Cat diagnosed congestive heart failure 5 days ago

[richard smith]

Hi, new to posting but going through the most traumatic last 5 days

My Devon Rex, Gizmo, 9.5 years old, started experiencing very heavy quick breathing 6 days ago (20/5/14), reaching 54 Breaths per min. I took him to the Vet early next day and was immediately referred to Vet Hospital where they put him on oxygen and later that day informed me of Congestive Heart failure. That was Thursday. His treatment of drip, diuretic and Ace Inhibitor all worked well and on Saturday, after 2.5 days in Hospital they we're happy for him to come home with the ongoing heart and diuretic pills. Saturday evening he ate well and seemed almost normal.

I woke Sunday to a very different story - he'd been vomiting and had diarrhea over night and was very lethargic, this worsened throughout Sunday, with no interest in even his favourite food and no signs of him drinking at all, he was very still and looked so very sad. So Sunday evening I took him back to the hospital, his breathing was OK, but very dehydrated, so he was put on a drip and blood tested for kidney failure, which was luckily ok.

I visited the Hospital today to see him still on a drip, he'd still not eaten at all and although was affectionate and purred a little, after about 10 minutes he went back to head hanging and looking very sad and ill. I'm now waiting till tomorrow for a further diagnosis from the Vet and tests.

I've read so many reports online to try and get some comfort that he'll recover, but I'm more than aware of the seriousness and what will eventually be.

Has anyone experience this illness, is the lack of appetite/drinking common, caused by the meds, sign of deterioration?? Or any advice.???

I'm going crazy with upset and concern, it's all i can think of is how he is doing, tomorrow seems like far too long away to hear further diagnosis and I'm racked with thoughts that his time may be up, but I obviously want him home and want more time....

It's very difficult to talk openly with friends about what my cat means to me, I guess just posting here anyways is helping me.

Thanks for reading

Richard

 

[stephenq]

Hi @Richard Smith

I've been through this with one of my cats and I know what its like, and its obviously very serious.  Did he have an echo-cardiogram and did they diagnose the cause of his CHF?  Possibly Hypertrophic Cardiomyopathy?

Regardless, here is the problem and the challenge: CHF is basically fluid in the lungs, it gets there because for one reason or another, the heart is having trouble pumping and fluid leaks into the lungs.  The big challenge is that Lasix or whatever diuretic they give, which causes the cat to pee and helps empty the lungs of fluid, not only can dehydrate your cat but tends to put cats into kidney failure over time.  The normal treatment for kidney failure is sub Q fluids, except that they go to the lungs in a patient with heart failure, putting the cat back into heart failure.  This can be avoided by putting in a central line and hydrating directly into a vein, complicated but do-able.

But the cat is now in a see saw position, kidney failure, heart failure, and the challenge is to manage both for as long as possible, and with as much quality of life.

One thing you can do at home, is have your vet instruct you in the proper way of counting your cat's respiration rate (always at rest or sleeping) and knowing when its time to go to the vet.  Your vet may also be willing to give you a dose of Lasix and instruct you on how to administer this injection of Lasix (diuretic) sub Q (under the skin and super easy) to give him help before you get to the vet.

I'm so very sorry that you are going through this, its a big ordeal.  Hopefully he will stabilize, and you will get some great time with him.

 

[richard smith]

Hi Stephen,

Yes that was the diagnosis, Hypertrophic Cardiomyopathy. It was picked up the signs of thickening last October from an ultrasound not related, but confirmed this was the cause. His breathing went back to normal after 1.5 days treatment last week and he's not on oxygen again.

I guess it's the not eating/drinking side which has put him back into hospital only a day after being home that is so distressing as he seemed ok after such a scare, albeit needing pills ongoing, I guess it lulled me into a false sense of security in his well-being.

The kidneys are apparently working fine from tests done Sunday (2 days ago), but we'll see what Im told later today.

The name of the diuretic escapes me at present, but a tiny pill that needs quartering, the Ace Inhibitor was quite large but easier ironically to get inside him. He usually takes pills easily in food, but not eating caused another challenge.

I'm taken aback how this has knocked me for six in coping with seeing him so ill, back at work and waiting lunchtimes call - thanks for your reply.

Could I ask how your cat responded to treatment, is he/she still with you?

Regards

 

[stephenq]

Hi Stephen,
Yes that was the diagnosis, Hypertrophic Cardiomyopathy. It was picked up the signs of thickening last October from an ultrasound not related, but confirmed this was the cause. His breathing went back to normal after 1.5 days treatment last week and he's not on oxygen again.

I guess it's the not eating/drinking side which has put him back into hospital only a day after being home that is so distressing as he seemed ok after such a scare, albeit needing pills ongoing, I guess it lulled me into a false sense of security in his well-being.
The kidneys are apparently working fine from tests done Sunday (2 days ago), but we'll see what Im told later today.

The name of the diuretic escapes me at present, but a tiny pill that needs quartering, the Ace Inhibitor was quite large but easier ironically to get inside him. He usually takes pills easily in food, but not eating caused another challenge.

I'm taken aback how this has knocked me for six in coping with seeing him so ill, back at work and waiting lunchtimes call - thanks for your reply.
Could I ask how your cat responded to treatment, is he/she still with you?
Regards

Richard
That's great that his kidneys are ok!
As for our dear Felix I see that you noticed I didn't include those details. He was 12 at the time and was given a prognosis of less than one year to live, a day that I will never forget, thinking on that Sunday that I was bringing him to the emergency vet for a case of asthma or something like that because his breathing was a bit labored and we had never had even a hint or a problem before. If that wasn't devastating enough - and don't take this next part as representative of your cat or any other cat - but he only lived 5 more weeks despite a great cardiologist, a 24/7 specialist and emergency hospital, and the best primary vet practice I've been to. He just didn't catch the right breaks, and things didn't work out in his case. He had amazing care, he rarely new he was sic

​

k, but he got into a spiral of kidney failure and heart failure that just became too hard, and when we couldn't control it anymore and with our vets agreement, we had him PTS.

We are a two cat family and so a couple of months later we were ready, and so was Felix's brother Simon, and so we went back to my shelter and while looking for an older cat for our older cat Simon, we ended up adopting a blind from birth kitten who we named Jenny after our vet. She is a super happy cat, great friends with her step brother Simon (long introduction), and she runs the entire house, the princess who I can deny nothing too and is super happy and goes running with me on the beaches of Maine in the summer. She has a public facebook page viewable by all and linked in my signature. Pictures of Simon are there too.

This is a picture of our Felix, who I miss to this day, 2 1/2 years later and who will forever have a piece of my heart. I hope Gizmo has better luck, and a long happy time with you, something which is certainly quite possible. Hopefully you will get him balanced out soon, and as I said in my last post, learn how to read his breathing and discuss with your vet taking home an injectable emergency dose of diuretic, Lasix being the common choice. Once you're shown how to give it, it's easier than giving a pill.

FELIX

felix.JPG

• stephenq
• Dec 9, 2013
• 1

 

[richard smith]

thanks, I also have another cat, they came together, 9.5 years ago, 1 week apart, so they have spent their whole lives together, a dilemma as to how he would feel if without his friend, indeed he is obviously showing signs after these 6 days.

BUT, after a trip back to hospital today, it seems things have turned around again, the 2nd issue was caused by the diuretic....

This seems to have worked overtime and created the dehydration, lack of appetite and spiralled his condition downwards. Today after 2 days on a drip and removal of the diuretic, he's bounced back to life and is eating again

I'm hoping he'll return home tomorrow...

It's too easy to start to think he's cured, I know he's far from it, but to have some more time is amazing.... be it days, weeks or months, all are good

What medication now follows I'm not sure, constant monitoring is a must.....

Can't wait to get him home

 

[stephenq]

Getting them home is always a great thing.  There is no cure for HCM, but there can be management, and hopefully yours will be for a nice long time.

Stay in touch.

 

[musicalcats]

I went through this with my 7-year-old, Felix, just over 2 months ago. It was probably the worst week of my life. I'm so sorry for what you're going through and I hope you and Gizmo have more quality time together. My Felix's condition escalated extremely quickly and over his 3-day hospital stay he was never able to be removed from the oxygen chamber or have any tests beyond his initial xray and ultrasound which indicated severe CHF. He fought valiantly but it was just too much for him.

 

[richard smith]

So sorry to hear about Felix too, I'm very apprehensive about bringing him home, thanks for replying. I'm going to find it difficult to not be watching him 24/7, work has been quite good with me leaving early and working from home, but not sure for how much longer. Fingers crossed.......

 

[musicalcats]

Thank you. My thoughts are with you guys. Keep us posted.

 

[stephenq]

 
So sorry to hear about Felix too, I'm very apprehensive about bringing him home, thanks for replying. I'm going to find it difficult to not be watching him 24/7, work has been quite good with me leaving early and working from home, but not sure for how much longer. Fingers crossed.......

The first few days may be more critical as you get used to the situation and hopefully see that he is stable. We're all wishing you all the best.

 

[jdollprincess]

I have a 14 yr old cat that went into congestive heart failure 2 yrs ago and was on oxygen for 2 days. She was diagnosed with HCM after seeing a cardiologist and having an echocardiogram. It took months to get the medications adjusted properly but she is still with me and her only issue is occasionally getting uti's from the diuretics. There is hope and the best thing you can do is work closely with a cardiologist and always keep track of his respiratory rate. Also get a cheap stethoscope and keep track of his heart rate.

 

[richard smith]

Thanks all, well he is home and I have the dubious please of trying to get 5 pills a day inside for a while

Fortekor (Ace Inhibitor),

Cereniia (for nausea & intestine inflamation),

Famotidine (Nausea and bleeding intestine),

Mirtazapine (appetite stimulant)

Metroidazole (Antibiotic)

No diuretic as the Frusemide(Lasix??) caused the dehydration and 2nd visit back

He's drinking, but not eating much (usually food is how I get pills in) so this pill challenge is new and not enjoyable !!!

Home all day so we'll see.

It's re-assuring that under this condition he can live on, so I'm happy to hear your cat has soldiered on JDollprincess.

Fingers crossed, for Cat and that I manage to keep my job from all the time off I'm needing !!! 

Insurance cost rose to £60ppm in April, so I cancelled in May.... great timing eh

 

[mycatwasthebest]

omg...if it's been less then 30 or 60 days can you get  it back?   I would definitely try, especially if you just stopped paying it with no explanation!

 

[stephenq]

 
Thanks all, well he is home and I have the dubious please of trying to get 5 pills a day inside for a while

Fortekor (Ace Inhibitor),

Cereniia (for nausea & intestine inflamation),

Famotidine (Nausea and bleeding intestine),

Mirtazapine (appetite stimulant)

Metroidazole (Antibiotic)

No diuretic as the Frusemide(Lasix??) caused the dehydration and 2nd visit back

He's drinking, but not eating much (usually food is how I get pills in) so this pill challenge is new and not enjoyable !!!

Home all day so we'll see.

It's re-assuring that under this condition he can live on, so I'm happy to hear your cat has soldiered on JDollprincess.

Fingers crossed, for Cat and that I manage to keep my job from all the time off I'm needing !!! 

Insurance cost rose to £60ppm in April, so I cancelled in May.... great timing eh

Metronizidole tastes terrible, and I'm curious why he's on this, but in any case  I'd put it in a pill pocket (all the pills can go this way if he likes them) and if he wont eat it then i'd pill him with the pill pocket.  Pill pockets are hollow treats, see
Lasix will cause what you describe but hopefully only in an inappropriate dose.  One could push back against this by offering him multiple water bowls and a water fountain, but given his CHF, i don't understand how you can keep him out of heart failure long term without it.   I would discuss this with your vet.  But, if you can control his HCM/CHF without Lasix, then so much the better!

Also i'm assuming the Cerenia, Mirtazapine, and Metronizidole are short term or limited term use?

Lastly, in the US cats with significant HCM also often go on a blood thinner to help prevent clots in the chamber where blood is pooling.

 

[richard smith]

Cerenia, Mirtazapine, and Metronizidole and Famotidine are indeed  short term, metronidazole for gut inflamation apparently, 2 weeks worth.

At present he is not eating as normal, and chews, spits a lot out, so it's pill in the mouth time, soon I'll be expert at it no doubt, got all todays in so far without too much stress to us both...

The diuretic I'll be discussing tomorrow at a follow up visit... as everything I read mentions this is required, the size of the pills really wasn't good, so tiny and had to quarter, so no guarantee the was getting the right amount Iguess, we'll see what they say

mycatwasthebest: unfortunately insurance is gone, had 7 days to reverse decision, that was 3 weeks back - thankfully I have savings, hopefully enough !!!!

 

[AbbysMom]

Hello and welcome to TheCatSite! I'm sorry you are joining under these circumstances.

My mother's cat had HCM and was given a few months to a year to live. She lived for about a year and half. It was a bit of a roller coaster ride. Things would go along fine for a bit and then Roxie would stop eating and refuse food. Since my mother would give her the pills in her food, this was a huge issue and off to the vet we would go. In most cases we would learn she had a minor cold and she would be fine a few days later. Any odd behavior should be reported to the vet right away, be it not eating, etc. Roxie would get blood work done every few months to check her kidneys, etc.

One of our Moderators from Germany also went through this with her cat Jamie. I believe Jamie lived for around a year and a half after going into congestive heart failure. She started a thread looking for suggestions on how to hide the pills in various foods. You may find it helpful:

http://www.thecatsite.com/t/237863/ideas-for-hiding-pills

Good luck! :cross:

 

[richard smith]

Thanks, thats a great thread

I'm going to (have to) try and master the pill manually, the days he's eating fine it'll get hidden to give us both a rest

 

[stephenq]

The diuretic can also be given as a super easy sub Q injection, much easier than pilling

 

[richard smith]

The Joy of seeing a cat eat

Happy Days, possibly the appetite stimulant, though I'm going with road to recovery !!!! (however long or short that may be)
A check up today and finding out realistically what the long term treatment will be, and meds (esp diuretic) but for now I'm just so Happy I have my cat back

 

[stephenq]

 
The Joy of seeing a cat eat

Happy Days, possibly the appetite stimulant, though I'm going with road to recovery !!!! (however long or short that may be)
A check up today and finding out realistically what the long term treatment will be, and meds (esp diuretic) but for now I'm just so Happy I have my cat back

I so TOTALLY understand!  Congrats!!! I'm so happy for you both!!!!