Monday, September 1, 2014

Feline Congestion CHF and Meds-What to Know, What to Use, Why Fluid in the Lungs Are NOT Normal

From the June 28 Facebook post about HCM meds:

HCM cats need a lot of meds. The Notes and blog tab Meds discusses what Myrna is on and what the med does. Your cat will need lasix to combat congestion and to keep it at bay. Congestion is extra fluid that backs up into the lungs. Too much fluid in the body and a thick heart valve cannot adequately pump it out or take it in. Then fluid backs up into the lungs, filling the lungs, causing congestion. This isn't about any fluid being "normal". There is NOTHING normal about fluid being in the lungs. Pets are not like us-a bit of fluid and a cough, some decongestant and we're ok. Fluid in pets indicates an illness and usually heart disease and that means a life long struggle for you and the cat to keep fluid out of the lungs by decreasing the amount in the body. And that is what lasix is for-to get rid of extra fluid. Fluid in the lungs leads to a lack of oxygen picked up by circulating blood; leads to overall body weakness; a reduction of needed oxygen to support organs; leads to organ failure; and lungs filling with fluid leads to drowning. It's a very complex bio/chemical process. Giving extra lasix on top of a regular dose-when needed-will help you get ahead of a congestion episode. And these episodes will occur on occasion. Any stress and congestion can seem to quickly escalate. Part of what happens also is that when under stress, the body can't handle the extra fluid that may have been there, not really getting in the way-yet-of breathing. Again, a very complex bio process. Don't be afraid to give more lasix as needed if the cat is congested. The problem with this advice is you personally must experience what we have in order to know what to do the next time there is a problem. And it is always trial and error. And there is always waiting involved. And then there is always trying to figure out if the cat needs the cardiologist or the ER or both and how soon. Develop a protocol: the regular maintenance dose schedule-precise doses and on time. Then know how to count the breathing rate. This is important because how well the cat is able to breathe indicates if the cat is congested and if it needs more lasix. One up and down chest movement is one count. # of those in 15 seconds=a minute rate. Every cat's rate fluctuates at rest, sleeping, playing, etc. They will go from 24 to 40 in a nano second but then come back down to 34 and 24 in the next few seconds. Cats dream. Cats are anxious. The breathing will increase. They sniff things and the rate increases. To truly count, you must see the cat resting. Then count it again a few minutes later. If the rate is 8 in 15 secs (8/15) or higher, that's too high and now's the time to give extra lasix to get ahead of-and not behind-congestion. Don't be afraid to give a little extra now. Don't wait to see if the breathing gets worse. Take care of it now. Right now. Give 1/4 of a tab-of 12.5 tab or 20mg tab (so 3mg or 5mg). Whatever you have on hand. Wait an hour and see if the breathing improves. Then give another 1/4 if the rate doesn't improve. Then wait an hour. If there is no improvement, OR if the rate increases at any time, OR if it's getting late in the day and the vet's office will close soon, call the vet. Or feel free to call the vet at anytime WHILE you also give extra lasix. If the cat collapses-go to the ER NOW. If the cat's rate increases and you can't get to the cardio or vet, go to the ER because the cat will need oxygen and IV lasix. If you have supplies on hand and have learned how to do injections, you could also give .15ml injection to .3ml injection. All this as long as the cat isn't in pain or distress from congestion. If you think the cat's in pain and distress, go to the ER now. It's easy to wait to see if things improve. For some reason, we act as if we expect things to not be as bad as they actually are. We want to will away the problem. We can't believe what we are seeing. But remember a recent blog post-we need to think of our cats like babies-those small little bodies. How long would you let a baby be unable to breathe, or collapse, or be in pain? Not more than a few seconds perhaps. We need to do the same with our cats. Little bodies, with little lungs, and large hearts-makes for a difficult disease to manage. But we can. We just need to act quickly.

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