Baby Heart Health Scare Becomes Just Asthma

We had a health scare this past week. Last weekend-June 8-I noticed Baby breathing hard. I kept noticing it, then noticed that it wasn't just when she was grooming or active or upset. It happened at rest. The breathing rate was 40s-50s. So, I took her to the vet on Tuesday. Xrays showed a possible enlarged heart-one rib larger than last time. Now, the actual mathematical equation used to calculate size of heart to ribcage is more involved than just counting ribs. But to my experienced but untrained eye, it looked larger from both views. The lungs were clear. They emailed the results and xrays to her cardiologist. The dear woman was away at a conference but her office was concerned and called her to take a look. She texted me for feedback and after discussion-she saw no congestion-but since there were no appointments until the following week to see the cardio, she put Baby on lasix 5mg BID (twice a day.) Baby responded well Thursday and Friday morning but the breathing rate was up again so I put her on 5mg TID (three times a day.) She responded well to that. Her breathing rate fell to about 24-32, and she was perkier, and playful.

At some point, I said "No, not again. And poor Baby. But she is 13 so this could happen at any time as she ages."

Finally, we saw the cardio yesterday. And...nothing.

No enlarged heart-it's just slightly larger because it can happen as a cat ages but that is not due to internal workings and does not affect her health. Plus, she wasn't centered well on the xrays. But the echo was clean, no heart size changes, no SAM, no murmurs, no other obstructions or physical changes, no congestion, no fluid in or around the heart or lungs, and no signs of fluid in the body.

So what gives? We had a good laugh because she said my kitties are always coming up with some odd medical thing she's never seen. It's possible it's allergies or asthma kicking up when it was hot and humid. It's possible she needs her albuterol (for asthma) twice a day now instead of once. It's possible that she responded to the lasix because it can have a bronchial effect that is lost with long term use but was there in the short term. So, she's off lasix. She will receive albuterol BID and I may need to put her on the steroid Flovent. But we'll see.

HUGE sigh of relief and a prayer. And a good laugh. Because really-you must laugh.

Myrna Update, Reminder on Breathing Rate, CHF, Diuretics

Last couple of days have been ok for Myrna but she slowed down her eating again despite Mirtazapine (appetite stimulant) so yesterday and today I gave her food by mouth.  I used my favs: 3ml baby food meat source (this time beef in gravy cut with some water to make the mixture thick but still able to syringe up easily); 3ml tuna juice drained from the can; and 2ml sweetened condensed milk cut with water.  I scoop out 1/2 tsp or so of condensed milk into a small plastic container (it's a Glad 4 oz container) and add "some" water-about 1-2 oz. I add more scm as needed, enough so it's not thick; enough so that it's slightly sweet.  If she's eating slightly, then I gave her this every 3-4 hours.  When in the past she was not eating at all, I gave this to her every 2 hours.  I gave her some this morning-not all listed above-and when I gave her solid food to eat a couple hours later, she ate half of it, enough that I won't give her more food by mouth until later today.  Otherwise, she seems ok.  She's needed extra diuretic as needed.


As for diuretic-REMEMBER-you need to stave off the possibility of the cat becoming congested by giving a daily maintenance dose of a diuretic like lasix.  All HCM cats should be on a lasix.  Once CHF-congestive heart failure-begins to occur, even after just one episode, the cat needs to be on larger doses more often during the day.


WHY?  Because fluid in the lungs leads to a type of internal drowning; the physical sensation is painful. It's a painful form of suffocation.


The lasix dose could be 5mg three times a day, then 5mg four times a day, then 10 three times a day, or 10/5/10 or 10/5/10/5mg or...whatever it takes to keep control, to stay on top of congestion.  As the cat's heart grows, as the heart condition worsens, congestion becomes more probable and more constant and you must fight it.  NEVER be afraid to give extra diuretic when needed.  I always advise to give an extra dose or 1/2 dose in between regular doses if the breathing rate has increased. You will do this as often as necessary until you see the rate return to normal. Yes, it can take a couple hours for the diuretic to seem to kick in.  Give an extra dose, wait an hour, if the rate is declining, wait another hour.  If it's still high and not declining any further, give another extra 1/2 or full dose and wait.  If the rate has returned to normal after one extra dose, then just keep an eye on the cat.  If the rate increases despite the extra doses, especially if the rate is a dramatic increase, then the cat needs the vet or vet ER immediately for oxygen and IV or injectable lasix.

BREATHING RATE-a normal cat at rest is 24 per minute or less sleeping; up to 30 while sitting around.  While dreaming, the rate may fluctuate 24-32 but should decrease again soon.  TO COUNT-one up and down chest movement is one count.  How many of those in 15 seconds? Times that number by four for a minute count. So, one up and down in 15-if it's six then times by four =24.  But if the cat is breathing an 8 or higher which is 32 per minute or higher, then the cat needs extra diuretic.


NEVER let the cat not be able to breathe at all.  Never wait around for hours ignoring the distress the cat's in.  Never wait for the vet if the cat's rate is up and not responding to the diuretic. Go to the local ER if you have one. 

Myrna's Breathing Rate Ramps Up Middle of the Night Due to Feline HCM

Posted to Facebook 2/9/15

Myrna had a rough day yesterday. Breathing was ok until after midnight. But in the am she vomited and wouldn't eat or drink. She vomited her meds so I waited until 1pm to give torsemide again. She kept it down so we resumes normal med schedule and gave supplements. She wasn't drinking so wasn't going. Knowing that water is necessary for kidneys to process diuresis of torsemide, we gave water by mouth, (sugar water , tuna juice also for protein) constantly. Eventually I gave mirtazapine appetite stimulant. Finally she began eating at. 9 pm but very little. She did finally start drinking on her own by then. And using the box. But then her breathing went up to 48 after midnight and then 60 around 2am. I fought it with lasix and more torsemide. At 7 am she was 48 and by noon 40. The cardio said to watch, do meds , and wait to see if she needs to go in Tuesday if breathing increases again. This not eating , giving mirtazapine, breathing increase, and more meds has been happening weekly for three weeks. I don't know why she went from fine Saturday night to being sick Sunday am. But it's upset her system and made recovery from congestion more difficult.

By 3:30 p.m. today, her breathing rate increased again suddenly. She stopped eating treats and food. I waited to see if it would calm down but it didn't so by 5 p.m. I gave 5mg of lasix.  Then at 6 p.m. 2.5mg of Torsemide.  At 8 p.m. she had the rest of her meds.  Finally, by 8:30 p.m. she was breathing 44 bpm; by 9:30 9bpm.  She began eating again.  Everything seemed back to normal. 

I texted the cardio who said to bring her in Tuesday if needed.  And that's where we are at 11:27 p.m. Except Myrna just seemed to begin to suddenly breathe hard again and seemed bothered by it.  I'm waiting to see if it's momentary of sudden onset of something again.  This time, if it's something, I may take her to the ER connected to the cardio's office.  I'll monitor for a short while and see how she does.  It's always difficult to tell now what is the best course of action now that the disease has progressed. 

Update 2/10/15:  Myrna needed extra Torsemide overnight but by 2 a.m was breathing more comfortably.  I will call the cardio in the later a.m. to see if need to bring her in Tuesday or make an appointment for Thursday.  They are closed on Wednesdays.

HCM Cats Taking Lasix Need Lots of Water-Use Larger Bowls

From June 28 Facebook post:

When your cat takes lasix to get rid of fluid, guess what it will do? Drink-and drink-and drink some more. If you look up excessive drinking of water, you'll find it's called polydipsia. And when you read what is the cause, you'll see a list of diseases such as kidney or hyperthyroidism. And then you'll worry. But have no fear! Lasix makes your cats drink because lasix is making your cat excrete. And it will urinate a lot or often. And when you look that up, it's called polyuria. And that is often due to...kidney disease, hyperthyroidism, etc. Except that YOUR cat is taking lasix, which causes it to drink a lot of water, which of course will lead it to urinate often. So, when to worry? When the kidney values show a severe decline in kidney function. But for now, don't worry. Just provide your cat with a very large bowl of fresh water. We have four bowls around the house for the cats. Because now two cats are taking lasix and drink the bowls dry, we have switched two bowls to serving bowl size and I'm using a large mixing bowl for a third,while one bowl in a bedroom is still a cereal bowl. 

We Survived the First Week of June With the Cardiologist Office Closed-but Myrna is Urinating Out of the Box

The cardio vet office was closed all last week because the entire office-two cardios and three techs, went to a conference. I was full of trepidation, fearing something would happen with my two cardio patients but we survived the week. Cooper's doing well on torsemide. Myrna's needed extra lasix almost every day this week, due I believe to the noise from the a/c and fans. She has also begun to have accidents out of the box, so far on the pads near boxes. It could be due to the extra lasix and the extra need to go. Urgency can make them uncomfortable. Usually it requires an adjustment with potassium (she may be too alkali) or a Valium adjustment, and may need Methigel, an acidifier. For the days I do this, she uses the box. When I skip one of these adjustments, she goes out of the box. She sees the cardio Thursday and at that time we'll do a urine test. I doubt she has a UTI because the classical symptoms are not there: going very frequently and very small amounts. But I will keep an eye on her and if I suspect she has a UTI, she'll go to the vet.

Potassium Necessary for Cats Taking Lasix

Aside from giving your cat potassium supplements-either by pill (we use Sundown Potassium tablets cut into chunks which can easily be given by mouth; we give four times a day to Cooper and to Myrna) or by powder (for pets or for humans. Just make sure it's safe for cats) you can also give your cat a variety of foods to boost potassium.  These foods can be mixed into the cat food, fed by hand or with a syringe, or if you're lucky, the cat will eat something out of a bowl. Here are some suggestions:

Baked potato with skin, avocados, cantaloup, eggs, chicken, applesauce, lima beans, tofu, bananas, peanut butter, and sweet potatoes. 

I prepare bananas by breaking them into chunks, lying them in a freezer bag and freezing them, then taking out a chunk each day to thaw. Then I mix that into the cat food.  Myrna Loy, our HCM cat, loves peanut butter. She will lick it off the plate. Cooper will not and spits it out if hand fed.

But I recently thought to check out baby food and voila! Sweet potatoes and bananas come in easy to use jars or plastic containers. And applesauce comes in easy to use single lunch packs (and in baby food but I've chosen to buy the lunch packs so that I can eat the applesauce as well.)  These liquid versions are easily mixed into cat food and both Cooper and Myrna will eat it.  And Cooper doesn't mind being fed sweet potatoes by mouth using a syringe.

Many of these foods also are a good source of proteins, sugars, and fiber.  While cats with heart disease need to watch sodium levels, since the foods are fed in small amounts, sodium will not usually be of concern. But do compare labels.  And some cats may need to watch protein or sugar intake for other health reasons.

Not sure if they will want to try avocados.  Myrna did eat the small chunks of baked potato I mixed into her food. No one is interested in cantaloup. 

Myrna Gets Congestion Again This Week; We See the Vet Friday

February 1, Myrna had congestion that developed in the morning out of the blue. We fought it with extra lasix and an injection of lasix.  Monday, February 17, Myrna developed congestion again and in the late afternoon into the evening and we gave her more lasix and did another injection.  And then once again, for no reason, except that perhaps Thursday's rolling thunderstorm that happened in the morning and afternoon (while it snowed no less) acted as a trigger, Myrna developed congestion Thursday February 22.  It came on suddenly in the afternoon.  Her breathing rate crept up from 8 to 10 and by the evening was at 12 (in 15 seconds.)  By 8 p.m. it was around 12-14 and eventually seemed to remain at 14 (normal is 6.)  Despite extra 5mg of lasix a couple of times, we had to give an injection around 10 p.m. of .15ml lasix and then 10mg of lasix at 1 a.m.  The breathing rate only came down to about 12 by then.  Between 6:30 p.m. and 1 a.m. she had received a total of 41mg of lasix when she would normally have had back in January 46mg total in a day and as of early February (after the first bout of congestion) she would have received 52mg in a day.  Her total for Thursday was 73mg.

And still, despite all of the lasix, she only urinated every 3-5 hours, her normal time frame, and her normal amount.  This is important to note because how much she urinates determines how quickly the lasix works to get rid of the extra fluid and the congestion.  How well she produces urine and how quickly also indicates how well the kidneys are functioning.   It wasn't until after the injection, that she finally began using the litter box more often.  From 11 p.m. until 6 a.m., she used the litter box about four times.  By the morning, Friday, she was better but still breathing around 10 at rest.

We already had an appointment for Friday to see the cardiologist after Monday's congestion.  Xrays showed she still had congestion-pulmonary edema.  The pleural effusion she had in January (along with pulmonary edema) was not present.  For whatever reason, her blood pressure has dropped again to 93 which made getting a blood sample from her difficult.  Her heart rate is only up slightly, from 140 to 160.  The heart is in stable condition, unchanged from January.  While her cardio function is stable, the cardiovascular system is having trouble.  The rollercoaster congestion, brought on by unknown triggers, requires more and more lasix to beat.  The congestion wears her down, becomes uncomfortable, and impairs normal body function of breathing and getting oxygen to her body.  The drop in blood pressure means the lack of oxygenated blood to the organs.  This makes her easily tired and somewhat weak.   This would explain why she was quiet all this week, even though she was always up and about.  She was never truly lethargic, just tired.

We are to keep her quiet.  She will receive 15mg lasix qid (four times a day.)  I am to tell the vet how well she is doing Saturday and Sunday and Monday. The emphasis will be on pushing lasix to bring down the congestion and get her to a more stable condition.

We discussed how difficult it is to decide when to give more lasix.  It's one thing to count breathing rate and to determine that it's up and she needs more lasix.  But I don't always know how long to wait. When the rate is up but she doesn't appear to be in pain or discomfort, I have no problem waiting before giving more lasix a few hours later.  Lasix pills can take up to four hours to work.  An injection takes about an hour.  When she begins to breathe even faster or if she looks really uncomfortable, my reaction is to give more lasix.  But if given too much, the amount can lead to kidney damage or a reduction in function. But getting rid of congestion is key.  But retaining kidney function is important.

The vet said:  "If she's struggling and she's due for lasix, give her an injection of .15ml.  If she's struggling and not due for a dose, give an injection of .15ml.   If she's wishy-washy-breathing rate up but not very high and she's comfortable, give her 15mg lasix."

Her blood work unfortunately shows a decline in kidney function.  We will push 15mg qid today and cut back as needed once the congestion seems to be going away and see how she does going forward.  The BUN is 35 and high is 36. The creatinine is 2.7 and the norm is 2.4.  Phos is fine, though. Potassium is 3.9-low but fine.   She is not in kidney failure since she's producing so much urine each time. But that she needs higher doses of lasix before she finally urinates indicates that the kidneys are tolerating the lasix in general but that kidney function is showing some decline. That's troubling.

Unless she gets sick again, she will see the vet in late March which was a regularly scheduled appointment.  

Myrna's Breathing at 8 Sunday Afternoon After Extra Lasix; More Lasix Monday Given; Video Available

Myrna received  about 3 mg more of lasix about 11:30 a.m. Sunday because her breathing was at 10 at rest.  By 1 it was down to 8.  That's 8 breathing beats per 15 seconds or 32 breathing rate in a minute.  So it finally came down from 48 Saturday night to 40 Sunday morning, to 32 Sunday afternoon.

It has remained steady since.  She is to receive 3mg more of lasix twice a day all this week to make sure the congestion won't return.

http://www.youtube.com/watch?v=RBJepQx1kqs

Check out today's video of Myrna.

Sunday Update on Myrna Loy's Breathing-Better Possibly If She Ever Decides to Stop Moving So That I Can Count

Myrna seems to be doing better this a.m. Gave her 10mg and 1/4 of a 12.5 mg (so about 13+mg overall) of lasix at 8:30 a.m. with the rest of her morning meds. Because she's difficult to get in the a.m., we have no way of getting her, monitoring her breathing, and then deciding what lasix dose she may need. The vet had given me guidelines of dosing lasix based on her breathing rate. So, that's why I gave her the lower dose of 13mg. We will monitor her breathing to see if she needs more. She seemed better today, even better than last night. Her breathing rate all night long was at 12. It's not that noticeable this morning so maybe it is finally lower. But we won't know until she rests but she's spent all morning up and about.

Myrna Had a Cardiology Check-up Thursday; Much Has Improved

Myrna saw the cardiologist Thursday and there was plenty of good news and only one slight problem.  First, we stopped at the regular vet for a blood draw for a full CBC/chem panel blood test that they send out to IDEXX.  While I don’t have the full report yet, her regular vet did call today to say that things look perfect and that her potassium level was up to 4.9 from 3.7 in September!  (Daily I give her a dime size chunk of banana-potassium source- mashed into her food in the morning; two potassium tablets divided into four pieces-one chunk per meal and one at bedtime; and a vitamin paste that has potassium.) They will fax results to the cardiologist.  I also had them do a urinalysis. 

When a cat is ill, and when a pet is receiving meds for an illness or for any reason, a blood test must be done from time to time to check the blood chemistry values.  As I’ve discussed before, kidney and liver function are affected by medications and diseases, especially heart disease.  You need to make sure the kidney and liver are functioning properly and you need to make sure the overall health of the cat is good.  Issues will show up in the blood test.   You can see if a patient has enough electrolytes: sodium, glucose, chloride, potassium, phosphorous, bicarb; you can tell if they are dehydrated: electrolytes will be low, blood count might be high, kidney values will be off; you can tell kidney function: BUN, creatinine, bicarb, potassium, phos, protein; or liver function: ALT, AST, phos, albumin, bilirubin, protein; and you can tell if a cat is hyper- or hypo-of an element such as hypercalcemia-too much calcium; hypokalemia-too low potassium.

A urinalysis is necessary to test kidney function in a cat that is taking meds because meds are processed in the kidneys and can adversely affect kidney function.  A disease may also affect kidney function.  So, an HCM cat on meds must have a urinalysis from time to time.  The test will show if there is glucose, protein, or red blood cells in the urine.   It will show pH levels which are important to know (6-6.5 is best) and will show if there is an infection, UTI, or any inflammation as well as disease of the kidney.   A vet can compare those results with the blood work to note any issues in function.   For example, too much protein in the urine can mean that protein is leaking out of the blood through the kidneys and not being properly processed in the body.   That can indicate kidney damage.  But some protein in the urine could also be something that occurs without kidney damage.  A look at the protein levels in the blood work will tell more.  If the protein is in normal range in the blood work, then protein in the urine shouldn’t be too much of a concern as of yet.  Glucose in the urine is a concern because that could be an indicator of diabetes.  But compared to the blood work, if the blood value is normal, then glucose in the kidneys could be a sign of stress.  Red blood cells found in urine could be a sign of an issue or could be from the needle used when the bladder was aspirated-urine withdrawn.  White blood count in the urine could indicate infection but if low and all other blood work is fine and body temp is normal, then that could just be an anomaly. 

The slight problem was that her breathing rate was high at 60 (should be about 24 at rest and only about 30 if at play or stressed.)   This could be caused by a week of noise from snow blowers and street plows due to the heavy snow fall as well as the stress from the vet visits and being out of the house since 1 p.m. (the cardio visit was at 3 p.m.)  She had some minor pockets of pleural effusion-congestion around the outside of the lungs-but not enough in one spot to be aspirated (withdrawn.)  She did have enough of the type of congestion she usually gets when congested, which is pulmonary edema.  They gave her a 5mg shot of lasix and instructed me to continue with her regular lasix dosages Thursday night; to give her 3 mg more of a lasix pill if needed; and to text the vet before bedtime to let her know if Myrna’s breathing rate had improved and to also let her know the next day.   By the evening, Myrna’s rate was 40 and by this morning it was 32 which for her is normal due to her heart condition. 

The really good news is that Myrna’s blood pressure and heart rate are normal again. The blood pressure had been very low at 90 after the heart attack in September and was 97 by October and was now normal at 118 (normal should be 118 to 124.)  Her heart rate, which had jumped to over 200 with the heart attack in September, and was 176 in October, is now also in the normal range and is at 144 (normal can be as low as 130 but at rest shouldn’t be more than 160. For an HCM cat, 140 is optimal but may be lower if on atenolol-which is what happened originally to Myrna. Her heart rate was once as low as 120 but she was never weak nor at that time, had a low blood pressure.  If the cat tolerates it well-which Myrna did-then there’s no concern for weakness or the heart rate leading to low blood pressure.)

I asked and she still cannot yet have her annual shots. The only one she really needs is the distemper.  There is no cure for distemper if she was to get it and it is a fatal disease.   There’s no way to prevent her exposure.  We could track it into the house on our shoes; it’s airborne; the other cats could pick it up when we take them out.   She cannot have her shot because she’s congested but also because of the immune response that would kick in and cause stress on the body.  Stress-while a natural reaction-could lead to congestion for her.   We will discuss it again at the next visit in March.  If Myrna does not have congestion, then maybe she can have the shot.

So, overall, a very good visit and a very good prognosis.   Here are the doctor’s notes:

Myrna napping in her favorite box

“Myrna’s heart rate has slowed again (144 min) indicating that she is getting more benefit out of her beta blocker (atenolol.)  The echocardiogram did not reveal any significant changes with regard to the left atrial enlargement or left ventricular thickening.  The mild thinning of the left ventricular wall that occurred following her heart attack has not progressed.  A small amount of pleural effusion was visible today and there was mild congestion (pulmonary edema) on her radiographs.  Based on your reports of her stats at home, I do not believe that she has chronic congestion in her lungs.  Rather, I think she is more stressed than usual today, and this is having some negative cardiovascular consequences.  We gave her 5mg Lasix IM (injection) today to help manage the mild congestion that was visible today.” 

Over a Week and Myrna Doesn't Need Extra Lasix So Far

Well, while anything can dramatically change at any time, I'd like to report that it's been over a week since Myrna Loy needed extra lasix last Friday, after spending the previous two weeks needing it every three days. Not sure why or what but I'm sure she did and now I'm sure she doesn't. She's breathing very well-down 28 to 32 instead of around 40 breathing rate; she's engaged, energetic, alert and not exhausted and out of it.   In order to know how our cats feel physically and how they are doing, we must become attuned with their emotions, looks on their faces, actions, physical stamina, etc. in order to gage even the subtle changes from not just day to day but moment to moment.

Of course I love analyzing Myrna's every move which drives my husband crazy: Me-"I don't think the cat (insert cat name here) is feeling well. See how she's sitting/didn't eat all her lunch/see how she furors her brow/she's not playing with her favorite toy today." Husband: THEY'RE NOT SICK!

Vet Visit Today Leads to Increased Breathing Rate

Myrna saw the vet again for blood and urine recheck, not only because she has a cardio appt. next week but because back in Feb. lasix dose was increased from 1/4 TID to 1/4 QID (4x day). While there today, her breathing rate shot up from a normal at home of around 32 to almost 80. She looked calm enough, didn't look stressed but when they took her in back to do the draws, they noticed the breathing. The vet took a listen, thought she heard sounds, did xrays, thought she might have congestion. They emailed films to cardiologist and we went home. Back home, Myrna was active-used the litter box, ate lunch, walked around, checked on the birds outside the window, and after an hour and a half, settled down for a nap at which point I could finally check her breathing. It was around 40. Meanwhile, the cardiologist called and said she thought the films looked fine but we discussed keeping an eye on Myrna and giving extra lasix if needed. We've come to the conclusion that since her heart size has increased-which we learned in Jan.-she is not able to handle formerly normal stressors such as travel to the vet and noise-I believe the congestion she had in Jan. and Feb was due to the use of the kitchen stand mixer which is very loud. So, this means better management of all stressors-noise, travel, visitors, work around the house, and temperatures (keeping her warm isn't a problem but balancing the heat and the cold AC in summer will be.) While we can hold off doing blood and urine draws on a regular basis, trips to either vet can't always be avoided. We'll need to come up with solutions to keep her calm during the trip and once she arrives.

We did not give extra lasix yet.  Unfortunately, this is a normal progression of the disease, where stress of any sort can set off CHF.

Update on Myrna and Breathing and Lasix

Myrna this week at vet getting updated blood work

After last week's Valentine's Day breathing issue, after we gave extra lasix to Myrna to combat what could be congestion, and after the vet eventually changed Myrna's lasix from 1/4 TID to QID, Myrna took a couple days to bounce back but by Sunday of last week, she was back to her usual energetic and alert self. And still seems to be. Handling extra lasix well. Blood work and urine sample this week showed no signs of any kidney or other issues. She'll have another blood check next month before seeing the cardiologist. The congestion may have been stress related and I think the source of stress was the stand mixer I used in the kitchen on that Monday and Tuesday prior to Valentine's Day. I used it off and on for two hrs. or so a day. It's rather loud. I used it also around Christmas and it was around that time she began to show signs of breathing issues. And that was when a visit to the cardiologist showed slight signs of congestion. We know her heart has grown 28 pts (however it's actually measured) since October (from 1.84 to 2.12.) I believe her heart is at the point where heavy, long term noise or stressful issues can no longer be tolerated, even if only a stand mixer.

Myrna Not Feeling Well, Breathing Rate High, Low Energy

Wednesday, Myrna seemed fine and was a little low on energy but still active and breathing well. On Thursday, she was really exhausted after breakfast, had no energy, and was not interested in litter box treat time with waffles.  (She loves waffles and gets tiny bites when we want to encourage her to use the litter box.)  She curled up and slept all morning.  Her breathing rate was up around 8 breaths per 15 seconds and slowly crept up to 9 and then 10.  By 2:30 p.m., she was around 10 and 11 and had no energy, hadn't played, and other than to eat and use the litter box, did not get up from sleeping.  

I gave her extra 1/8 tab of lasix and called the cardiologist.  I wasn't sure if I should bring her in or how long to watch and wait.  The vet said to watch and wait, give more lasix later, and call her in the morning.  We gave extra lasix at bedtime.  By late in the evening (before the bedtime dose) her breathing rate had returned to 9 breaths per 15 seconds.  

This morning, Myrna is still tired but more alert, a bit more energy, and breathing well at around 8 breaths.  I called the vet to give an update and she said that Myrna should from now on be given 1/4 lasix q 6 hrs.  (every six hours.)   So, for now that means giving an extra dose at bedtime which makes dosing lasix almost a perfect six hours.  I might have to actually do on the clock six hours such as 6 a.m., noon, 6 p.m., midnight.  The trick is when we start the med in the morning.  Myrna hates taking meds in the a.m. and always hides.  Getting her to swallow isn't the problem.  Catching her, cajoling her, tricking her into being picked up is the problem.  For as sick as she is, she is also the quickest cat in the house.