Wednesday, March 11, 2015

Prep for Summer and Feline Asthma Triggers

Getting ready to spring/summer prep the house. The snow in MI is melting and the temps are decent for a change-mid 40s. Since Myrna has asthma, and it triggers congestion and visa versa, I am researching triggers for asthma one of which is humidity, and how to control humidity. We already have two portable AC units. I think we need a third. We have one dehumidifier. I think we need a second one for the main floor even though the two AC units are suppose to also dehumidify by removing moisture. But it never seems to be enough as the main floors can seem clammy. I will buy two inexpensive in-home humidity LCD monitors which I can move around rooms to find where it needs to be cooler. The problem with our house is that while AC cools a section of the room, another section can be too warm or other rooms still too hot. This allows humidity to increase in rooms or pockets of rooms. We will also keep shades low-which we always do-to keep rooms cool. We will keep windows closed-unless I can keep Myrna out of a room, for those days when I might want to sit and have a moist cool/warm breeze blow in. But she can't be in opened windows, which she enjoys for sure. But any breeze at any temp can trigger asthma because of the presence of some level of humidity. And outdoor pollution/pollen also comes in. I will vac and damp mop floors 2-3 times a week. I need to change the type of mop I use because it allows water to sit on the floor. A damp floor leads to moisture in the air; can increase mites, mold, mildew, etc. All asthma triggers. And I will wash all cat blankets and bedding every two weeks. And I need to make sure the shelves in the basement are clean and clean under tables and such-places where they like to hang out in the summer. We already have a dehumidifier in the basement which helps to keep it dry, free of dampness and damp smells.

Monday, March 9, 2015

Litter Update and New Litter Scoop

We are using a metal, sturdier scoop to scoop up all the litter we now go through since Myrn'as been on Torsemide.

Now that she's on torsemide, Myrna Loy urinates a large amount and very frequently. We go through two and no longer one of freezer gallon bags in a day and over night of scooped litter. We use up a lot of litter during the week and must refill some boxes during the week. We have enough litter in the house to look as if we are building something out of concrete. When she goes a lot overnight, the used litter builds up in a corner of a box if she uses that box often. It sits like large chunks of glued in place, wet, sticky, concrete. The plastic scoop could no longer scoop through the thickness. Solution is this found on Amazon: a heavy, made of heavy metal, with attached heavy secured handle for only $12.00. It's a tad wider than the plastic scoop and weighs maybe a pound or so. Works like a charm. If you hate the way your plastic scoop works, get this one or something like it.

For your litter consideration-we use Wheat litter, Fresh Step litter unscented, Precious Cat, Cat Attract, and Clump and Seal litters. We tried the Clump and Seal light weight black litter but we do not like it. It doesn't clump as well and is light weight enough that it is scattered all over, beyond the litter boxes. But we do like the regular Clump and Seal which clumps tight and decreases odors better than other litters. Of course we scoop a million times a day but still, it gets rid of odors.

Jimmy Stewart Visits New Vet for Laser Treatments for Chin Acne

There's a new vet in town and she's on Myrna's Cats Living with HCM Facebook page.  She read about Jimmy's chin acne and her new practice has a new laser treatment machine. She invited us to come have a free laser treatment and visit the practice. Jimmy was really well behaved and wore his glasses. The laser wand is small, warm-not hot, and the skin doesn't peel as it would with humans.  While the Convenia shot curbed the redness and swelling, the laser treatments have healed his chin acne, almost after the first treatment.  He's had two so far and will have one this week. But each subsequent day after treatment, when I clean his chin with chlorhexadine pads, there is less and less debris coming off.  I highly recommend laser treatments for stubborn, infected chin acne. There are also other reasons for laser treatments. Call around and find a vet who does such treatments if you need anything.  
Jimmy Stewart getting new glasses! He wore these goggles today during his first laser treatment for his chin acne. He was a trouper!

Myrna Loy Feline HCM Visits Cardio to Have Fluid Withdrawn from Pleural Cavity

Myrna had her two week visit to the cardio for withdrawal of fluid from pleural cavity. She's been doing well this week. Hasn't needed extra Torsemide since two weeks ago; eating well enough; bright and alert and sometimes active. This time, only 2oz (8oz two weeks ago) had to be removed! Kidney values are still great-no improvement but no change: BUN 36 and creatinine 2.9. Potassium was up to 3.4 from 3.2-which does matter. Her afib unfortunately returned but there seems to be no real affect on her. She will return 3/23-the day after she and siblings turn six years old. If she's doing well, we can push appointment back to later that week. But the cardio still wants to see her about every 2 weeks to withdraw fluid. Unlike in December, when they withdrew 2oz but her breathing rate was up in the 50s per minute, which meant that she couldn't tolerate 2oz, she can now tolerate such a small amount before we see any problems.
Myrna Loy asleep on top of dresser

Wednesday, February 25, 2015

Myrna Has Her Two Week Cardio Visit to Remove Fluid Build-up-and Jimmy Stewart Tags Along for the Visit to the ER

Jimmy Stewart saw the vet on Friday for swollen chin acne.  We spent the weekend cleaning his sores.  He seemed otherwise fine until Sunday when he wasn't urinating the volume that he would usually.  And then late in the day he began to sit in the box.  We took him out and then he went back in.  He wasn't cleaning his genitals; he wasn't going frequently; he wasn't going tiny amounts.  So, I didn't think he had a UTI. But that didn't mean he couldn't suddenly have a blockage.  The antibiotic shot wasn't suppose to make him sick and he hadn't had any gastro upsets or diarrhea.  Since I was taking Myrna to see the cardiologist Monday and the regular vet can never see last minute patients on Mondays, I decided to take him to the ER in Novi that is in the same building as Myrna Loy's cardio.

Jimmy Stewart at ER
Xrays didn't show stones, most of which would show up on an xray. Urinalysis didn't reveal crystals-another cause of blockages-nor any bacteria.  Xrays did reveal that his colon system was full of bile that hadn't been expelled yet.  Exam didn't reveal that it was impacted but his anal glands were impacted.  The vet expressed them.  She hypothesized that packed glands may have made him feel unable to pass fecal matter and being uncomfortable made him lay in the litter box-which cats are known to do when trying to go and are unable to or when upset enough that the box is a safe place.  Blood work didn't reveal anything other than slight dehydration which would also lead to less water in the colon, lead to constipation.  His urine pH was 8.5.  With a lack of water and a high pH, he is susceptible to forming stones and getting a blockage.  I am to give him daily doses of Methigel-DL methionine, an acidifier-which should lower his pH.  They gave him sub-q fluids to rehydrate.   So, we are to give water by mouth, add fiber to his food, give Methigel, clean his chin acne, and continue to monitor.  

He came home smelling of vanilla which must be from the shampoo they used to clean him after expressing his glands.  His siblings didn't care for it.  "You stink!" they seemed to hiss.  He has been content to spend last night and all today upstairs in bed.  He could have come downstairs but never did until this evening. He has used the litter box twice during the day, going large amounts. He continues to eat very well.  

Myrna Loy
Myrna Loy is now seeing the cardio every two weeks since Christmas to have fluid withdrawn. We have regular two week appointments set up through April for now.  And we will go in sooner if needed.  Myrna had more fluid withdrawn from her pleural effusion.  She had 7 oz. last time and 8 oz. this time, despite high levels of torsemide and despite me giving her extra torsemide this past week as needed to lower her breathing rate.  The ONE good news: her afib-atrial fibrillation, has disappeared.  The cardio has never seen that before.  But that's how it goes with Myrna-she's always presenting with something other cats don't present with to the cardio. 

Her heart rate is steady at 160. 

Her weight is down now to 9.4 lbs, down from 9.8 just a few months ago and around 10 lbs a year ago.  While we wanted her weight to come down for her heart, she's now at the place where we want her to be.  To help her kidneys and her body function, she actually can't get below 9 lbs.  It's a bad sign when cats lose weight which they do because they don't feel like eating which can have many causes. But the result is a lack of water which leads to dehydration, which itself leads to a myriad of issues because of a lack of electrolytes.  And a lack of eating means a lack of protein which causes the body to waste away, and a lack of vitamins and minerals to supply the body with what it needs for energy which would allow the body to function from brain to heart to kidneys, etc.  We have had to give mirtazapine, an appetite stimulant, about once a week which helps her eat enough.  We will have to make sure she eats well every day and give more mirtazapine if needed. 

Her potassium is down to 3.2 from two weeks ago at 3.5.  Potassium is needed for kidney function and a decline in potassium means a decline in kidney function. So, we must increase her potassium levels by increasing the amount of supplements and sweet potato baby food we give her.  The BUN is 37 the same as two weeks ago; creatinine is 2.9, up from 2.7 two weeks ago.  Those are the kidney values that are analyzed the most for kidney function. An increase in values means a decrease in function which is crucial when you are asking the kidneys to process the diuretic medication for the diuresis process of removing extra fluid from the body.  

So, she's ok, stable enough, eating well enough, and for about three days a week still plays with toys and runs around before she runs out of energy.

Here are the vet's notes: "We removed 130ml of chylous effusion from the right side of Myrna's chest today.  Only a small pocket of fluid remained after the procedure was performed. Myrna's kidney values are stable compared to her last visit earlier this month. However, her potassium level is on the decline again. Myrna's is developing pleural effusion at a more rapid rate despite our incredibly aggressive medical efforts.  I see no benefit to increasing her torsemide dose further. Rather, it is very likely that this will be a detriment to her health.  Sadly, we have maxed out on all of her cardiac medications.  We are left with no other great options other than to periodically drain her pleural effusion as her symptoms dictate." 

Tuesday, February 24, 2015

Jimmy Develops Horrible Case of Chin Acne

Two weeks ago, Jimmy developed chin acne.  I cleaned it with chlorhexidine pads and the next day it seemed to clear up.  But last Thursday, I noticed his face was misshapened but couldn't figure out why.  He just seemed to have taken on a new longer, pointer shape. Then I realized that his chin and bottom lip were swollen. Upon closer examination, the entire area of his bottom lip, chin, and underneath were horribly red and swollen.  Friday, he saw the vet who gave him an antibiotic shot of Convenia so that we didn't have to pill him each day.  The shot also helps avoid gastro upset such as vomiting and diarrhea.  I have to clean his chin each day with the chlorhexidine.  The area is a mess of dirt and blackheads.
I thought they were bugs but thankfully, just horrible blackheads covering the area that unfortunately are infected.  

Wednesday, February 11, 2015

Myrna Visits Cardio for Pleural Effusion Fluid Withdrawal for Feline HCM

Posted to Facebook 2/10/15
At cardio-even though she wasn't and then she was better this a.m. and about noon, I brought her in. They took out 6oz which explains the roller coaster breathing rate and difficulty. The torsemide took out the extra fluid that must have existed in addition to the 6oz they withdrew which is why her breathing would go up and down.  
No word on why she was sick Sunday unless kidneys are not well or the effusion

lymphatic fluid was involved. But we could have come in yesterday but definitely today. We are waiting to see blood results. There's no scarring in lungs so this must be due to Rutin supplement!
Torsemide should take care of the fluid but it's not and we need to give more as needed or maybe more regular daily doses.

Myrna came home feeling better, more alert, breathing well. 
Myrna's potassium is up to 3.5 from 3 on 1/22 which is good. Not great news but not really bad is that BUN is up to 37 from 33; creatinine is 2.7 from 2.3 so not bad.
She will get extra 2.5mg of torsemide and extra potassium.
We will schedule a vet visit for every two weeks in case she needs fluids withdrawn.
But the cardio wanted me to understand that Myrna is in the end stages of her disease. You know it's bad when the cardio is using her calm, serious voice and not the one I've heard for over five years that was hopeful, optimistic, and laughing. We had the beginnings of the talk in January. And there have been times in the past-as Myrna developed increased heart size, clots, other incidents-that the serious voice was used. But Myrna always bounced back and surprised us all.
That her kidneys still function must be due to the vitamins and supplements we give. The cardio is surprised that she needs such a high level of torsemide and that her kidneys are still functioning. We will keep up all that we've been doing , pushing extra meds as needed, etc.

Myrna's sixth birthday is March 22. My goal is to celebrate it with her.