Tips


Here are some quick tips.  You'll find similar or more information in the other information tabs.


·         Your HCM cat must see a vet cardiologist if one is available in your area in order to discover the   type of heart disease your cat has, the prognosis, and treatment options. Most vets do not know  enough about cardiology to treat heart disease.

·         Your cat should at least have lasix-to get rid of congestion, and a beta blocker such as atenolol to  slow the heart rate and ease the work of the heart.  Other possible medications are listed below.

·         Your cat must have a stress free life from now on: decrease the noise, the interactions with children or pets or strangers, and watch the cat for stress caused by storms or construction noise.  Playtime should be kept to a minimal if the cat is recovering from an episode of congestion or other heart  disease complication.  Don't encourage running and jumping with an HCM cat even if the cat is stable. If the cat is stable, let them play but not get too over worked.

·         Your cat must be kept warm or cool.  Keep the heat up or the air conditioning on and decrease the humidity. If you do not have air conditioning, buy a window unit which you place in the window  or that vents outside through the window screen (which I prefer because you don't have to take down any screens, leave the house vulnerable to theft, and you can keep bugs out.)

       Affording Cat Care


·         When getting meds for your cat, compare prices between the vet, the local pharmacy, and online pet med stores (see the Medication tab for more info.)  Local pharmacies usually offer the same medications for your cat that the vet carries and can often be less expensive.  But make sure they have the dose or milligrams that you need.

·         Shop around for an affordable cardiologist and vet that your cat needs. Time and distance may be a deciding factor as well as cost but know your options. 

·         If possible, get pet insurance.  But some don’t cover pre-existing conditions (they won’t insure a sick cat). 

·         Set a monthly budget for cat care-meds, vet visits, cardio; and set aside a monthly savings for emergency care. 


·         There is also Care Credit which is like a loan that you borrow against, pay back in six months interest free. For every $1000 you borrow, you’ll pay back about $166 a month in six months (more or less as there are various terms. Check online with Care Credit and check to make sure your local emergency, vet, and cardiologist take Care Credit.)

When Transporting Your Cat

·         Always use a carrier.  While your cat might sit in the car seat and not roam, most cats roam and can get stuck under seats and front panels of the car.  In an accident, the cat would fly through the car and be severely injured.
·         Place a thick towel in the carrier to give cushion to the cat.  While you could also use a small blanket, a towel would absorb any urine better than a blanket.  We also line the carrier with bed liner pads (we buy the ones for humans and we buy them from Target.)
·         Cover the carrier to not only protect the cat from the sun but to shield it from noise and movement.  A cat feels protected when it is enclosed (most cats do any way.)  It will decrease stress.

·         Place a blanket or towel under the carrier on the seat to cushion the carrier from car engine noise and the movements of the car as it travels. 
·         Always strap the carrier in with the seatbelt.


Treatment Options for Cats with HCM

·         There are many different types of medications that can be given to a cat depending on severity of the disease. 
·         Lasix is a diuretic and is necessary to rid the body of extra fluid and to control the level of fluid in the body. Will help prevent or decrease the ability of CHF to form and will aid in the breathing function.
·         ACE inhibitors such as enalapril, slow the heart rate and lower blood pressure and keep blood veins from being constricted.

·         Beta blockers such as atenolol slow the heart rate and help lower blood pressure.

·         Plavix and aspirin act as blood thinners which decreases the chance of a blood clot forming; thinner blood lessens the work of the heart.

·         Spironolactone acts as a diuretic and helps to preserve much needed potassium which is necessary for kidney function.  

·         A cat with heart disease and which is on meds, needs a good overall vitamin made for cats.  
·         Other supplements that aid in heart health are amino acids (those formulated only for cats), and COQ10.  Potassium supplements (cats may take almost any form made for humans but check the brand or type with your vet) will increase the blood potassium levels that usually fall due to the much needed lasix.   The vet will do a CBC/chem blood panel from time to time to check the body's function and overall health as well as the effects of medications on the liver and kidneys. The results  should always be reviewed with the vet and any levels too high (hyper) or too low (hypo) should be discussed.


Blood Clots in the Legs-What to Watch For

*Look closely at your cat’s legs as it walks.  Does it slip from time to time? Is it on pain meds or something like Valium that could affect muscle tone?  Or is there a problem with the leg and the ability to walk? A call to the vet should be placed.  If the cat seems in pain or cannot walk, then a visit to the vet or ER is warranted.

       *Check the paw, paw pads, and color of nail beds now to know how they normally look.   If you feel your cat’s paws and think they feel cold, check the color of the paw pads and the nail beds.  If the nail beds (which should be pink) are getting blue/black or dark grey (as long as dark grey isn’t part of the cat’s normal toe bed color) then a trip to the vet or ER is needed immediately. This could indicate a blood clot in the legs that is causing loss of circulation, blood loss, lack of feeling, and eventually pain and an inability to walk.   

       *Does your cat clean or pick at its paws or nails?  Cats clean all the time but if the paw bothers the cat because there’s a blood clot, they will pick at it. They will also pick at a paw if there is an infection on the paw pads.  

Behavioral Issues Might Indicate Illness

       *Is your cat howling in pain? Is your cat lying down, lethargic, almost unresponsive and crying out in pain? These are signs of illness and the cat may be in serious trouble with either kidney, heart disease, or other illness.  The cat must see the vet or the ER vet immediately.  A cat that howls in pain-even if it eats a bit or uses the litter box-is a cat that is very sick. See the vet NOW.

       *Has your cat ever blanked out? When your cat is walking around or playing or interacting with you, have you ever noticed it suddenly seem to not know what it is doing? Has this trance or pause lasted only a few seconds to 30 seconds or so?  Has your cat ever lifted its paw as if it is trying to decide what to do with it?  These could be due to arrhythmia, an unusual heartbeat and should warrant a call to the vet and a visit to the vet.  If it passes in a few seconds, then call the vet cardiologist and discuss it with the vet.  If it is prolonged, then a rush to the ER or vet cardiologist immediately is necessary. This means that there is a problem with the heart beating, circulating blood, etc. and it needs to be taken care of as soon as possible. 

        *Have you noticed your cat being sleepy, quiet, or a lack of play or a lack of energy?  This is important to note because it could be due to congestion in the lungs or an increase in heart size.  A visit to the vet cardiologist is needed.

        *Has the breathing rate of the cat increased even at rest or while sleeping?  Does the cat that is normally breathing 26-30 now breathing 30-40 per minute?  This is very important to note and could mean congestion in the lungs.  A call and a visit to the vet cardiologist are needed immediately.  Additional lasix might be warranted. 

        *Is your cat not eating well? Is your cat not urinating enough? Is your cat not drinking enough? Or is the cat eating too much, drinking too much, and urinating too much?   These are not normal, even for a cat sick with a heart disease.  This requires a trip to the vet to pinpoint any problems.

        *Is your cat hiding?  Cats that are well do not hide.  Cats that are sick will hide.  A trip to the vet or ER is necessary.  Sure, your cat likes to climb shelves, sleep under the bed, crawl under a blanket, be quiet and disappear for a few hours.  But is it now disappearing for hours on end and not interacting, not playing, not coming out to greet you when you get home, and not wanting to eat?  Those are signs that a cat is very ill.

       *For possible urinary/bladder issues, check the Litter box tab and Other Health Issues tab.  


Vital Signs

Breathing:
  • Around 20 - 30 breaths per minute in a cat at rest is normal.  
  • Average normal at rest is 24.  
  • One up and down chest movement is one count. How many of these do you count in 15 seconds? Times that number by 4 to get a per minute breathing rate.
Temperature:
100-102 is normal


How to Pill a Cat:

1) Cut pills per vet's instructions.  Dip the cut pills into wet cat food to coat them. Then place them one at a time in the back of the roof of the cat's mouth; close mouth; follow with a small bit of water from an eye dropper placed in the side of the mouth.  Make sure the cat swallows and does not spit it out.  Repill if that happens.

2) Some use pill pockets for ease of pilling. Place cut pills in pill pockets and pop into the cat's mouth.

3)  Gel caps allow you to place a dose of pills-if you have more than one pill to give at a time-into one container, making it only one dose that you'll give the cat.  You can purchase gel caps either from the local pharmacy or online.   Gel caps come apart in two. You can place the pills in them depending on the size you are able to use with your cat.  After filling the gel cap, close up the two halves and coat the gel cap in wet cat food.  Then place it in the back of the cat's throat and follow up with some water.   I recommend that you buy from a local pharmacy first to see if they work for you.  You should be able to buy just a few instead of a whole box.  Then if they work for you, you might be able to order more online. Unfortunately, gel caps made Myrna vomit.  When we stopped using them, she stopped vomiting. We tried this for a week and knew quickly that there was a problem. 

4) Some pet owners are able to place pills into a plastic syringe and then "squirt" the pills into the back of the cat's throat.  This is very tricky and can lead to choking or inhaling of the meds.  Not to be done quickly or without much practice. 

5) Some pet owners place pills in food, hoping the cat will eat all of it in the food. Unless you only have one cat, unless the cat licks the plate or bowl clean, do not use this method.  Too much of the med can get left behind this way.

6) Some meds can be made into liquid form for ease of giving by mouth or gel form which is placed on the cat's ear to be absorbed, otherwise known as "transdermal".   Lasix should not be given via transdermal because the absorption rate may vary and it is necessary to have lasix in the body as quickly as possible so that it can get rid of fluids.


How to Feed a Sick Cat That is Having Trouble Eating

When feeding a sick cat that won't eat, you can give tuna juice by mouth, cat sip or kitten milk from the pet store (but watch for signs of diarrhea so maybe 3ml at a time) and you can make homemade chicken or beef broth. The cat needs hydration-so water by mouth is fine also. But it needs protein which is why tuna and chicken and beef broth are good alternatives. These can also be added to wet food if the cat is eating wet food. They will enhance the flavor, provide hydration, or entice the cat to eat the wet food if the cat is having trouble eating. Depends on the cat of course. 

BE CAREFUL when buying broth from the store. We were told by the ER to give Cooper low sodium broth by mouth if he wasn't eating on his own. But broth usually has garlic and onion in it (which I had forgotten) and low-sodium broth (that we saw at the store) has even MORE which we could smell once we opened the container. So, I'm making my own with only some salt added. 

Salt/sodium is an electrolyte and serves many valuable functions by regulating blood pressure, fluid retention, muscle and nerve functions. For a cat with HCM, additional fluid is what we want to avoid and get rid of. Too much sodium and fluid retention/blood pressure rises, and can lead to CHF in the HCM cat; too little and the body can experience other difficulties with low blood pressure (weakness, fainting, etc.) So, a little is needed for the HCM cat but not too much. But the cat cannot have at all, garlic and onion.

Always ask the vet/cardiologist if the cat should have an appetite stimulant.  If the cat is on a psychotropic, the cat may have to decrease or avoid that med in order to take the stimulant.  

The stimulant can make the cat too wired which may cause them not to eat.  I would recommend starting with a half dose, waiting a couple of hours, and then giving another half dose if the cat has not begun to eat.  If the eating problem continues, you will need to call the vet for advice on further doses or other solutions.



6 comments:

  1. Thanks for contributing your experience with your cat. I'm having an issue with one of my three cats. His name is Baci, and he was diagnosed with hypertrophic cardiomyopathy shortly after it was discovered he had hyperthyroidism. He's a very loving cat with me, but at the vet he completely freaks out. I've been lucky to have the vet come to the house, but the cardiologist treating him is at the vet hospital. I know he has been scheduled for an Echo, but they want to completely get his thyroid under control before they repeat the echo. Almost a year has gone by since he was diagnosed, and I see him becoming more short of breath. I'm torn between taking him to the hospital which could kill him from the stress and letting him stay at home where I might lose him sooner. The whole thing frightens me, and I want to do what's best for my animal. I can't think straight because it's so upsetting to me. I have other issues going on with my family members who are sick also, and these cats are my kids and give me lots of love and support. I just lost one cat last week to old age at 20.

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    1. There is no reason to control the thyroid before treating HCM or having a checkup with the echo. The concern is the stress when leaving the house. Perhaps a mild safe sedative such as Valium-which would hopefully calm him. There may be other safe alternatives. Also, the use of a calming spray in the carrier (spray on the blanket or towel, not the cat). But he should have an echo, he should be on medications to prevent symptoms of HCM-a diuretic to prevent fluid build up; atenolol, enalapril to slow the heart rate, lower blood pressure; etc. He is short of breath because he may need meds if not on them; he may need more meds especially more doses of the diuretic. A vet at home should be able to hear the heart rate and if there is congestion in the lungs and treat with necessary meds. An echo shows the extent of the disease and what other meds are warranted. Have the vet come to the house and check the cat especially for heart rate and congestion. If the cat's not on meds, have the vet prescribe meds; if the cat is on meds, talk to the vet about increasing them as needed, especially the diuretic. Talk to the vet about a mild, safe sedative/relaxer such as Valium. Try the calming sprays and such in the crate. And eventually get an echo. But there is no reason to treat the thyroid before the heart. The poor cat could be suffering from complications of HCM that have possibly gone untreated. Good luck!

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  2. Thanks for the advice. I took him to the vet on Saturday, which was as soon as I could get off from work. He did have some build up of fluid around the loan which they removed with a thoracentesis. It was a life-saving procedure. I have now come to realize that he did not like the Lasix and was avoiding taking it. I also realize that it was probably shutting down his kidneys. He weighs literally half of what he weighed at this time of year ago, but they had him on the same dose of Lasix. Not only did they have him on the same dose, but they increased it after the vet visit thinking that he had been taking it all along. I have come to recognize the symptoms of the congestive heart failure and then working to manage a good dose of the diuretic to keep the cat breathing well but out of renal failure. Best wishes to you! And thank you again!

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  3. Additionally, would you be willing to share some of the supplements you are using to help your cat with cardiomyopathy? My cat has restrictive cardiomyopathy, which is common in the breed. He also has hyperthyroidism. Thanks in advance.

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  4. It's likely that drawing out the fluid will be a necessary procedure that will be repeated a few times more in the future. He needs to be on lasix and more than once a day-I don't know what they prescribed. But doses given throughout the day, will be able to fight off congestion, as opposed to a huge amount once or twice a day. A large amount at once does tax the kidneys. So, for example, a better regime of doses might be 10mg in the a.m., 5 at noon, another 5 at 6 p.m., 10 at 11 p.m. Or even higher doses if needed.

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  5. The supplements that helped Myrna are listed in the Med tab above, along with all of her meds. Myrna lost weight in her last few months but she was only down to 9 lbs and very healthy and had not lost muscle or fat by the time she died. We struggled many times in the last few months and used Cerenia, cypro, and mirtazmine as needed to get her to eat (not at the same time.) We eventually let her eat whatever she wanted when she didn't eat her regular food, things such as treats and tunafish. I hand fed her often via 3ml syringe a variety of things-baby food, home cooked beef or chicken juice (no spices), and tunajuice, sugar water with cornsyrup or sweetened condensed milk cut with water, and kitten formula with corn syrup (for energy), and peanut butter, and sweet potato. These provided protein, energy (sugar), potassium, and other nutrients, and calories-every little bit helps. The best supplements for her kidneys are vitamin C and E, and iron, sweet potato for potassium (baby formula), COQ10 (again it's in the Med tab.) Most of this was mixed and given via 3ml syringe 2-3x daily. The cat really needs more potassium and iron. Try Renal K powder and gel-gel by mouth is easier than mixing powder into food the cat may not want to eat. Order via Amazon or online pet store. We also gave Sundown potassium pills, cut into chunks, dipped into wet food to coat, and given by mouth. The iron was Nature Made and we cut that into chunks, coated, gave by mouth. Iron is extremely important and kept her kidneys going. From 9/14 to 8/15, her BUN and creatinine were stable even if elevated because of these supplements. The iron caused diarrhea and constipation and finding a healthy balance was difficult but I couldn't find at the time an easier and more pet friendly version. Increase the potassium now and give iron a try. Good luck!

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