Saturday, January 31, 2015

Feline HCM Complications in November 2014 for Myrna Loy

Posted to Facebook November 6, 2014

I have decided to start Myrna on Pepcid, 1/4 of 10mg q 2 days. Will do daily if needed but will start slow. Vinegar-which I'll continue because it's good for the kidneys, and club soda/bicarbonate, good for kidneys-is no longer enough. She's smacking her lips too much, a sign of acid reflux, indigestion, nausea, and/or an increase of kidney values. This may be why she has stopped eating well this week. I gave mirtazapine yesterday which helped.

Posted to Facebook November 10, 2014

(Myrna hid under the bed in the morning of 11/10/14 and I couldn't give her medications until I was able to push her out with a broom.  When I picked her up, she began spewing water which was exactly what Cooper had done in May, which I knew to mean that she had a major CHF episode, so much fluid coming out of her lungs that it was coming out via mouth and nose and that she would not be able to make it to the cardio 40 minutes away.  So, I took her to the local ER.)

Myrna in-unfortunately-local ER. Suddenly CHF, breathing and gurgling. Too much to take her to cardiologist 40 minutes away. 

(Two hours later:)  Miss Myrna's not responding as quickly to treatment as in the past and not since 3 pm. But the breathing rate did decrease from about a million with spewing of liquid to closed mouth at 60 plus a minute. She's not eating for me as she used to when in the ER. She needs our prayers. I may not have paid as close attention to her breathing rate last night or today. We must be more vigilant and stay ahead of and not behind congestion.

(Hours later:) Little girl now breathing better at 44. Far better than before. The plan is to transfer her to Novi tomorrow to be seen by the ER/cardio office if she's well enough to travel.  (She was well enough to come home and her lungs were clear so we did not see the cardio.)

Posted to Facebook November 11, 2014

(Next day, very early in the morning after the ER called with an update:) Myrna still only about 40 breaths per minute today. Has been off oxygen for only two hours whereas in the past she would have been able to come off overnight. I will get her in two hours and see if she is the same and comes home or goes to the Novi ER/cardio. Some temp med changes and lasix increase. BUN up from 39 to 53, creat is 2.9 from 2.2. Needs to come down but expected.

(Hours later:) She's home. Breathing ok but not pronounced. Not yet eating but drinking a ton. Is alert, glad to be home but not happy with me. I'm the only one home and she is still managing to ignore me. Sigh.

At the ER last night when I was told they weren't being aggressive with lasix and not giving pain meds which the other ER does as protocol, I wanted to pull a Shirley MacLaine in "Terms of Endearment": "Give her the shot!!" Instead I simply texted the cardio who then rang the ER.  While pain meds were never given, more lasix was per cardio's plan. We must not be afraid to be patient advocates for our pets.

(Myrna had trouble breathing when she got home. Her rate was up to 60 and she did not respond to meds.  She couldn't settle down either.  She kept pacing.  I touched base with the cardio who said to give the meds time to work but maybe to give an injection later.)Gave. 20mg lasix dose at 5pm as prescribed but breathing rate was high at 12/15.   At 6:30 breathing was 56. By 7 pm she was breathing with effort and wheezing. We gave her the inhaler for asthma and injected .3 ml lasix. She is finally  (around 10 p.m.) breathing clearly, resting and breathing at 32.

Posted to Facebook November 12, 2014

Myrna update- better. Gave meds and 20 mg lasix at midnight and not at one am. (6 hrs after lasix injection as prescribed ) because breathing was up to 48. Used box four times midnt to 6:30 am and good amts. Br now 36 and comfortable. She had tremors or trembling last night whenever she would try to rest, stop moving, try to breathe comfortably. Isn't pronounced so far today. Heart rate? Lack of electrolytes? Congestion and oxygen exchange difficulties? I'll give more potassium today. Eating was ok yesterday around 6-7 pm after Pepcid at 5 pm. It takes an hour for Pepcid to make her feel better. That was the case last week as well. I thought I'd do 20 mg lasix qid ( four times) today; 20 tomorrow am and then 15, 15, 18; then back to regular schedule if she's better unless cardio changes the schedule.

Myrna and I slept in the guest room last night so she was away from the others . The frame had been removed do she couldn't hide under the bed and not get her meds. My husband is going to build a wood frame around our bed to prevent the cats from getting under it. Then Myrna can go back to our room but she won't have a place where we can't get her.

Posted to Facebook November 14, 2014

After improving Wednesday and Thursday, Myrna slowed Thursday night, not eating , breathing up a tic, and later, a bit anxious . Today only ok. Not eating except that at 4:30 am she woke me and demanded food-a half long process of me being aggressively woken, then giving a treat , checking her breathing, asking if she needed the litter box, returning to bed, only to have the process start again. Finally , I gave her some dry food which she ate and then came back to bed to sleep. Lasix had been reduced from 20mg qid to 18mg qid. She may need more lasix. Have updated the cardio. Will give mirtazapine to get her to eat.

November 15, 2014

Cardio wants us to begin the day with .3ml injections of lasix.

Posted to Facebook November 16, 2014

Myrna had a really good Saturday. Morning shot went well. Breathing remained about 32 all day. She ate everything. Today is off to a slow start but the injection went well and she's breathing still at 32 and eating. But she's more run down after the injection. It could be due to the load on the kidneys from the lasix. We may need to vary when the injection is given going forward as long as she does not need it first thing.

Myrna has been ok today. Still eating well. Breathing keeps going up to 9 and she's had two in between doses of 5mg lasix. She's more tired today but that could be because she was up most of the night. How do I know? Because I was up most of the night with her. She kept waking me. I don't know what she wanted each time but she did use the litter box and she did want some food. I kept checking her breathing and petting her and talking to her the other times she woke me.

Posted to Facebook November 20, 2014

Myrna continues to recover well from last week's major CHF incident. She doesn't need a.m. injections every day-and I judge that by how she is breathing and feeling in the a.m. Since this Tuesday, I've varied them from a.m. to afternoon. I give an injection to replace a regular dose of lasix and if no injection, then give pills. I don't let the injection be missed past the 2 p.m. lunchtime dose. I will know when she sees the cardio in December if we need to continue these. Neither she nor I likes them.

Not to jinx anything regarding Myrna's recovery but I wanted to say that it's been five years since her first CHF incident, at age 8 months, when on 11/18/09 she collapsed with rapid breathing and was rushed to the ER where Dr. Michele Forbes saved her. Then, on Nov. 19, 2009, she first saw Dr. DeSana who diagnosed HCM and spent the next two months (and the next five years) working with me, seeing Myrna a couple of times, talking to me on the phone every few days to get updates, adjust and add meds, and help me administer and organize Myrna's care. Dr. DeSana said she would live 2-5 yrs. She is now 5 yrs and 8 months, and since it's five years and a day since she first saw Dr. DeSana, she has officially-by my reckoning-outlived the doctor's projection.
Posted to Facebook November 29, 2014

Well, for the last two weeks, Myrna's being doing well. But we've kept her on 18-20mg of lasix QID-four times a day, up from the normal 15, 13, 15, 18 dose she was on the last few months. The cardio had us injecting lasix in the a.m. of .3ml which is equal to 15mg. I gave that shot and often along with a 3-5mg pill as needed. The first few days I gave the shot in the a.m. and then gave later in the day if she didn't need it first thing-if she was breathing fine. We skipped it last Saturday and I think we spent Sunday catching up to congestion as her breathing rate increased. So, she seemed to need the injection daily. But this week the lesions have developed ( an issue that first appeared last summer when she struggled with congestion and that continues to appear anytime we do many injections)-one came up and scabbed at the scruff between the shoulders so I didn't know it was there until I tried to use the area again to inject. There are two others on her flank that at first felt like part of her rib cage but now have changed shape. So, now I'm trying to avoid injections and just keep up with pills. We did inject her Thanksgiving since we were going out. We may need to do this every other day or so if she still needs an injection. She sees the cardio Monday at which time we'll do blood work to see how her kidney values are doing and see if they've improved since her CHF ER visit about three weeks ago. Why inject lasix? Because it works faster than pills and relieves the pain and stress of congestion faster, which helps the cat breathe better, which in turn keeps the cat calm, which in turn decreases stress, which in turn decreases the possibility of congestion due to stress. It's all connected.

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