The First Incident in November and What We Discovered

Understand that Myrna was a typical cat before she became ill.  She could run, jump, catch, and fetch.  She had energy and was fearless.  She showed no signs of lethargy or weakness or breathing problems.  The steroid medication didn't create the hypertrophic cardiomyopathy, only revealed it.  One can argue that if she had not gotten the allergic reaction, she would not have received steroids, would not have developed congestive heart failure when she did, and could have suddenly died of the disease by the time she was a year or so old.  Per her vet, since she was born with it, she would have died young had it not been discovered early.  Her body would have outgrown the heart's ability to support it.  If her vet had not put her on steroids, and since no one had suggested we discover the cause of the heart murmur, again, her disease would not have been discovered.  Someone should have suggested that an echo be performed to discover the cause of the murmur especially since cardiomyopathy is often the cause. (Another cat of ours has stress induced heart murmurs but his heart is fine.)  Knowing that a murmur had been heard, even if she had not heard it, should have been a warning to the vet not to prescribe steroids.

What is hypertrophic cardiomyopathy?  Here is one of many web links:

http://www.petplace.com/cats/hypertrophic-cardiomyopathy-in-cats/page1.aspx

Basically, it is the thickening of the left ventricle of the heart.  The heart valve pumps.  It opens to collect all the blood and fluid that is in the heart and closes tightly and quickly to push it out of the heart to circulate.  Blood enters on the right, runs through the lungs, out the left, runs down the body to deliver oxygen to the organs and tissue, and comes back again to the heart. When the left ventricle thickens, it does not have enough room when it opens to collect all the blood and fluid.  The leftovers flow back into the lungs, causing congestion.   Meanwhile, because it cannot push it all out, some pool in the ventricle and can lead to blood clots forming.  Clots can pass on to the rest of the body causing other major issues by blocking arteries, causing aneurysms, etc.  (Please see other heart related websites to better fully understand the functioning of the heart.)  As the ventricle thickens over time, it becomes harder for the heart to function, to send oxygen to the rest of the body and organs, for the cat to be able to have strength, to be able to breathe.  Sudden heart attacks or a malfunction of the heart can occur in untreated cats or if the cat is lethargic, is having trouble breathing and the owner ignores it or doesn't notice it, the cat will suffer and die.

That evening in November, she collapsed because oxygen wasn't sufficiently getting to her organs and muscles and tissues.  She had been in congestive heart failure for two days, since the breathing became heavy.  Her respirations were 100 and shallow.  As much as she was suffering, she was such a good cat at the vets.  It's amazing how sick they can be at home but once at the vet's, she was very active as if to say, "I'm fine and don't want to be here." 

The vet's notes indicated tachycardia, adequate and synchronous pulses, and they heard the mild heart murmur.  She had harsh lung sounds bilaterally.  Body condition was 2/5.  Xrays revealed abnormal pulmonary pattern, primarily a bronchial pattern (caudo-dorsally) with patches of alveolar (ventrally). The cardiac silhouette was poorly defined and the heart had enlarged (due to fluid intake.) They began oxygen and diuretics and kept her overnight.   Eventually, her respirations decreased from 100 down to 40 which is more normal.  

The next a.m., the ER said to see the regular vet so we took Myrna to see her vet for follow-up care and they recommended that we call a cardiologist they recommended to make an appointment.  I called and received an appointment for two days away.  I left her at her primary vets and they placed her on oxygen and gave more lasix. Her vet looked at her ER results and called the cardiologist and got us an appointment for later that day.  I collected Myrna and took her to the new doctor who was an hour away.

Lesson learned:

Go on instinct.  If you think your cat is sick, it may be.  Take it to the vet.

When a cat is having trouble breathing, even when the chest is heaving, the cat must be taken to the ER or to the vet immediately. Do not wait a day or a few hours. We should not have listened to the vet when she said to monitor and wait another day. I had my doubts and I should have acted on them. I understand the vet hadn't seen Myrna in this stricken state and could not determine over the phone how bad were her breathing problems. I should have acted on instinct and taken her to see the vet.
When a heart murmur or other heart issue is discovered early, the cat must receive a cardioac ultrasound so that you know exactly what is the problem. Problems discovered early can be tackled with a better outcome than problems that are ignored and left to render the cat lifeless.
If a heart murmur is detected, the cat should NEVER receive steroids for any illness until the cause of the murmur and the condition of the heart is determined. Giving steroids to a cat that is ill will damage the heart further and cause conjestive heart failure.