraise
6,224
Location
The kitty playground
:cross: that Qubert continues to improve on he is new meds. Let us know how the vet visit goes, and remember - we're here to support you all we can :hugs: :vibes::vibes::vibes::vibes::vibes::vibes::vibes::vibes::vibes::vibes::vibes::vibes::vibes::vibes::vibes::vibes::vibes::vibes::vibes::vibes::vibes::vibes::vibes::vibes::vibes::vibes::vibes::vibes::vibes::vibes::vibes::vibes::vibes::vibes::vibes::vibes::vibes::vibes::vibes::vibes::vibes::vibes::vibes::vibes::vibes::vibes::vibes::vibes::vibes::vibes::vibes::vibes::vibes::vibes::vibes::vibes::vibes::vibes::vibes::vibes::vibes::vibes::vibes::vibes::vibes:
 
  • Thread Starter Thread Starter
  • #12

geojlc

TCS Member
Thread starter
Young Cat
Joined
Aug 2, 2015
Messages
23
Purraise
6
I really appreciate the check in.  The good news is that he perked up the last couple of days.  The bad news is that the X-rays aren't showing any improvement.  The vet wants to get the formal radiologist's report as well as consult with the cardiologist to see if we should tweak Qbert's meds anymore.  Other than that, we may be looking at watching how he's doing and maybe making hard choices soon.

I've learned that chf is harder to watch than a cat who fades away from renal failure.  I hate watching him during his rough breathing moments, but I guess it also will make hard decisions a little easier and less fraught with "is it time?  did I wait too long?"

This is an awful disease and I wish no one had to go through it!
 

Columbine

TCS Member
Veteran
Joined
Feb 27, 2015
Messages
12,921
Purraise
6,224
Location
The kitty playground
Chf is one of the cruelest diseases I've had to watch. There's nothing quite like watching your fur baby gasping for air. I'm so sorry the news thus far isn't good.

When it comes to hard decisions - trust your instincts. I find that, no matter what point you make the choice, you'll always torture yourself with the 'what if's and 'if only's afterwards. For me, if the cat has little interest in food and is refusing to eat enough (even with help and when offered favourite treat foods) then its time. I can tell you that the deaths I regret the most are the ones where I waited too long, not the ones where I decided early. Qbert will tell you when its time. :hugs:

I hope you're still a way off having to make these choices :vibes::vibes::vibes::vibes::vibes::vibes::vibes::vibes::vibes::vibes::vibes::vibes::vibes::vibes::vibes::vibes::vibes::vibes::vibes::vibes::vibes::vibes::vibes::vibes::vibes::vibes::vibes::vibes::vibes::vibes::vibes::vibes::vibes::vibes::vibes::vibes::vibes::vibes::vibes::vibes::vibes::vibes::vibes::vibes::vibes::vibes::vibes::vibes::vibes::vibes::vibes::vibes::vibes::vibes::vibes::vibes::vibes::vibes::vibes::vibes::vibes::vibes::vibes::vibes::vibes:
 
  • Thread Starter Thread Starter
  • #14

geojlc

TCS Member
Thread starter
Young Cat
Joined
Aug 2, 2015
Messages
23
Purraise
6
Thank you so very much.  We have several things we are watching as we go down this road.  My vet is also having me try to notice more of his breathing patterns so we can get an idea as we go on whether his breathing is same/better/worse.  He still has perked up moments where he acts almost normal.  

I can't decide whether it would be better for him to decline and go quickly or hang out on the border of ok and have to face those struggling to breathe moments...  I guess part of me is hoping he'll at least hang on until his first birthday on the 23rd.  

A hard thing I've been noticing recently (for me) is that other cat owners express sympathy but then tell me how grateful they are their cats don't have health issues.  On one hand, I completely understand that gratitude.  On the other, though, part of the "it's not fair" for me is that I keep getting cats who develop health issues and pass on at young ages and within 3 years of my adopting them...  That part of me is going on about how it's not fair that many people adopt a cat and *maybe* take it in once a year for checkup & vaccinations...  I mean, I'm grateful that I am a person who will take care of these babies and give them the best possible life and outcome, but it's exhausting and heartbreaking at the same time.  

Anyway, I guess that's my venting for the day.  I just got to spend 15 minutes monitoring Qbert after noticing he was having a hard & fast breathing spell.  Within 5 minutes, the labored breathing and speed had calmed, but I kept checking until it was back down to a more normal for him rate.  Poor baby
 

Columbine

TCS Member
Veteran
Joined
Feb 27, 2015
Messages
12,921
Purraise
6,224
Location
The kitty playground
:hugs: It is so NOT helpful for others to go on about their healthy cats :bat: You're right - its not fair for you and Qbert to be going through this, any more that it was fair for your other cats to pass before their time. At least you know they had the best of care right up to the end, and they all knew for certain that you loved them, and loved you right back just as much. :hugs:

You're more than entitled to vent here - among other things, it's what we're here for.

It is absolute torture to watch chef - especially the laboured breathing. I really hope Qbert picks up a little and has a better afternoon/evening and night. :vibes::vibes::vibes::vibes::vibes::vibes::vibes::vibes::vibes::vibes::vibes::vibes::vibes::vibes::vibes::vibes::vibes::vibes::vibes::vibes::vibes::vibes::vibes::vibes::vibes::vibes::vibes::vibes::vibes::vibes::vibes::vibes::vibes::vibes:
 
  • Thread Starter Thread Starter
  • #16

geojlc

TCS Member
Thread starter
Young Cat
Joined
Aug 2, 2015
Messages
23
Purraise
6
So my vet called last night after getting the radiologist's report and conferring with the cardiologist.  The latest thinking is that there is something secondary going on that is affecting the lungs and making it harder for the diuretic to do it's work.  She threw out several possibilities like pneumonia, toxoplasmosis, heart work, and lymphoma.  I think there was another one, but I don't remember.  Most of these are pretty unlikely but do present symptoms similar to what we are seeing.  We talked about lots of options and pros and cons and decided to skip testing and throw a couple antibiotics (clavamox and clindamycine) in the mix to try and fight the treatable possibilities.  In a perfect world, we would do testing and try to figure out what's going on.  But we're at 3 weeks with worsening conditions and decided to not take that extra time.  

The extra complicated part of all of this is that my husband and I are leaving next week on a 6 day trip that we've had planned for over a year.  Normally, they would check the X-rays again at the end of next week, but we won't be here.  So we decided to check on Tuesday (after 10 doses of antibiotics) and see if we see any changes and then again the following Tuesday after we get back.  

Cat trip care planning has also been up in the air and shifting around a lot.  When finding someone to take care of Qbert started getting really complicated, the cardiologist recommended an ICU/ER tech he used to work with who now has a sitting/boarding service.  I contacted her last night and we're hoping that she's available and that we can afford her rates.  If that doesn't work out, we're going to board him at the vet's office even though they don't have overnight staff.  I figure that if, at worst case, something happens overnight, he would at least get ER care as soon as staff came in...  

I also realized yesterday that if this were any other trip (well, except a cruise), I would totally bag the trip, at least for myself, and stay home to take care of my baby.  

The bright spot in all of this is that he has done some perking up during his awake hours the last few days.  He's been coming up on the bed and comfort nursing his fuzzy blanket (something he has always liked to do) and even snuggling a bit with me when I'm lying there.  Yesterday he even asked me to pick him up for snuggles and stayed a while.  That's the first time he's done that in a couple of weeks.  Most of his moments during the day are still sleeping/meh, but I'm ever so grateful that he's started having more good moments when he acts more like a tired version of himself.  That makes me hope that maybe the meds are starting to help make him feel better.  

Watch and wait is hard.
 

Columbine

TCS Member
Veteran
Joined
Feb 27, 2015
Messages
12,921
Purraise
6,224
Location
The kitty playground
I'm glad Qubert's perking up a little, but I'm so sorry to hear of the complications...that's the last thing any of you need. :cross: that the antibiotics do their job quickly and clear his lungs up some more. I hope that the ex vet tech is able to look after him while you're away. She really does sound ideal.
 

2bcat

TCS Member
Alpha Cat
Joined
Feb 8, 2015
Messages
363
Purraise
103
Location
Southwestern PA, USA, Earth
As I've kept up with this thread, I keep searching my memory for any tips from my CHF/CKD cat care that might apply here, but they seem to be too different.  My cat was first diagnosed with CKD, and we started treatment for that (she was also already treating for hyperthyroid for the previous 3+ years).  Then when she reacted not exactly as expected to fluid treatment we found the CHF.  She responded pretty well to furosemide though, or so we thought at the time.  We didn't pay close attention to her breathing and it's somewhat likely she was having some trouble because she had little interest in eating.  It is hard to know for sure how much of that was the CHF and how much of that was the kidney disease.  Maybe a little of both, although I was always going forward with the thought that her kidney values were not so far along.

Regardless, what ultimately happened was she passed what was kind of suddenly (to us anyway) at home while we were still in mode of hoping she would turn a corner if we could just dial in the eating/meds/whatever.  I do remember the vet telling us the CHF meant it could be an any time sort of thing, but I wasn't focused on that.  Possibly it was because my father had lived with CHF for years, still IS!  But it's quite different trying to treat it in a cat.  So I don't think there's much I can suggest, but I can get what you are going through and I wish you all the best.

I will say, one thing now with your most recent post:  we also had a basically unavoidable trip, a one-time thing that we really couldn't miss with the family involved (a wedding with close family, but it was in Florida).  We did consider trying to shorten the trip a bit, and I looked into boarding facilities, but in the end what happened was one of our vet techs came by the house each day.  Amber was being syringe fed at the time and the vet tech took care of all that.  It was much better in the end for Amber to be in her familiar surroundings vs boarding, although I will say the boarding place I was considering was very patient and answered many questions for me.  I hope you are able to get the ex-tech for sitting.  You can check even with current techs; many of them will do sitting on the side if you are within a reasonable distance from their home.  For a current tech it probably helps if it's a tech you already know, such as from your regular vet practice.
 
  • Thread Starter Thread Starter
  • #19

geojlc

TCS Member
Thread starter
Young Cat
Joined
Aug 2, 2015
Messages
23
Purraise
6
Thank you so much for sharing your experiences!  

I initially was going to have our favorite vet tech come stay at our place while we are gone.  Then Qbert's meds got more complicated and he now has 4 med administrations a day (breakfast: furosemide, antibiotics, vetmedin.  lunch: furosemide.  Dinner: plavix, antibiotics, vetmedin.  Bed: furosemide.  Fun, fun times...)  The vet tech said she couldn't do it because, oh, that whole work thing.  The cardiologist would really rather have Qbert be were someone is around to look in on him a lot of the day in case of emergency.  I mean I sometimes leave for several hour stretches, but I also work at home.  

I just heard back from the tech the cardiologist recommended and it turns out she will also be out of town while we are gone.  Sigh.  

There just isn't time to keep trying to find someone and then waiting while they tell me whether or not they are available...  His care seems to be getting more complicated each week.

I think it's time to say that we are just going to board him at the vet.  All the techs there love him and he will get as much attention during the day as he wants.  He'll have his fuzzy blanket and a couple favorite toys.  And he really is spending a whole lot of his day asleep right now...  I just have to hope that will be enough...
 

Columbine

TCS Member
Veteran
Joined
Feb 27, 2015
Messages
12,921
Purraise
6,224
Location
The kitty playground
I think that's a reasonable decision, and possibly the least stressful option in the circumstances. My vets don't have on site staff at night, but the on call/night duty vet does a few checks during the night to be sure any inpatients are ok. I wouldn't be at all surprised if your vets do the same.

If it makes you feel any better - I was hospitalised shortly after my greyhound had an accident. He ended up having to board at the vets longer than he medically needed to. He came home with more toys than he'd gone in with after all the nursing staff fell in love with him. I'm sure Qbert will be similarly pampered whilst he's there.
 
Status
Not open for further replies.
Top