Wednesday, May 27, 2015

Myrna Had Strange Anxiety Attack-Maybe a Clot Moved or Issue with Heart Function

May 26, 2015

Strange incident this afternoon: about two p.m. Myrna became vocal and needed a lot of attention and petting and was rolling over being "Cute". Which was fine but that quickly turned into "something's bothering me and I don't know what it is". She was breathing fine. But then she began to panic and tried to hide, kept going from room to room. Finally, I put her in our bedroom and closed the door. I tried to calm her to see what was the problem because I thought another clot incident was occurring. She seemed to lose use of her back legs again but when I picked her up and checked toes and paws, she was pink and warm. When I put her down, she could walk but was really out of it. I placed her on the bed where she seemed to gladly stay. By this time it was about three p.m. Since Buprenex made her zombie-like when I gave it to her last time after the thrombosis, I opted instead to give her the 3/4 or .75mg tab of Valium she would normally get at 6 p.m. She already had received a .50mg at noon. And I gave 1/2 Torsemide. In five minutes, she was calm and after ten more she was resting and sleeping after fifteen. By five p.m. she was up again and drinking. She didn't eat much this evening until bedtime when she ate a lot. I'm not sure what happened or what's still to come but she came through it. So, we had one more day with Myrna. Valium-as I've posted before-is the only safe psychotropic for those people or cats on Plavix. Your HCM cat may need it to use the litter box (all that lasix, water, and urinating can be bothersome, irritating); helps calm when it's storming; eases anxiety-like attacks when (as today) you can't figure out what's going on (it was the first time I had used it as such); etc.

Tuesday, May 26, 2015

Why Sick CatsThat Don't Eat Need Hand Feeding Nutritional Support and Stimulants


What I do and what I keep advising owners to do: "Treatment of the condition will be tailored to the needs of each individual cat, but supporting the strength of heart contractions, reducing fluid buildup, nursing and supportive care (including nutrition), and dietary adjustments are some of the common strategies..." 

If a cat is sick, as Myrna was after the saddle thrombosis, and if they won't eat enough or at all, hand feeding of various liquid food sources every two hours, along with water (if not drinking on their own) is what is needed.  It's one thing for a cat not to eat a meal or two in one day or to skip a day.  But it's another thing when they won't eat anything the next day.  The depletion of nutrition, decrease in electrolytes needed to run the body, decrease in hydration to keep up the blood pressure, will make a body weak.  A weak body won't want to eat, won't be able to recover.  Your cat will feel as terrible and as weak-but at a faster rate-as you do when you are sick and not eating.  

Hand feeding liquid food keeps up the hydration and the nutrition and helps the cat recover.  It will help spur the appetite, also, because a weak cat will lose its appetite.  But Mirtazapine, an appetite stimulant, may also be needed.  Usually, 1/2 tab every two weeks was all Myrna needed. But after the saddle thrombosis, Myrna needed 1/2 tab every day for three weeks. I finally have her down to 1/4 tab a day and will see if I can wean her to every other day.  

What I fed: with a 3ml syringe (from the vet, pharmacy, or order online), her sweet potato vitamin kidney support mixture three times a day; 3ml of tuna juice, and 3ml of baby food beef or turkey (mixed with some water to make it just liquid enough) three times a day; and 3ml of sweetened condensed milk cut with water (use only if the cat is not diabetic) once or twice a day.  The sugar source provides the body with an energy source so that the body does not attack the fat reserves in the body and the liver, leading to hepatic lipidosis. 

After a few days, Myrna began eating on her own.  The next few days, she needed intermittent hand feeding. Finally, after two weeks, she began eating regularly on her own but still receiving Mirtazpine. 

Why Cats May Need More Lasix, More Often to Combat Congestion

Why cats need lasix, and may need more of it and more often:

"Signs of heart failure decompensation and congestion such as a persistent increase in resting respiratory rate or recurrence of cough may respond to an (often temporary) increase in furosemide dose. In most cases (check with your veterinarian first), if your pet has been doing well on heart failure medication but subsequently develops signs of congestion again, you can increase the dose or add an extra dose."

Cat Updates-Myrna, Bette, Katharine, and Baby

May 26, 2015

Bette, Baby, and Katharine had blood work this past week. Bette received a shot last week of Convenia for her chin acne and that got rid of it quickly-she had a cyst so it was a bit more infected than the others. Baby's T4 value went up 2.6 to 3.1 and at ten years old she's considered in the gray zone for watching for abnormal thyroid level. But the Free T4 test-which should tell us if she's in hyper or hypo thyroid level-came back normal. We will continue to monitor her behavior at home and blood tests every few months. We've questioned the thyroid only because she's been "off" for about a year or so now: fussier, grouchier, not eating well enough (her weight maintains despite this at around 9.13 lbs.) She needed Trixin-hyloronic acid-for a year for mobility and that helped a lot. As for Katharine-clean as a whistle, perfect blood work all around. Baby and Katharine go to see the cardio for rechecks in two weeks.

Another week and Myrna's still doing well. Despite the loud canon sounds coming from an idiot neighbor this weekend-due to Michigan's too lenient fireworks law-she is doing well, breathing well, eating well, drinking a lot and all on her own, and getting around easily and playing and talking. We continue to monitor for breathing congestion, anxiety, clots and general disposition. As the heat increases outside, we've kept windows closed and fans going and that has kept the house reasonable. Soon, we'll need to run the AC portable units and monitor more closely the humidity levels, her breathing, and when she'll need Aerocat/albuterol asthma inhaler.

May 20, 2015
Little girl (Myrna) continues to do well. Now it's back to getting work done around the house-sans smells and noise. The ER vet may disagree but this "normal" phase is fine for her. She's up and about, eating, etc. things could change rapidly and so I'm not comfortable being out of ear shot/view but there's work that's been on hold that needs to proceed.

May 15, 2015
Well, it's been over a month since the cardio thought she was at the end; over a week since the thrombosis and not eating and she's ok so far and eating well enough despite meds and the occasionally syringe feeding. Hasn't been tapped since 4/23/15. Not dragging around, not looking too worn out. Odd biological clock: up and active and using litter box and wanting to eat overnight; slow and quiet in the a.m. into the early afternoon; eating more late in the day and early evening; then slowing down again before being perky again. This might be normal as our other cats sort of do the same.

May 14, 2015
For now we will skip today's scheduled cardio apt unless vet needs to see her. Breathing ok, we push extra diuretic as needed; syringe food and water as needed and monitor if she's not taking in enough on her own. Syringing food when she's not had enough seems to spur an appetite and she returns to eating more. I don't do it immediately. I wait half an hour to an hour after she's eaten the regular food and then syringe.despite daily 1/4-1/2 mirtazapine, she doesn't have much of an appetite-due to pain caused by heart, decline of kidney function, which leads to general malaise? Not sure-all if it and more I guess. It's just that mirtazapine should jump start the appetite and it's not. That is what is confounding.

Tuesday, May 12, 2015

Myrna's Vet Notes from May 5, 2015-Saddle Thrombosis Diagnosed

Vet's notes from May 5, 2015 visit:

"I have no explanation for Myrna's episode last evening other than a saddle thrombus.  The clot must have dissolved during her drive to AEC which allowed her to regain movement in her hind limbs and prevented accurate diagnosis with the testing that was performed (lactate measurement palpation of femoral pulses).  Her recent GI symptoms and general decline in energy make me concerned that she is experiencing small clots in her GI tract and/or elsewhere throughout her body. It is appropriate to continue general GI support with syringe feedings, mirtazapine, and Cerenia.  Today's echocardiogram revealed that she currently has only a mild amount of pleural effusion, which indicates that thoracocentesis is not of benefit Her left atrial dimension is stable compared to previous exams (currently 2.74cm) and there is no change in the disorganized clot that we have been monitoring in this chamber. Her left ventricular walls are thinning as a consequence of chronic fatigue (burn-out HCM.)
Myrna in recent days

Websites and Information to Read RE: Kidneys and the Heart

Kidney  Do you know how urine is created out of blood? Do you know what filters it all? of kidney function to better understand what your cat needs to support the kidneys, why they are important.

study-looks-for-better-way-to-detect-cardiac-blood-clots-in-cats   CT scans are supposedly cheaper. But do they really tell the vet the whole story?

Update on Myrna's Condition Post-Saddle Thrombosis

May 6, 2015 

Forgot to describe saddle thrombosis: cardio thought a shower of clots had broken off from the clots in the heart and traveled. One sat long enough in the hind leg artery and then suddenly caused pain. The clot wasn't large enough to stay but moved and went elsewhere or disintegrated. Luckily there was no damage. A similar clot may have entered the stomach artery and led to the vomiting which caused stomach acid.

May 7, 2015 

Over joyed that hungry cat wakes me at 5 am to tell me she wants food-and continues for the next three hours. Exhausted I am-but how can I complain?

May 8, 2015

She's doing well. Ate almost each hour from 2-6 am then again 10-1pm. Br ok, needs extra Torsemide on occasion. But up and about and then resting comfortably.

May 10, 2105 

Myrna's doing well enough. Eating well enough on her, still taking a bit of Cerenia and Mirtazapine. But now we need to give water by mouth because she's not drinking enough, which means the diuretic may not be working well enough, which means kidneys are not processing well enough, which leads to her increased breathing, which then leads to me giving more Torsemide. And we did an injection tonight to replace a dose which did work to ease her breathing a bit. I'm trying to get her through the weekend without the ER for tapping and will call the cardio Monday morning. She's not been tapped since 4/23 but may have needed it Friday but extra Tor got her through the day. She's quiet during the day still but not as run down as earlier in the week.  

May 12, 2015

Despite Mirtazapine yesterday and today, Myrna began not eating well enough last night. She had some treats overnight but wasn't eating enough this a.m. I decided to syringe some tuna juice and baby food again this afternoon. She's burping again. Either she's going to vomit from the syringing or there's another issue in the works like a clot.

But it has been a week since the last clot and no other issues.  It has also been 19 days since she last needed tapping to remove fluid. We are giving her 7.5mg Torsemide QID and 2.5 extra as needed once or twice a day.