Wednesday, August 25, 2010

Myrna Has a Check-up in March with the Cardiologist

Myrna was now to see her cardiologist every two to three months.  Her next appointment was in March. Myrna seemed to be doing well.  She was receiving meds at breakfast and at dinner time. When it came time to admininster the meds, we often had to hunt for her as she knew when it was med time and she would hide.  We hunted and tricked her but always made sure her meds were given on time.  She still bit me from time to time (with joy I suspect.)  She still tried to spit out her meds from time to time but was taking her pills.  And she was breathing easily at rest and running around with the other cats.

We saw her regular vet again for a blood test to check for renal values (which were again normal.)  We took more x-rays which appeared normal enough.  Then we saw her cardiologist and here are her findings.  Myrna was responding well to her meds:

Today's echocardiogram revealed that Myrna's hypertrophic cardiomyopathy is overall stable.  There has been some progression in the thickening of the left ventricular walls (previously .44cm and .91cm; now .62 cm and 1.07 cm.) However, the left atrial dimension has actually decreased slightly since Myrna's last evaluation (previously 1.83 cm, now 1.69 cm; normally less than 1.3 cm).  Further, the dynamic obstruction to blood flow (SAM of the mitral valve) that was previously present was not present today.  These findings indicate a good response to her current medications.  Although Myrna's heart rate was lower than normal today (132 beats/min), this is not having any negative effects on her heart condition or her circulation.  Myrna has now developed mild enlargement of her right atrium and right ventricle due to natural progression of her hypertrophic cardiomyopathy.

So, we had progress and improvement and yet some mild form of disease progression.  But no congestive heart failure and no fluid buildup in the lungs and no ill response to her meds. 

But her heart beat was low. Initially, the beat was lowered so that the heart did not have to work so hard.  There is a medical explanation which I won't go into.  But too low a heart beat and blood will pool in the valve.  Blood that pools can form clots. Clots can travel to other parts of the body and form in the legs leading to loss of blood to the legs and loss of the use of the legs.  A clot could also settle in the other valves and organs and rupture.  All very complicated and all with their own medical explanations.  So, not only did we have to watch for her breathing rate and her energy level but also if she was going to develop trouble using her legs, or develop a swollen stomach (due to fluid buildup) or for signs of any other trouble.  In order to prevent clots from forming, she was given an additional medication, Plavix.  This is a drug that is about $6.00 a tab and costs humans about $250 or so a month.  Luckily, she only needed a 1/4 tab once a day.  So, 8 tabs costs us $50 a month.

So, now we were giving her four meds in the a.m. and five in the p.m.  I was still using the pill cutter to cut the pills and storing them in the pill holders and using trays to keep it all organized on the kitchen counter.

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