Tuesday, October 6, 2015

Jimmy Has an Annual Checkup

Update on cats: Jimmy had his annual physical late September and his blood work is great. His fructosamine-blood sugar level test-is normal. Last year it indicated hyperglycemia or a pre-diabetic condition that could become diabetes. This condition can cause sudden urination when sugar builds up in the urine and the bladder becomes suddenly full, and the cat needs to suddenly go. This may have been one reason for his out of box accidents which he had on occasion despite taking Prozac (since 2010) to help him use the litter box. We changed his diet to decrease his carb intake (carbs become glucose) by changing him to pate' type of food and not gravy based food (or food that is more wet than compact.) It worked out well. This week-Bette and then Elizabeth then Katharine in October. Baby goes in November.

Methamazole Contraindicated with HCM Heart Meds and Blood Thinners

Methamazole, given to cats for hyperthyroidism, is contraindicated with atenolol, blood thinners, and other meds. Methimazole decreases or prevents the effectiveness of other drugs. If your cat is on meth, I'm not sure what would be the best approach. If your cat's thyroid is overacting, eating iodine free foods such as Hill's y/d and not eating regular food that has iodine, will help decrease thyroid levels. Meth should be used if the thyroid level doesn't improve with a diet. Your cat may need some meds such as atenolol more often if also on meth. Always discuss this with your vet/cardio and watch for symptoms that the beta blocker isn't working. These could be weakness, fainting, lethargy, even breathing too hard because the blood pressure and or heart rate have increased or have dropped.

Friday, September 18, 2015

COQ10-Necessary but Use Cautiously and Watch for Interactions with Other Meds

A question came up about COQ10. This is a substance found in the body and necessary for heart function. It is believed one should take a supplement in order to provide the heart with more of the substance to improve heart function, and because some meds may interfere with the body's use of COQ10. 

We gave it to Myrna beginning in 2010 and within weeks, her heart size deceased by some tenths and she seemed healthier in general. I would pierce and squeeze and mix a 100mg into her food once a day. As of 2014, I added it to her kidney support vitamin mixture. 

I don't know if it ever interfered with her meds. Her blood sugar was normal. Her blood pressure was only influenced by her heart attack in 2013 (three years after being on COQ10 and Plavix at the same time.) I believe Pepcid which she was on since September, may have interfered with Plavix (which unfortunately we had to give due to the stomach acid I was not able to control with other things such as bicarb/club soda or vinegar) because of the numerous clots she experienced this past year. 

Some articles such as this Mayo Clinic article states that COQ10 may interfere with every medication on earth. And yet articles such as the Wikipedia post state that there is a need for supplementation of COQ10. I believe in giving it and highly recommend it. We use Nature Made. 

Begin with 50-100mg per day and watch your cat for any negative interactions which you may see in blood work or in heart rate or blood pressure. Always proceed with caution with anything that you give. After all, even electrolytes-natural and necessary for any body-can be too high or too low and cause negative interactions or changes in the body. 

Friday, September 11, 2015

Katharine's Eye Infection Hits Again-Vet Visit and Eye Drops

Before I left, Katharine seemed to becoming quiet and then while I was gone, she developed goop in her eyes. I took her to the vet Tuesday (offices were closed Monday due to Labor Day) and she has an eye infection but one that is probably brought on by the herpes virus. Since Saturday, we've given extra lysine (which fights off the herpes virus) and when she seemed feverish Sunday, I began giving her Buprenex .2ml twice a day. By Tuesday, she had a normal temp. The vet gave antibiotic eye drops. By Wednesday she had no eye goop. She will take the eye drops for two weeks. Meanwhile, I'm giving everyone extra lysine.

Friday, August 28, 2015

Possible Cause of Death-Respiratory Acidosis

From reading, I have a theory about what led to Myrna's death. It's much like stacking dominoes-as one thing declined, so other processes in the body followed. But it's not a process that I believe I could have prevented. And she was on oxygen in the ER and was not improving. The chemical process may have been caused by hypochloremia-low chloride-caused by vomiting, diarrhea-which leads to hypercapnia (respiratory acidosis) which is too much carbon dioxide in the blood. Or somehow, on it's own, hypercapnia developed in the blood. Respiratory acidosis develops when there is decreased ventilation-inability to get enough oxygen-which leads to an increase in carbon dioxide in the blood. Because the body cannot expel carbon dioxide due to congestion/lung damage/heart condition, more CO2 than O builds up. This becomes hypercapnia and leads to increased breathing rate as the body struggles to produce oxygen. The heart beats faster, this leads to blood pressure increasing, and the inability to breathe, to produce oxygen is exacerbated by damaged lungs and increased heart size and congestion. Her heart had been stable the day before and she only had three oz of fluid removed. And yet, we know congestion was returning rapidly since 5 oz had been removed the day before.

Wednesday, August 26, 2015

The Importance of Sodium and Chloride

Near the end, Myrna was suddenly low on sodium and chloride due to chronic diarrhea, and the vomiting that would occur from time to time for whatever number of reasons. In July, it became so chronic that she couldn't hold anything down. When her blood work showed she was low on sodium-and I read that being low on sodium can contribute TO vomiting and diarrhea-I gave her some salt in the food I was feeding her by mouth. This improved her condition within a couple of hours. 

While HCM cats do not need added sodium, in this rare instance it was what she needed. But why? Here's a website called Pet Education. Com to tell you why. I've referred to this site before. It's a really good, basic site. Bookmark it and search for additional information. "Sodium and chloride help maintain the balance between fluids inside and outside individual cells of the body...Sodium aids in the transfer of nutrients to cells and the removal of waste products. Chloride helps maintain the proper acid/alkali balance in the body. Chloride is also necessary for the production of hydrochloric acid (HCl) in the stomach which helps in the digestion of protein..."

For more information, read this website: "In addition to its functions as an electrolyte, chloride combines with hydrogen in the stomach to make hydrochloric acid, a powerful digestive enzyme that is responsible for the break down of proteins, absorption of other metallic minerals, and activation of intrinsic factor, which in turn absorbs vitamin B12. Chloride is specially transported into the gastric lumen, in exchange for another negatively charged electrolyte (bicarbonate), in order to maintain electrical neutrality across the stomach membrane. After utilization in hydrochloric acid, some chloride is reabsorbed by the intestine, back into the blood stream where it is required for maintenance of extracellular fluid volume. Chloride is both actively and passively absorbed by the body, depending on the current metabolic demands.  A constant exchange of chloride and bicarbonate, between red blood cells and the plasma helps to govern the pH balance and transport of carbon dioxide, a waste product of respiration, from the body. With sodium and potassium, chloride works in the nervous system to aid in the transport of electrical impulses throughout the body, as movement of negatively charged chloride into the cell propagates the nervous electrical potential."

Thursday, August 20, 2015

Preliminary Report on Myrna Loy's Necropsy (Animal Autopsy)

Gross Description

6 years

Necropsy Preliminary Report
A 6 year old spayed DSH died on 8/19/15. The cat had a history of clotting secondary to heart disease. Owner isconcerned about gastric and renal disease. A 4.45 kg female spayed cat is necropsied on 8/19/15. Autolysis is mild. There are adequate visceral fat stores and the body condition score is 6/9. The eyes are mildly sunken into the orbits, and mucous membranes are pale pink. The thoracic cavity and pericardial sac respectively contain 15-20 ml of red, clear, slightly opaque fluid, and 5 ml of dark red clear fluid. The parietal surfaces of the pericardial sac and pleura are multifocally and loosely adhered to the thoracic wall by numerous fibrinous adhesions. The edges of the cranioventral lung lobes are collapsed and plumb colored. All lung lobes float in formalin. The heart is enlarged weighing 20.1 g (0.45% of total body weight), and the right ventricular free wall and left ventricular free wall respectively measure 0.1 cm (RVF) and 0.8 cm (LVF). The left atrioventricular valvular leaflets contain numerous, 0.2-0.3 mm in diameter, tan, firm, smooth nodules. Lining the endocardial surface of the left ventricle are ~10, thin, white-pink, string-like bands of connective tissue (moderator bands) bridging the ventricular septum and the left ventricular free wall. The liver has slightly round edges and a prominent reticulated pattern. The cortex of both kidneys is slightly granular. There are no additional remarkable gross lesions.

Left ventricular concentric hypertrophy
Left atrioventricular endocardiosis
Excessive moderator bands
Liver: Mild hepatomegaly and centrilobular congestion

Pericardial sac: Pericardial effusion
Lung: locally extensive atelectasis and mild fibrinous pleuritis

The heart was overall large and the left ventricle was markedly thickened, consistent with hypertrophic cardiomyopathy which is a condition in which the muscle of the heart thickens (especially on the left side) and compromises the contractility and blood-pumping efficiency of the heart. Left sided heart failure often presents clinically with a thoracic/pleural effusion, as seen in this case; however, the slight milky consistency suggest a chylous/lymph component which can occur if there is damage to the thoracic duct. In addition, the large liver and centrilobular congestion are common changes seen in right sided heart failure. There was also evidence of endocardiosis of the mitral valve, and excessive moderator bands, but the significance of these changes in relation to the enlarged heart is unknown.  Endocardiosis is a common age related degenerative of the valvular leaflets. If severe, these lesions can cause leaky valves and eventually heart failure, but the changes were mild in this case. Excessive moderator bands have been observed in normal cats and in cats with hypertrophic cardiomyopathy, but the significance is unknown.

A final report is pending histopathologic examination of all the major organ systems.