1/15 KT PMPS 270......Congestive Heart Failure in Cats

[Squeaky and KT (GA)]

Good morning World!! Yesterday

+10 - 369
AMPS 361

My extra sweet BIG pink toad today....increased dose by another drop this morning - I'm calling it skinny 2.0. It's one drop more than what I was calling 1.82u's.

Scruffy update - Scruffy has a butt!!! It was just a big blob for the last 2 weeks but today, his bony butt is showing again. We're now having an issue with him NOT pooping - have only had one poop since Thursday morning altho' he's eating things that should make it happen. If I don't see poops today, he's going back in tomorrow to be sure there isn't a blockage that's developed or something.

Jess (& Earl) replied to my email about Congestive Heart Failure in cats in yesterday's condo. THANK YOU JESS!!! It contains a lot of good info so decided to just quote it all here. It's long but all of it is very interesting. She asked a few questions so I'm going to answer those first ahead of the article.

Lyresa, you are describing right-sided CHF (fluid in the belly aka ascites) which is very unusual. I'm curious why your vet thought that the fluid was caused by CHF? Did he tap the fluid and analyze it? Did he drain the belly at that time?

Vet actually CALLED it "CHF with ascites' - even written on the receipt. He tried to get fluid but didn't get any from 2 attempts so no analysis and no, he didn't drain it. He just gave me the pills, said he had CHF and give the lasix and enalapril. I'm not sure he was very confident that I could even save him - I didn't get a very positive feeling from him. With my track record, if it's 'unusual' or 'rare', it probably IS that. I also have a cat with situs inversus and hubby with rare mutant ion channel disease.

Does this cat eat a commercial diet or do you cook for him? There are heart defects that can cause R-CHF but it would be strange for this to finally show effects in a 9 yr old cat.

Commercial canned - Friskies, 9 lives, Sophistacat, mostly pates. An occasional few pieces of hard food but he doesn't care for it much. I don't have any idea of his medical history altho' I can pretty well guarantee you that his only vet trip in his prior life was to be neutered.

The other possibility is DCM, which is exceedingly rare in cats eating a commercial diet. So I'm not sure about this being heart disease, though it's possible.

I have a feeling it was his 'best guess'....

Are you in a heartworm area? Heartworm is another disease that can cause R-CHF though these cats usually seem to be quite sick by that time.

Yes we are in a heartworm area but if he has heartworm, it's happened very recently as I use revolution. Last application was in September.

====================
Here is the full quote:

Sorry, I know I'm risking a confusion by re-starting yesterday's condo but I wanted to address this out in the open for everyone to see because I think it's important ...

link to info on furosemide (lasix). There is a drug interaction between furosemide and enalapril and you should get some additional blood tests so there aren't kidney problems due to the interaction effects.

I looked at the Marvista vet article and was a little disappointed, their articles are usually better. Anyway the drugs don't interact with each other, it's more that you worry about them both causing elevations in kidney numbers (azotemia). I say 'azotemia' rather than kidney damage because it is very important to understand that dehydration (caused by Lasix) can cause pre-renal azotemia (azotemia caused by something other than kidney function) but does not damage kidneys. It's possible to permanently damage kidneys through chronic severe dehydration; it's possible to damage any organ that way really. But therapeutic Lasix does not do this.

I'll give a bit of a complicated explanation on enalapril. Enalapril and benazepril are both ACE inhibitors, and they counteract an emergency response we all naturally have to certain kinds of physical stress. When an animal goes into CHF, they have an activation of this http://en.wikipedia.org/wiki/Renin-angiotensin_system emergency response. This response makes the body hold in more water and sodium, which is exactly what a patient in heart failure wants to get rid of. So in treating CHF, you want to disable this in order to decrease work for the heart. (The more blood volume, the more overloaded the heart gets.) Patients who already have renal disease may not be able to tolerate both Lasix and enalapril/benazepril so the enalapril is skipped, but for otherwise healthy patients, both drugs are given. For animals suffering an acute crisis in hospital, the tendency is to push as much Lasix as they need to start breathing well again, and then add the enalapril.

THANK YOU SIENNE! This is EXACTLY what I was wondering and worrying about - how can you slow down the heart and blood circulation then expect a med like Lasix to get rid of the fluid fast? That just isn't logical.

So you're not slowing it down, instead you're keeping it from speeding up. If I'm an animal who's just fallen into an icy river and finally dragged myself out, I want my RAAS (see wikipedia link) to run at full speed, bringing up my blood pressure and conserving my fluids. If I'm a cat who's in CHF because I'm overloaded with fluid, I do not want my RAAS to run at any speed, as increased pressure and volume is forcing my failing heart to work even harder.

Speaking of CHF ... there are 2 kinds of CHF: left-sided, which causes fluid to build up in and around the lungs in cats, and right-sided, which causes fluid to build up in the belly. Left-sided is much more common in cats and is usually caused by HCM; the hallmark is a cat who is having difficulty breathing. Lyresa, you are describing right-sided CHF (fluid in the belly aka ascites) which is very unusual. I'm curious why your vet thought that the fluid was caused by CHF? Did he tap the fluid and analyze it? Did he drain the belly at that time? Does this cat eat a commercial diet or do you cook for him? There are heart defects that can cause R-CHF but it would be strange for this to finally show effects in a 9 yr old cat. The other possibility is DCM, which is exceedingly rare in cats eating a commercial diet. So I'm not sure about this being heart disease, though it's possible. Are you in a heartworm area? Heartworm is another disease that can cause R-CHF though these cats usually seem to be quite sick by that time.

Sorry again to mess up your condo order. Hope this helps. Please let me know if I've been unclear.

====================

THANK YOU AGAIN JESS!

Hugs for everyone today! ...and an extra one just 'cos....

 

[Ella & Rusty & Stu(GA)]

Re: 1/15 KT AMPS 361 Info! Congestive Heart Failure-cats

Hi Lyresa,
What an informative reply from Jess! I hope it will lead to a good conversation between you and your vet and to a healthy Scruffy. It's great that the lasix is working and that he is beginning to look "normal". Have you tried adding FortiFlora or plain Greek-style yogurt with active cultures to his food for the poop problem? Canned pumpkin (100% plain pumpkin, not pumpkin-pie mix) is also used by many people for constipation problems.

Good luck with KT's new dose. Come on down, now, KT!

Hugs,
Ella & Rusty

 

[Karrie and Maverick]

Re: 1/15 KT AMPS 361 Info! Congestive Heart Failure-cats

Amazing info. Sounds like further investigation may be needed.

Also, can you ask Jess about whether its best to abruptly stop lasix at the end of the two weeks - assuming its right sided heart failure.

Keeping you guys in my thoughts.

 

[CD and BigMac]

Re: 1/15 KT AMPS 361 Info! Congestive Heart Failure-cats

Thanks for information about CHF. I'm sorry that you are needing to learn about this for Scruffy, but it was kind of you to share what you've learned.
All my best for your sweet kitties. cat_pet_icon

 

[Squeaky and KT (GA)]

Re: 1/15 KT AMPS 361 Info! Congestive Heart Failure-cats

(Wiki-http://en.wikipedia.org/wiki/Renin-angiotensin_system) If the perfusion of the juxtaglomerular apparatus in the kidney's macula densa decreases, then the juxtaglomerular cells (granular cells, modified pericytes in the glomerular capillary) release the enzyme renin.

:? :arrow: HUH? ...dat's not engwish...iz it?

Some of those words aren't even IN my dictionary...

 

[Linda for Weezer]

Re: 1/15 KT AMPS 361 Info! Congestive Heart Failure-cats

The depth of knowledge on this board is absolutely amazing! But I'm with you Lyresa, huh?

 

[Anne & Zener GA]

Re: 1/15 KT AMPS 361 Info! Congestive Heart Failure-cats

Yay for Squeaky's butt! :smile:
Liz

 

[Jess & Earl]

Re: 1/15 KT AMPS 361 Info! Congestive Heart Failure-cats

Lyresa you didn't say if Squeak eats a commercial food? I asked you a few questions in my post -- was the belly tapped, heartworm tested, etc.?

I would speak to the vet about stopping the Lasix. There is no harm in suddenly stopping it except that the fluid will come back What I mean is, there is no physical dependence on the drug per se, but since the underlying problem is not curable, it's likely that he'll always need medication. That''s if it is CHF. I would speak to the vet tomorrow, figure out why he says heart failure vs not, see if he wants to stop the Lasix or not.

Ha yes that Wikipedia article is a mess, it's ridiculously written as if for a med student rather than a layperson. I hesitated to include it but thought it was better than nothing since it was late and didn't feel like writing a treatise on the RAAS myself

 

[Squeaky and KT (GA)]

Re: 1/15 KT AMPS 361 Info! Congestive Heart Failure-cats

Jess - THANK YOU AGAIN!! PLEASE PLEASE don't take my post above as 'making fun' - I didn't mean it that way at all. I'll pound it until I figure out what it's telling me. It just struck me as really funny right then. I was all hunched over my keyboard reading the screen, looking thru my dictionary and tapping my feet. DH started giving me a hard time. I have to keep a sense of humor about my whole world right now or I'll run screaming into the deep dark night.... :roll:

I'm sorry I didn't make my answers above easier to spot....they're in my original post. I'll color them red making them easier to find when I finish this.

The ones I see right now:

* Yes he eats commercial food - mostly soft pates, Friskies, 9 Lives, Sophisticat, FFeast. Sometimes few bites of hard such as Whiskas, Purina One or 9 lives.

* Was the belly tapped - tried twice but didn't get fluid so nothing was really tested.

* No heartworm test but he's been on revolution for months until september.

I'm going to talk to vet tomorrow and maybe take him in altho' it will probably be Tuesday. My arrangements for DH's 'babysitter' (shhh...he hates me to tell that) is for weekly shopping time tomorrow and really too late to change it. I can usually do the vet trip without having to have someone checking on him.

Again, THANK YOU for all you're doing for us!!!!!! BIG HUGS!!!!!

 

[mybuddybinks]

Re: 1/15 KT AMPS 361 Info! Congestive Heart Failure-cats

Hooray for Scruffy Butt!!!

KT, however...you could come down some, buddy...

 

[Amy&TrixieCat]

Re: 1/15 KT AMPS 361 Info! Congestive Heart Failure-cats

Great news that Scruffy has a butt again!!!

Yes, the wealth of knowledge on this board is amazing!!!

 

[Jess & Earl]

Re: 1/15 KT AMPS 361 Info! Congestive Heart Failure-cats

I'm sorry I didn't make my answers above easier to spot....they're in my original post. I'll color them red making them easier to find when I finish this.

No, that was just me being a dunderhead. When I scrolled to your post, I must have scrolled past the first part so I just saw it from where you were quoting me.

So his belly looks a lot different after the Lasix? I am wondering, if he did have a giant belly full of fluid, why he couldn't get a sample. The pieces don't fit together quite right here, but if he is looking better and feeling better, that's all we can ask for. Keep us posted

 

[Squeaky and KT (GA)]

Re: 1/15 KT AMPS 361 Info! Congestive Heart Failure-cats

Scruffy seemed to have a tight belly then just pillows of fluid under his skin around his (first) back middle, flanks, (second) full middle, each side of top of spine and pockets hanging in front of flanks (last) chest and one front leg. He wasn't and still isn't tender in any area altho his actual 'body' area is still very tight feeling. Even I could feel the 'fluid' that was there like it was under the skin. That's what's mostly gone.

He still has these issues:

* body area still very tight feeling
* back left leg still has looks a little swelled
* back legs still weak - he reached around and tried to scratch his ear but fell on his back side. Couldn't tell if his other leg buckled or he lost his balance. He just looked indignant afterward.
* Has only pooped NOW twice last few days.
* He still seems to be sort of walking humped a little but no signs of nausea
* When I can distinguish from his purr, his heart seems to be beating very very fast even resting

I have NO medical training - just lots of things that life's thrown at me so please excuse my wierd explanations.

What else would cause this?

HUGS!

 

[Squeaky and KT (GA)]

Re: 1/15 KT PMPS 270......Congestive Heart Failure in Cat

KT's beginnin' to wonder who's condo this is... ;-)

+10 - 283
PMPS 270

He's ready for a dive so I'm feeding him MC food for the early part of this cycle as well as leaving some out. He's still not waking up to eat during the night any more. I think that has to do with the cold - warm bed or cold food...hummm...nite nite...

Scruffy has less water on his legs and flank areas, actually looks like most of it is about gone other than the middle I mentioned above.

Sweet dreams on velvet paws....

 

[Ella & Rusty & Stu(GA)]

Re: 1/15 KT PMPS 270......Congestive Heart Failure in Cat

Ni ni, Lyresa, KT, Scruffy, and all the fur kids, and DH, too

Sending good thoughts for tomorrow.

Ella & Rusty

 

[Marje and Gracie]

Re: 1/15 KT PMPS 270......Congestive Heart Failure in Cat

Lots of interesting info here today. Holy cow!!

Glad to see KT coming down...hope he likes his dosecrease!

 

[Melissa and Bailey]

Re: 1/15 KT PMPS 270......Congestive Heart Failure in Cat

That was a great explanation from Jess, very interesting. Has KT had any labs recently, maybe liver function tests? If Scruffy has ascites that might be another cause. Do you have any pics of him while he was puffy? It is hard to tell but it sounds like a lot of the fluid was outside the belly area, a pic might be helpful. So glad he is doing better :YMHUG: