Friday, June 9, 2017

Jimmy Stewart and Roxanne Have Cardio Echos June 2017

Jimmy Stewart and Roxanne saw the cardiologist today.

Jimmy was last seen in 2014, a checkup prior to having dental surgery to check his heart to see if he could have surgery.  He was fine then and he is fine now. Since he has been ill recently and seems to have trouble keeping on weight, it was a good time to have a recheck and rule out any heart issues.
Luckily, there are none.

Roxanne will continue to see the cardiologist annually to monitor her heart. She saw the cardiologist last October and the cardiologist saw some mild spots of thickening in the left vent. Those spots are still there but have not changed nor have any new spots of thickened areas emerged. We will continue to monitor her heart and her overall health and watch for symptoms. For now, all is normal.

They were both really good at the vet. Roxanne, despite giving her Cerenia (which helps combat motion sickness and vomiting) at noon-about 20 min. before we left-vomited in the car after being in the car for 15 min. The car ride was 35 min. She did not vomit coming home. Jimmy only hissed at the technician a couple of times but his hisses are never really loud or threatening. Unless he's really mad.

Here are the vet's notes:

"Roxanne's echocardiogram is unchanged in comparison to her initisal study...mild thickening of a cople of regions in her left ventricle...likely unrelated to hypertrophic cardiomyopathy given the lack of progression..."

For Jimmy-the good news is that his blood pressure is normal at 118. It was 150 at the regular vet's back in April when he was sick. 

Thursday, May 11, 2017

Jimmy Sick Again This Month

Jimmy presented this morning with diarrhea with blood and vomiting.

He was sick a month ago with blood in diarrhea and some vomiting and lethargy and poorly eating, and some weight loss (minor) which I posted back on April 11, 2017. Home treatment calmed the diarrhea but he was still lethargic so he saw the vet. His Cobalamin fasting and Folate fasting and Pancreatic Lipase tests were normal (no sign of pancreatitis; good absorption of nutrients, etc.) Blood work CBC/chem panel had questions but no definitive answers. He had high cholesterol; normal but edging up fructosamine test (for diabetes); high albumin; proteinuria of 30 in his urine. Diabetes? Cancer? Organ inflammation (like pancreatitis)? Kidney disease? Poor adrenal gland? Albumin is related to kidneys or dehydration. For cats it's typically dehydration but in humans, failing kidneys causes high level of albumin to be in the blood stream. High proteinuria means poorly functioning kidneys. Or it's a matter of how the urine was drawn with a needle. Vet had no concerns and said let's monitor and do a scan.

Next step was an ultrasound which he had Tuesday. They also took his weight. He dropped 11 oz in a month despite eating well and three times a day. What's the cause if he's eating as much as usual and if his Cobalamin and Folate tests were normal? The ultrasound showed no issues with heart, stomach, intestines, liver, pancreas, gall bladder, kidneys, or bladder. Again, vet said monitor.

Then today, we woke to find him sick with vomiting and diarrhea and blood in the stool. We scooped out samples; called the vet; and I took him in. They gave sub q fluids, a shot of Cerenia (calms stomachs after vomiting and helps cats feel better) and by the time we got home he was much better and has been eating. He is to take antibiotic Zeniquin for 30 days to cure any gastro issues. He is to eat a non-fish based food and we might try a hypoallergenic food. The vet thinks it may be a food allergy, including the weight loss but that there may be bacteria in the gastro system. For now I will stop all supplements except lysine and potassium just in case any are causing weight loss (however, he's been on them about a year with no issues.)
Jimmy at the vet

I think it's the herpes virus trying to come back stronger. When he was initially sick in 2009-2010 before we got it under control (with lysine and Forta Flora and vet trips every two months or so when he was too sick for home treatments) the virus would hit on schedule each month at the same time. It comes back under stress but there wasn't stress that we know of in March or early April. I think the virus has been appearing and I didn't take it seriously. He has had black discharge from his eyes-very slight-but it has always been a sign of the virus. While I've given him extra lysine, perhaps it was not enough. Perhaps he should have had antibiotics in April. Perhaps he had bacteria in his system that gets active with herpes or stress. Who knows. When he was given antibiotics in 2009-10 to fight the attacks, he presented with vomiting, diarrhea and a fever. No fever this time. But with blood in the stool, the belief is there might be bacteria. Luckily, stool samples were free of worms-hook, round, and something else (but not tapeworm: those you see from the rear not in the stool sample.)

And Jimmy is a sensitive boy. He was the one hit hardest and hit first with the herpes virus as he was the first sibling to be spayed/neutered (neutered of course.) He reacts strongly to smells and stress and changes and viruses and bacteria.

For now he is secluded where I can monitor if he's eating or has diarrhea and can seclude him from the other cats. I'll keep him secluded today and maybe tomorrow. I'll give him some rice water later to help bind up the stool.

And I researched glycerin (April 21, 2017 Facebook post) which is used in Jimmy's prozac. It has carbs-not good for prediabetic, diabetic cats. 1 gram of glycerin has 1 gram of carb. He receives one tenth of glycerin per dose so only one tenth of a carb. No need to change his medication.

Thursday, March 2, 2017

New Drug Shows Promise to Decrease HCM Effects

http://journals.plos.org/plosone/article?id=10.1371%2Fjournal.pone.0168407

http://science.sciencemag.org/content/351/6273/617

New drug might help cats with HCM: "The novel drug, MYK-461, proved effective in a study of five cats with a naturally occurring form of inherited hypertrophic cardiomyopathy (HCM)...eliminated left ventricular obstruction in five cats with HCM...MYK-461 was already shown to stop the thickening of the ventricle walls in mice."

Here's the paper about the new trial drug discovered for the treatment of HCM. Understand the drug treats obstruction, not something all HCM cats have; and it may not decrease the progression of the disease, just some physical issues of the disease. But only time will tell. Keep an eye on this drug. Let me know if you read more about future developments. I'll try to stay aware of it. "Treatment with MYK-461 reduced contractility, eliminated systolic anterior motion of the mitral valve and relieved LVOT pressure gradients in an exposure-dependent manner. Our findings provide proof of principle that acute reduction in contractility with MYK-461 is sufficient to relieve LVOT obstruction. Further, these studies suggest that feline HCM will be a valuable translational model for the study of disease pathology, particularly LVOT obstruction."

Tuesday, February 7, 2017

Roxanne Back to Usual Self

No word yet on bartonella test results. But Roxy did finally begin to pick up starting Friday night and into the weekend. And I would say that as of yesterday, she's back to acting like her usual self. Not sure what happened. But there was definitely a change about her last week.
Roxy when she wasn't feeling well and was sleeping a lot. She's curled up with my favorite childhood doll Grandma (from Sears early 1970s.) She's in the bassinet of toys.

Thursday, February 2, 2017

Roxanne Not Feeling Well, Lethargic-Not Sure


1/31/17

Took Roxy to the vet today. She has seemed run down this past week a bit more each day. Still eating but just not as energetic. We are retesting for Bartonella (she had it last summer) and for Feline leukemia (tested negative last summer but just in case) and did a full CBC/chem panel to see if anything shows up in blood work. Bartonella takes two weeks to test which is sad since if she's sick she could use the antibiotics sooner than later. But we will keep an eye on her and see how she does. I will give extra lysine (she gets the powder in her food.) Have cypro in case she needs help eating. She's breathing fine and there was no congestion but I will monitor for any signs of heart issues (none expected but you never know.)

2/1/17


Chalk it up to learning something new everyday. Because Roxy's still run down but the blood work was almost normal except that the creatinine kinase was over 800 (normally way less than 400 and in July for her it was just over 400), we are doing the BNP test. This only requires that IDEXX run her blood work; it does not require another trip to the vet. So, what's new? I've never recommended the test. There are blood tests to detect heart disease-genetic tests and the BNP. I've never recommended BNP because if the cat is showing signs of heart disease, has a heart murmur, or any known issues with the heart, getting the blood BNP is a waste of time since only an echo can tell the vet what's wrong with the heart. The BNP test measures brain natriuretic peptide levels in the blood. There will always be a nominal amount but if the heart is having difficulty or the human or pet has had a heart attack, the BNP will sharply rise. Again, if the pet is having a heart attack, why test the BNP? Have an echo, have the vet treat the issue at hand. And an echo will show a heart attack and damage far better than a blood test. And yet, we're testing her blood. Why? Because she saw the cardio in October; because she's showing no signs of heart disease-no change in breathing rate so far; because her heart was beating normally at the vet; because we already drew blood and can test BNP to rule out any other cause that could raise creatinine kinase. However, I did make an appointment for Friday for the cardio just in case (which I can cancel if BNP is normal.) The other way creatinine kinase can rise is due to a hard physical injury to the body or brain. Did she fall? Not that we are aware of but in this house anything's possible. Here's a link to creatinine kinase and below is the link to the BNP explanation. https://www.healthgrades.com/sympt…/elevated-creatine-kinase

2/2/17 

Roxy still a bit run down but the BNP heart test came back normal. Reference range is 0-100 and she's at 24. The cardio said if she's not showing signs (cold feet, fast breathing, not moving, etc.) and the blood test is low, then she is assumed to be fine. So, we will monitor and wait for the bartonella test to come back next week.

Thursday, December 22, 2016

Jimmy Needs a Prozac Adjustment Again

Once again, after about a month with the increased Prozac (I'm assuming because Prozac can cause aggression), Jimmy is once again attacking his sisters. Never sure of the cause but something happens in his head and he gets angry and attacks. This isn't just swiping and hissing but a full on attack. Fur flies, cats cry, and when two are fighting, they all get involved. And it happens in a flash. So, I will dial down the Prozac-this time to .18-and see if he improves. Problem is, with the lower dose, he then begins to have accidents which we've seen since about September (the last one being 11/26 when he went against a window.) Maybe I'll try a week of a low dose and a week of a high dose and alternate. I could tell a change was coming, though. He has always had these maniac/depressive mood swings when on Prozac. He would spend a couple weeks very happy and then begin to slow down and not be active or involved, and would seem lethargic and disinterested in his environment. So, I would adjust the Prozac. Since September, the depressive mood swing has led to attacks against his sisters (because those are the cats he's near) and going out of the box.

Thursday, December 8, 2016

Echos Necessary Before All Surgeries to Detect Heart Health and Avoid Problems

When writing up a medical history list of Bette for the cardio visit, I came across her 2013 dental surgery record. It was written for her and Cooper's dental surgery record which they both had had the same day. I realized in reviewing it that I had not taken either Cooper or Bette to the cardio for a scan prior to surgery. I believe it was because at the time Myrna was so sick, and we were spending so much on her care, and now were faced with $1000 for two dental surgeries, that spending another $600 for cardio echos was going to be out of reach. And yet I wished that I had spent that money.
Cooper had had an echo summer of 2012 and was fine. He had dental surgery a year later in 2013 and afterwards, began to slowly exhibit symptoms of being ill but symptoms I attributed to his reoccurring hypercalcemia (high calcium rate) which we had battled the year before and which had not returned. Blood tests didn't show anything other than a minor increase in calcium. Months later, March of 2014, after another dental surgery, he did not bounce back and we took him to the vet two days later, only to discover he had CHF. We rushed him off to the cardio. He would be on heart meds March-July and die of CHF in July.
If I had taken him to the cardio in June 2013, we may have caught early signs of heart disease. And certainly, he had heart disease by March 2014 which an echo would have caught and we could have avoided dental surgery and the onset of that first CHF-even if the outcome would have been the same in the end.
From now on, every cat gets an echo before surgery.