Please Help - Our cat can't survive outside of oxygen. Vet(s) are at a loss.

Hi everyone,

We are so stressed out right now. Our Toby was recently diagnosed with Hypertrophic Cardiomyopathy and was placed on three meds, Lasix, Benazepril and Plavix. We first found out about his condition when he failed to eat one morning and we called our mobile vet who said there was some fluid in lungs and detected a low grade murmur.  We were referred to a cardiologist where HCM was confirmed and meds were started.

At first he seemed to be responding well for about a week or so.  Then in the last 24-48 hours has really gone down hill fast.

He can't survive for more than 1-2 hours outside of oxygen before he goes into respiratory distress and full open-mouth breathing.

Yesterday his appetite was gone again and he couldn't seem to find a comfortable spot and was panting pretty heavily.  When he started open-mouth breathing we rushed him to the Emergency Vet who placed him in oxygen box.  He responded beautiful and xrays were pulled revealing no fluid. We took him home and he was 90% back to normal. He even regained his appetite and ate some of his food.  Then again, 1 hour later full distress and within 5 minutes he went from being fairly normal to full open-mouth breathing. We again rushed him to the Emergency Vet and this time he stayed for a few hours in oxygen.  We went and get him and brought him back to his cardiologist.  After just 2-3 hours after he left oxygen while at the cardiologist he again went into full distress over the course of about 5 minutes.  We're talking purring, jumping up and down on us and then 5 minutes later he can't breath and full open-mouth breathing.

The cardiologist does NOT think what is happening with his breathing is related to the HCM.  She will be hooking him up to heart recorder to check for arrhythmia thinking maybe that could be it but she didn't sound confident that was it but wanted to rule it out. She also suggested that we may try going to a neurologist for evaluation.  He was sort of growling still even though he appeared to be in respiratory distress (she said that didn't seem right) and he was also doing something vet's call "fly snapping/biting or air biting" which again could point to seizure or neurological.  

The poor thing can't breath without aid from the oxygen chamber. We are not even sure we could make it to the neurologist since he's over 2 hours away.  He is now at the cardiologist's vet's office which has a full ER and other docs on staff. He is in oxygen and will be staying overnight again in oxygen.  Our little guy looked so bad this last time when we left him. Markedly worse than even the last overnight event. He was just laying there and didn't really respond much to us, a quick glance at us and a low tone growl. His temperature was dropping when we left which was also bad but they have not called us with any drastic changes as of yet. It was so heartbreaking. He doesn't appear to be in much pain though but I think he's very good at masking it. 

Does anyone recognize these symptoms? Any potential guesses that we can run by the now team of vets that are overseeing him? We are so lost on what to do and even if we could get him to a neurologist and they can actually determine something what direction could that take us in?

Could this possibly be symptoms of FIP or Toxoplasmosis? Or?

Please please help us. 

MORE INFO: He is 10 years old by the way and other than the recent Hypertrophic Cardiomyopathy diagnosis and this new unknown (and sound like unrelated) breathing distress issue, he has been a healthy lucky and very loved kitty from birth to now. He is an indoor cat. We don't think he suffered any trauma that we can see. 

We are wondering also if he did have fluid around lungs, responded well to Lasix which was prescribed by the mobile vet but maybe he picked up some bug in the mobile vet that took a few days to manifest? Could that be a possibility some kind of infection or something?

I'm so sorry for this. I don't know what it could be. Did they check him for asthma? Xrays would show cloudy donuts tramlines but since they treated for heart disease and he improved I don't know.

What about the color of his gums and tongue when he was home? I'm sure you don't remember as this sounds very scary.

Did they talk about any options other than oxygen? I don't know how it could be neurologic but I guess it could be. What is the bloodwork for his red blood cell levels and hemocrit levels? This poor baby sounds so miserable the poor boy. Sending positive thoughts and energy that they figure out what it is. Too bad they can't get the nerve doctor to visit your cat rather than risk transport without oxygen.

After rereading what you said-are they going to do another ultrasound on heart? That would be my recommendation. Lets see inside the heart what exactly is going on. Fluid buildup is due to heart not being able to adequately pump blood out of the heart so it pools into lungs which is why he pants.

Also they can raise the meds levels. It sounds like maybe they need to up the meds. Its possible that the heart disease is progressing faster than they can treat. There are a few different meds they can try if one doesn't seem to be working. Just because no fluid doesn't mean that the heart is not under pressure. Him not finding comfortable position is one sign that heart is not pumping enough.

You must be so scared.

Hi Foxxycat,

Yes we are all at a loss and when the vet's are at a loss it's very scary indeed.

His gums look normal and pink.

His xrays showed no problems with the lungs really at all (not impressive is how they put it - which means pretty normal looking)

When he was having the episode at the cardiologist the ER doc on staff administered an asthma treatment of some kind and Toby did not respond at all other than another growl. It did nothing to help his breathing distress.

I don't have the answer on the blood work but I do know his BUN and Creatinine was slightly elevated but nothing at alarming levels said all three vets.

We are now wondering if he had the underlying Hypertrophic Cardiomyopathy but that wasn't what was causing him not to eat and the HCM while there was not really the issue he was having the other day.

OR

If maybe he caught something since being treated for the HCM (fluid in lungs) possibly from the mobile vet mobile that treated him.

We feel so helpless right now.

Sorry to read about poor Toby. I wish I could help you but I've not seen or heard about anything like this in cats. You can't do more than you are doing for him and his best chances are where he is now.

I hope the vets can treat him and I'm sending all my best wishes for his recovery.  

Hi again Foxxycat,

With regard to a 2nd Ultrasound, we had one last week.  The reason we brought him straight from our local Emergency Vet to the Cardiologist today was to indeed do another Ultrasound but after she saw the x-rays taken last night she is in agreement with the Emergency Vet that there really is no fluid in the lungs. She doesn't hear any and the x-rays show none.  She still may do another Ultrasound anyway once he gets more stabilized. He was really bad off when we left. Just 20 minutes before he was jumping on us and purring almost like normal other than being nervous being in the vet's office which he's always like that.  

We're trying to stay positive but I never seen our poor little guy looking like he did when we had to leave him tonight.

The asthma meds they treated him for would have been albuterol which in some cases does help with heart but I can't remember what exactly. I'm very familiar with albuterol. I doubt it is a bug. The breathing is more likely heart related. Sometimes they have to try different heart meds to stabilize them bust lasix is the gold standard for fluid buildup. Its been awhile since I've studied which med does what but there are three different classes of meds. Sometimes they keep the lasix and try something new. Some of them are available as injection so maybe they could try that instead of the meds he is already on.

I wish I knew more about those classes of meds to help explain what they do. So sorry for what you are going through.

I would do another ultrasound. Sometimes things progress faster. At least for me I would only because they can't stabilize him without oxygen. But this is only my opinion. Sometimes xrays don't show very well what is going on.

Thanks for your kind words and info Foxxycat.

Yes we are thinking she will do another ultrasound, that was the point of bringing him into her today after leaving the emergency vet.  Unfortunately we didn't even make it that far before Toby went into respiratory distress right in front of all of us. He also urinated on her as she scooped him up to bring him to the oxygen chamber. I'm sure he was so scared. I wish we knew how to help him.

Thanks Gigmargl for the vibes and well wishes. We really need them right now.

I have no idea what might be wrong but see if your vet(s) can consult with other vets for advice. VIN.com is a popular vet only web site with a message board. US vet schools often do consults. This very well respected vet hospital has many specialists your vet can consult with: https://www.mspca.org/angell_services/referral-services/

Wow, that sounds horrible. I'm so sorry Toby (and you) have to go through this. Thinking good thoughts for him that he feels better very soon.

Thanks guys. This is so hard. I never thought it would be this hard.

I just got off the phone with the emergency vet where he's staying in oxygen and now he's starting to have episodes including mouth-open breathing even inside the oxygen chamber but then he calms down again. It's obvious that he's getting progressively worse virtually by the minute now.  They will be checking his electrolytes soon and also hooking him up to telemetry monitoring. 

I'm starting to think his little heart is just giving out on him.

Unfortunately we just lost Toby. We are just heartbroken. 

It's just not how I expected Toby would go. But I knew last night that when we had to rush him right back to the emergency vet that something was seriously wrong and I just felt it in my gut that we were going to be out of options much sooner than first anticipated. Then we saw him earlier this evening and he was 90% his normal self. We must find comfort that we got to interact with him once more in that state. He probably mustered all he could to give us that last bit of time with him. But in the end, he just couldn't keep fighting.  The ER doc said Toby kept going in and out of respiratory distress with open mouth breathing in the last few hours and oddly even felt well enough not long ago to eat his dinner. But during the last episode he just let go. The ER doc said he really thinks it was something other than heart related and was going to make a neurologist referral in the morning. So we may never really know what happened to our little guy.

He will suffer no more and we tried everything we knew to try. And even with a team of vets working for him he just couldn't hold on any longer. We ran out of time. We will miss you dearly little buddy. Sadness has now replaced the worry that had filled my heart. 

Thanks again everyone for your care and support.

Oh no I'm so very sorry for your loss. What a beautiful boy.

Oh no! I'm so sorry. . Threads are locked after someone has suffered such a loss, as a sign of respect. When you feel you are able, we invite you to place a tribute at http://www.thecatsite.com/f/19/crossing-the-bridge as an enduring testimony to Toby.


Rest in Peace, Toby.