Myrna's Thursday Visit to the Cardiologist and a List of Things to Watch in a Cat

On Thursday, Myrna visited her cardiologist for a chest xray recheck.  Two weeks ago she had congestion in her lungs at the last check-up.  It was enough to have increased her breathing.  I noticed the increase breathing rate a few days before the appointment.  I should have called the vet but instead, kept an eye on the count and how often it occurred.  And since we would be seeing the vet soon, I didn’t think it warranted moving up the appointment.  I should have because the sign of increased breathing rate did mean that she had congestion.   Next time, I’ll know better.  She had also, for some time, decreased her level of activity. 

After the last visit, we increased the lasix from ¼ tab (of a 25 mg. pill) in the a.m., 1/8 at lunch, and another ¼ tab in the evening with dinner to ¼ of a tab TID (three times a day.)  After two weeks, well after even three days, her breathing rate had decreased from 32-40 to 28-32.  And there has been a marked increase of energy and an increase in playtime.   

The vet said Myrna is doing well and is stable even as the disease progresses. That might be hard to explain: how can she do so well and yet be so sick?  It means that she responds well to med therapy which props up her heart and keeps it working.  Myrna has always been an unusual case in that she is very sick but (and I’ve mentioned this before) has responded well to her meds.  What should go wrong-some cats have issues with some meds-does not.  What shouldn’t happen-needing Valium for inappropriate litter box use for example-happens.  I’ve also been observant and I’ve been able to catch some odd actions by Myrna that either warranted a trip to the vet or ER-fainting, being anxious with heavy breathing and not settling down after a couple of minutes-or a call to the vet or a mention at the next visit-blanking out or pausing for a few seconds as if in a trance, weakened leg muscles soon after starting Valium, etc.   

One thing that has helped me be vigilant is using a notebook to track questions and issues.  I take notes in the notebook about all seven of our cats.  I use a simple college rule, wire bound, spiral notebook for $1 from the store.  Use anything that helps you track your cat.  I place it in the kitchen cupboard. The pen fits in the spiral binder.  Neat and tidy and easy to reach.

But what are some things you should look out for when tracking your cat’s progress?

Here are some things to watch for:

1)      Take a look at your cat’s legs. Watch your cat for signs that something is different and might be wrong.  Look closely at your cat’s legs as it walks.  Does it slip from time to time? Is it on pain meds or something like Valium that could affect muscle tone?  Or is there a problem with the leg and the ability to walk? A call to the vet should be placed.  If the cat seems in pain or cannot walk, then a visit to the vet or ER is warranted.

2)     Check the paw, paw pads, and color of nail beds now to know how they normally look.   If you feel your cat’s paws and think they feel cold, check the color of the paw pads and the nail beds.  If the nail beds (which should be pink) are getting blue/black or dark grey (as long as dark grey isn’t part of the cat’s normal toe bed color) then a trip to the vet or ER is needed immediately. This could indicate a blood clot in the legs that is causing loss of circulation, blood loss, lack of feeling, and eventually pain and an inability to walk.   

3)     Does your cat clean or pick at its paws or nails?  Cats clean all the time but if the paw bothers the cat because there’s a blood clot, they will pick at it. They will also pick at a paw if there is an infection on the paw pads.  Watch the legs closely and take a look at the nail beds and the paw pads to see if there is anything wrong when you see them constantly cleaning. If there are any concerns or infections or issues, the cat needs to see the vet.

4)     Has your cat ever blanked out? When your cat is walking around or playing or interacting with you, have you ever noticed it suddenly seem to not know what it is doing? Have you ever seen it go blank or stare suddenly after being busy with something else?  Has this trance or pause lasted only a few seconds to 30 seconds or so?  Has your cat ever lifted its paw as if it is trying to decide what to do with it?  These could be due to arrhythmia, an unusual heartbeat and should warrant a call to the vet and a visit to the vet. If it passes in a few seconds, then call the vet cardiologist and discuss it with the vet.  If it is prolonged, then a rush to the ER or vet cardiologist immediately is necessary.  If it’s short but happens again and continues to occur, a call and a visit to the vet cardiologist is in order.  This means that there is a problem with the heart beating, circulating blood, etc. and it needs to be taken care of as soon as possible. 

5)     Have you noticed your cat being sleepy, quiet, or a lack of play or a lack of energy?  This is important to note because it could be due to congestion in the lungs or an increase in heart size.  A visit to the vet cardiologist is needed.

6)     Has the breathing rate of the cat increased even at rest or while sleeping?  Does the cat that is normally breathing 26-30 now breathing 30-40?  This is very important to note and could mean congestion in the lungs.  A call and a visit to the vet cardiologist are needed immediately.  Additional lasix might be warranted. Xrays will be needed to see if the heart has increased or if the lungs have congestion.

7)     Is your cat not eating well? Is your cat not urinating enough? Is your cat not drinking enough? Or is the cat eating too much, drinking too much, and urinating too much?   These are not normal, even for a cat sick with a heart disease.  This requires a trip to the vet to pinpoint any problems.

8)    Is your cat hiding?  Cats that are well do not hide.  Cats that are sick will hide.  A trip to the vet or ER is necessary.  Sure, your cat likes to climb shelves, sleep under the bed, crawl under a blanket, be quiet and disappear for a few hours.  But is it now disappearing for hours on end and not interacting, not playing, not coming out to greet you when you get home, and not wanting to eat?  Those are signs that a cat is very ill.

Being vigilant to changes and the behavior of the cat; being organized; keeping the meds on a set schedule; giving the cat all the meds and vitamins and supplements it needs; keeping it warm/cool as needed; keeping it free from stress; and of course, loving it, will contribute greatly to slowing the progression of the HCM disease.  Good luck!