Fluid in Lungs continued

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babyg

babyg

Member Since 2019
Previous: https://www.felinediabetes.com/FDMB/threads/lasix-helpp-fluid-in-lungs.280641/
Super quick summary...

Xrays from primary vet (told fluid IN lungs; heart size appears normal):

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Tests done by hospital:

"Point-of-case thoracic and abdominal ultrasound: no free fluid or masses found...ProBNP Snap Test: Normal" Yet they're still thinking it's her heart? Is that possible?

Meds on:

Lasix .4 ml twice daily; Clopidogrel 1/4 of a 75 mg tablet once a day
 

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Lasix -- the name is based on "lasts 6 hours" at least in humans. I'd follow the cardiologist's directions.

Clopidogrel - its common name is Plavix. It's used to prevent platelets from clumping. Since the fluid is in the lungs, I'm guessing they are trying to prevent a clot from forming there.

If you can track down some pet sized gel caps you can put the pill in the gel cap. It prevents the bitter taste from effecting your kitty. I keep them on hand. There are lots of meds that taste awful.

If the heart isn't functioning like it should, it can cause fluid to accumulate in the lungs.
 
Unfortunately she still has yet to actually see the cardiologist (since the ultrasound and blood work came back normal, the on-call cardiologist didn't come in to do the echo; they said to call Monday and they'll get me in this week for it). But I'm glad some tests were done under the cardiologist's instructions vs us going home empty-handed. I just think it's so weird that if it's heart, nothing is showing up on any tests, but then I really don't know much about heart-related stuff with cats and have been trying to read as much as I can in between little mini snoozes here and there while waiting (I've been up basically over 24 hours!). :eek: My girl looked so happy to see me when they brought her back to me. I'm sure it was a tough day on her and she's tired too.

I checked her respiration and got 24. I'll continue to keep an eye on it throughout the day.

I want to say thank you to everyone for the advice and well wishes! It really means a lot. I basically have no family so my cat is all I really have, and it sucks dealing with this alone, but being able to come on here and share what's going on and dialogue about it helps immensely. I'm really hoping that whatever it is, that it is something we can manage and she can still keep on keeping on. I want my senior to become even more of a senior...I don't think 14 is all that old.
 
Please remember that you're not alone. We may not be sitting next to you at the vet's office but we're here. Please don't hesitate to tell us if we're adding to your stress. Everyone wants to help but sometimes, it can be too much. Just know that we're here and we want to know how you and BabyG are doing.
 
She sounds worse with the crackling and the swallowing to clear it. I kind of know how that feels from when I had crackling in my lungs from allergies. I personally consider that distress?? The ER said she could be clearing some mucus so to just continue watching the other signs they gave me. I hate seeing her like that. :(
 
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To answer a question from your previous post, Neko was also on Plavix (chlopidogrel). They fit nicely in size 5 gel caps. Size 4 would also work. I used a size 4 to fit more than one med in per capsule. Smaller number means larger gel cap. My specialist vet game me a few gel caps, and I also got some from a compounding pharmacy, to hold me over until the on line ones showed up. I've also heard of some people getting their kitties heart med cocktails compounded into a liquid.
 
Wendy&Neko said:
To answer a question from your previous post, Neko was also on Plavix (chlopidogrel). They fit nicely in size 5 gel caps. Size 4 would also work. I used a size 4 to fit more than one med in per capsule. Smaller number means larger gel cap. My specialist vet game me a few gel caps, and I also got some from a compounding pharmacy, to hold me over until the on line ones showed up. I've also heard of some people getting their kitties heart med cocktails compounded into a liquid.
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Thanks, I will definitely look into the gel caps because pill time is very difficult over here. :banghead: She's too smart for pill pockets, and the pill gun doesn't work too well with pills cut so small like the Plavix.
Not going to lie, it's all been really hitting me now and I've been having meltdown after meltdown over here. I'm so worried. I'm going to stay home from work tomorrow so I can keep an eye on her, plus who knows..maybe we'll get lucky and get to see the cardiologist right away. I will continue to keep you all updated.
 
:bighug::bighug::bighug::bighug:
Been there with the helpless feeling. You are doing all the right things. Give Baby G some scritches from me.
 
She is still crackly and swallowing back the fluid. Why can't anything more be done? I consider that suffering as I've had that somewhat too.
Should (or could) I demand they give her more lasix, like another injection or an iv or something to clear this out? I'm getting ready to give her insulin and lasix here at home but feel like the first dose of lasix at home did nothing.

Edited to add: I hear the crackling and swallowing every time she purrs or drinks water.
 
She just got the Lasix so I'm interested to see if she will sound better after the first hour, especially since she hasn't thrown anything up like she did this morning. I just cleaned her litterboxes and there was only one pee for the whole day thus far. That makes me think the Lasix might not be working because shouldn't she be peeing more as she clears more fluid? And I've been home with her all day and checking on her frequently so I very highly doubt she peed somewhere she shouldn't have. Funny enough, she just peed in her box as I'm typing this, but I still would have expected more.
 
I called the vet hospital and told them how 1) ever since yesterday, the crackling seems worse when she purrs or drinks, and 2) the Lasix doesn't seem to be working, IMO, because of the crackling still being there plus she's only peed twice today thus far and usually she'll pee about double that. She is eating and drinking good though. The hospital said if to me I think she is worse, or if she stops peeing altogether, that yes, I should bring her in to get reevaluated. I explained what happened last night and that I don't want a repeat of that where we come out and wait forever and then they don't want to do anything. Sounds like the only answer I can get out of them is if I personally feel like she's worse, to bring her in and when they evaluate, if they also agree, then they'll do something. Otherwise, same bologna. I asked if she could get more damage to her heart waiting around with fluid like that if the Lasix isn't working and they said no. Do you guys think it's ok to wait until the morning when I can call and get an appointment with cardiology? I hate for my girl to sit in her own fluids like that though. I just don't have guarantees they'll do anything if we go tonight. :banghead:
 
Wendy&Neko said:
How have her BG numbers been? Neko's skyrocketed when her body was in heart stress.
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I'll update her spreadsheet. I just checked and she's 305, so kind of high and flat.
I also noticed when she gets up to go walk, she seems kind of stiff. I wonder if she's sore from all the manhandling they did yesterday with the ultrasound.
 
Should be updated now. I still really need to sleep but have only caught maybe fifteen or twenty minutes here and there. I've just been so consumed with research, having meltdowns, and checking on her. Sounds like if it is heart, the average prognosis time is 6 - 18 months; sometimes more, sometimes less. So many stories of cats suddenly dropping dead or going into great respiratory distress or having to be euthanized within days. :( Terrifying.
 
Perhaps check her resting respiration rate again and, if it’s normal range, try to get some good sleep. Everything is significantly harder to deal with when exhausted and I’m concerned for you. You need to be able to think clearly and be safe to drive if need be. Just my two cents having been through something similar recently. It’s so hard to feel helpless. :bighug:
 
Thanks, I fell asleep for maybe a couple hours that were broken up a little but it was at least a bit more substantial. She still hasnt peed since her pm shot/lasix dose. So basically only 2 pees all day yesterday. I don't think that's very normal for her. Could there be a kidney issue the lasix is exacerbating? I'm thinking if she doesnt pee again by shot time in 4 hours, I need to ask the hospital before giving the next lasix dose. Especially because she is drinking a lot/her normal so where is that going. No poop all day.
 
I called and vet hospital said to still give the lasix again in the morning regardless and then call cardio when they open. I hope she doesn't have a blockage or kidney issue.
 
She literally just peed! :) omg this cat is driving me crazy. I guess my pep talk to her while on hold with the hospital worked.
 
Will definitely need to get some gel caps or compound or find some better way to give her these meds because the Plavix must taste super nasty. She hates it. I tried disguising it in a piece of chicken but she can smell it a mile away. Even the Lasix, she fights me on, but at least with liquids it's not as bad. I'm just thinking to myself that if she will need these meds or some kind of meds long-term, we'll definitely need to evaluate a better way to go about giving them every day so she's not fighting me and miserable.
I am really going to push for the cardiologist to see us today. They open in an hour and a half. Praying they will take us right away. Either way, I'm not going into work until we get this all figured out. There's no way I'm leaving her unattended. I tried to sleep as much as I could the rest of last night in anticipation of us making the trip out. She peed again since I last posted, so that's good. No poops yet, though. I think I read somewhere Lasix can constipate so maybe she's constipated or just not ready yet. Eating and drinking good, but still sounds crackly and not like herself. I almost don't like hearing her purr now because I hate hearing the crackle. :(
 
I'm compiling a list of questions and tests...I already know they need to do the echocardiogram. If there are any other tests you all think should be run or any questions I should ask and have them look into, please let me know. Trying to get ready.
 
They don't think it's heart and they think it's a lower lung issue and to schedule with internal medicine?! And to stop Lasix and Plavix, but soonest they have is Sept 12th

Edited to add: I'm also on a waiting list in case there's a cancellation, so praying I can get in sooner. I also left a voicemail with my girl's internal medicine dr so I can at least talk with her and maybe glean some info til then.
 
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Trying to check with primary vet now for more info. What on earth could lower lung issue be that could be causing this? The cardiologist didn't think it was cardiac at all based on all the tests already done, so they didn't recommend doing the echo. Do you guys have any ideas?
 
I think good news?!
The cardiologist talked with the primary vet and primary called me back just now. Cardio vet told her the following:
  • Stop all heart meds/Lasix
  • he thinks it could be a lower airway disease like bronchitis or asthma, so do not spray anything of any sort in the house
  • have internal medicine do a complete workup to check into the lower airway issue
  • that she's not in any respiratory distress and she is perfectly fine to wait until her appointment next month
  • and funniest of all: what they saw and thought was fluid could actually have just been fat, that the noises and everything could be just because she's fat o_O
 
So now I've gone from researching heart stuff to researching bronchitis and asthma. :confused: I think maybe now you all can understand why I have trust issues with vets. If anyone has experience or knows anything about lower airway diseases, feel free to share!
 
Quick update. Peeing more like normal now. No poop yet but she's been eating good so I'm anticipating that soon. I really hope her getting that Lasix and Plavix when she didn't need either of them didn't do any harm or damage? That's why I really dislike starting meds without a proper diagnosis and it makes me feel like I won't do that again no matter how "obvious" or strong their hunch is about what's going on. I don't know how angry I should be about this.
 
Plavix is a blood thinner. A few doses, as long as she's not about to undergo an operation, should be fine. I think she also only had a couple doses of the Lasix?

If you don't get answers here, there is a groups.io group for feline asthma that looks fairly active.
 
Wendy&Neko said:
Plavix is a blood thinner. A few doses, as long as she's not about to undergo an operation, should be fine. I think she also only had a couple doses of the Lasix?

If you don't get answers here, there is a groups.io group for feline asthma that looks fairly active.
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Yes, 2 doses of Plavix at home, 1 injection of Lasix at the vet, and 3 doses of Lasix at home. I guess I'm the most worried about the Lasix. I don't need a kidney problem next.

Thanks, I'll check out the group. I've been trying to read up on asthma and bronchitis and was amazed to see that sometimes cats are put on Flovent. Pretty sure that's what I used for my crackling lungs during my bad allergy season years ago and just one puff brought instant relief. It was amazing.
 
Did more reading on cat asthma and bronchitis and found an asthma video on YouTube where the cat sounded similar to my cat. I don't understand why the vets think it's ok to wait so long for a proper dosage and treatment. Sounds like you want it checked while they're actively having an episode, and also sounds like if you wait to do anything about it, it could progress, get worse, and in severe cases cause damage or death. Otherwise if you get on it right away and get the inhaler or whatever treatment, then it can be very manageable.

They had a cancellation I could have gotten in a little sooner but it was with a rotating dr and not a straight up internal med specialist, so I turned it down and kept my original appt. because I want to make sure she gets the correct person and diagnosis, plus they made it sound like this isn't an emergency and she's safe to wait. Now I'm not so sure?
I think I'm going to call the primary vet again tomorrow to go over my concerns to see if they're valid in any way because if so I'll bug the hospital again to give me a sooner internal med appt.
 
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Chrispooky12 said:
Hey just checking in to see how you & Baby G are doing? I hope all is well :bighug::bighug::bighug:
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Thanks, Christina. :bighug: We are still awaiting our appointment next week; so far there have been no cancellations to bump us up sooner. On and off I still hear a little crackling/ gurgling when she purrs, but she's eating good and seems normal otherwise, so that's leading me to believe it's probably just her being overweight or maybe a bit of asthma and nothing serious. I'll update what the internal medicine specialist says when we see her. Hoping and praying for a good report! :)
 
Our appointment is finally here tomorrow. I'm dreading it; praying everything will be ok. Sounds like they'll be doing bloodwork and xrays (they don't do CT scans or bronchoscopies on the same day but I'm not looking to do anything invasive anyway). Not sure what else they'll do or what else to expect. I've slowly moved her shot time over so as to allow time in case we get stuck there longer. I'll keep you all posted.
 
They just listened to her and they recommended monitoring to see if she develops any other clinical signs. If she does, then they can check if laryngeal paralysis or a tumor by larynx and do a ct scan, scope, or laryngeal exam. All of those are invasive and require sedation/anesthesia so that's why we are just going to monitor. They dont think she has asthma. No tests were performed today.
 
Basically they think it could be either nothing or it could be laryngeal paralysis or a mass by the larynx, which if it were either of those the prognosis is guarded. Sounds like if she's not exhibiting any other signs, to leave her alone and not take on the risks and extra-ness of further diagnostics unless she gets worse, especially since those potential diagnoses are pretty bad ones. They call the sound she was making while purring stertor. We'll continue working on her weight loss and just keep an eye on her.
 
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babyg said:
Unfortunately she still has yet to actually see the cardiologist (since the ultrasound and blood work came back normal, the on-call cardiologist didn't come in to do the echo; they said to call Monday and they'll get me in this week for it). But I'm glad some tests were done under the cardiologist's instructions vs us going home empty-handed. I just think it's so weird that if it's heart, nothing is showing up on any tests, but then I really don't know much about heart-related stuff with cats and have been trying to read as much as I can in between little mini snoozes here and there while waiting (I've been up basically over 24 hours!). :eek: My girl looked so happy to see me when they brought her back to me. I'm sure it was a tough day on her and she's tired too.

I checked her respiration and got 24. I'll continue to keep an eye on it throughout the day.

I want to say thank you to everyone for the advice and well wishes! It really means a lot. I basically have no family so my cat is all I really have, and it sucks dealing with this alone, but being able to come on here and share what's going on and dialogue about it helps immensely. I'm really hoping that whatever it is, that it is something we can manage and she can still keep on keeping on. I want my senior to become even more of a senior...I don't think 14 is all that old.
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I have a cat with Hypertrophic cardiomyopathy: mild LVH but severe LAE and reduced function (stable) Reduced systolic function: secondary to cardiomyopathy. Her left atrium is severely enlarged. Her heart doesn’t pump well. She is on Pimobendan (a total game changer for us) and Lasix every 12 hours and Clopidogrel (definitely needs to go into a gelcap - it can be squeezed into a size 4). I pretty much put all her meds into gelatin capsules of various sizes (order on Amazon) so she never tastes them. Clopidogrel is notoriously bitter. Ginger just recently passed her one year anniversary of her first pleural effusion (they had to draw off a lot of fluid from her chest.). She had another one a few days later, but since starting the Pimobendan she’s never had to have another chest tap. One time back in March she had some fluid on her chest but some extra Lasix was enough to clear it. She just saw her cardiologist last Friday and the good news this time is that her heart is stable. Her echocardiogram measurements were virtually the same. Be sure to monitor her breathing as you are already doing. Do it when she is sleeping (not awake and not purring.). 24 BPM is good. I usually get 22 on Ginger but occasionally a couple more. I hope I can help you. I have a lot more to tell you, but I have to run. I just saw the title of your thread and was upset and wanted to stop by.
 
Thanks. They no longer think it's her heart. They're really not sure what it is or if it even is anything at all, and they said even if they go do all these invasive, expensive tests, they could still end up not knowing.
We just got back home and are going to take it easy the rest of the day.
 
babyg said:
Thanks. They no longer think it's her heart. They're really not sure what it is or if it even is anything at all, and they said even if they go do all these invasive, expensive tests, they could still end up not knowing.
We just got back home and are going to take it easy the rest of the day.
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I hope she will get over this and do better. I think with a pleural effusion that I would insist that my cat have an echocardiogram performed by a cardiologist. It is very odd that they don’t seem to know what is the cause of the pleural effusion.
 
They think what the primary vet saw as fluid in the lungs was actually just fat from a skin fold since she's overweight. Plus they said if there had been fluid, there's no way it would have disappeared that fast from the xrays and Lasix in the morning to the time of the thoracic ultrasound not even 24 hours later (ultrasound found no free fluid). When they listened to her today with the stethoscope, they said her lungs sounded clear.
 
I will say it does frustrate me all the things I've been told... primary vet and er vet thinking heart... cardiologist thinking not heart but a lower airway disease like asthma... internal medicine thinking not asthma but maybe laryngeal paralysis... it's been a crazy ride.
Based on all my own personal research online, it sounds like asthma to me. She doesn't cough but her gurgly purr sounds similar to asthmatic cat purrs I've heard on YouTube. I don't think she sounds like laryngeal paralysis at all. And as for a larynx mass, sounds like that's rare in cats so I'd like to hope the odds are with us that it's not that. Seems like all I can do is monitor to see if anything else changes or crops up.
 
T
babyg said:
They think what the primary vet saw as fluid in the lungs was actually just fat from a skin fold since she's overweight. Plus they said if there had been fluid, there's no way it would have disappeared that fast from the xrays and Lasix in the morning to the time of the thoracic ultrasound not even 24 hours later (ultrasound found no free fluid). When they listened to her today with the stethoscope, they said her lungs sounded clear.
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That is wonderful news - I mean about the lungs sounding clear and her heart not being the problem and not fluid on her lungs— How is she doing at home now?
 
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Suzanne & Darcy said:
T

That is wonderful news - I mean about the lungs sounding clear and her heart not being the problem and not fluid on her lungs— How is she doing at home now?
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She's doing the same. Eating good and everything good, though I still hear some noises I don't like.
 
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