Monday, September 3, 2012

Myrna Loy, HCM, on Aspirin, and New Blood Work

Since July, Myrna is also taking, along with her five meds and other supplements, a baby aspirin of 81 mg twice a week. She began taking this after her Juyly checkup showed an increase in heart muscle size.  The aspirin will help thing the blood and keep the platelets from sticking together and forming clots.  I set the range to dose it for Wednesdays and Saturdays. To make sure she was handling this well, we did a blood recheck last week.  She's had minor symptoms of stomach upset but no vomiting.  The only thing she did was to sort of burp but that went away after a couple weeks. So, her blood show that the BUN and Creatinine-renal values-and AST, ALT-liver values-are all normal.  The potassium level went from 4.2 to 5.1 and is now high normal instead of very low.  This neds to be monitored for possible hyperkalemia which could indicatre that she has renal issues.  Or it could be a combination of  factors but that still need monitoring because potassim levles canot be above normal. We think it's a combination of factors:

Aspirn-Aspirin effects renal blood flow and can decrease blood flow and therefore, affects glomerural filtration, and the decrease excretion of sodium and potassium.  Both her sodium and potassium levels are high normal but the sodium has always been high.  This could be a problem in the future as it could lead to water retention or edema which, for an HCM cat, isn't what we want.

Enalapril or ACE inhibitors-These effect renal blood flow and therfore effct the funciton of the filtration ability.

Spironolactone-a drug that retains potassium levels for the kidneys while acting as a diuretic.

Valium-She is taking Valium for anxiety and litterbox issues .  It's othe only thing HCM cats can take. They can't take a psychotrophic becaause they are contraindicated with Plavix.  Valiium delays the need to go and since she is excreitng less frequently, she therefore is not excreting potassium as much as she had been.

As I have said before, it's very important to understand the relationships between the different blood chemistries and to understand what is normal or not and what it all means. Check out the linked website for more information.

The other concern is that the aspirin-and I'm not sure how-has lowered her platelet count to 135, below the low end normal that is 170.  This could lead to internal or external bleeding. We need to watch her closely for bruising or marks on her that indicate internal bleeding, for edema caused by internal bleeding, and watch any external injuries that would lead to bleeding.

We will test her blood again in November before her next  appointment.

ET-left-and Myrna Loy-right-How do they sleep that way?

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