Diabetic diagnosed with heart disease after ER clinic scare

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Laura & Heffernan

Laura & Heffernan

Member Since 2013
Good Morning! My Heffernan spent Saturday night in to Sunday at the ER clinic with respiratory problems. The vet at the clinic feels the xrays show heart disease, bloodwork was unremarkable and the fluid in his lungs resolved with lasik. We are desperately trying to get in to the specialist for an ultrasound today. Any tips or suggestions? He's being extra fussy about eating, which he never was before. I'm extremely worried. I have had a cat with HCM so it's not the heart disease that scares me, its the combo of diabetes & heart disease.
 
Hi Laura,
My cat Clyde has heart disease and diabetes. It's been interesting trying to get everything under control and regulated. I found Clyde's heart disease while Clyde was OTJ and noticed his BG going up and he wasn't eating as much. My vet did blood work, specifically it was the proBNP test. His numbers were in the range that indicated heart disease. She also took some x-rays and saw what she thought was an enlarged heart and fluid in his lungs. He also received lasik to clear up the fluid and was put back on Lantus since his BG started to go up.

I did have an echocardiogram done on Clyde and the cardiologist prescribed some meds to help treat his heart condition. I ended up going to a compounding pharmacy and had the prescription made into something Clyde would willing eat and incorporated that into my routine for his diabetes treatment. His treat after his PMPS is now his heart meds compounded into a tuna or chicken flavored treat. (If I had to pill him every day...let's just say it wouldn't have been a good experience for either of us. :))

Since the heart disease was diagnosed I've found that Clyde doesn't want to eat much and will even refuse treats until his BG is under 150. I found that if I treat the diabetes and get his BG down he will take his heart medication and will eat more.

It's a balancing act. I need to make sure he's eating something and at the same time he gets his medication for his heart. Fortunately, when his BG is down he is eating the LC food he's been on for the last year.

Otherwise, I would be looking for alternate LC foods.
 
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Maggie had diabetes and HCM. She also had chronic kidney failure. I found Maggie's BG was all over the place, which I attributed to her feeling not feeling well. I don't remember if she became a more fussy eater after all this time (6 years since my sweet cat died at age 18). She was ALWAYS a fussy eater, so I can't help you there. Maybe Heffernan just doesn't feel good and that's putting him off his food.

My vet detected the typical "galloping" heart rhythm that indicates HCM. I then took her in for a ultrasound, which confirmed the diagnosis. She took a baby aspirin twice a week, lasix when needed and diltiazem. Diltiazem is bitter so I had to find some other way to get it into her, so I had compounded into a transdermal gel. The key to the gel was regularly cleaning the residue off Maggie's ear. If I had been able to find it in treats I'm sure it would have been better - if she was willing to eat them.

It's definitely a balancing act. The treatment for the kidney failure was subq fluids. The treatment for HCM was lasix to remove fluid. The diabetes was easier by comparison - test and shoot if high enough.

She died at age 18 on 1/30/08, 2 hours before her vet appointment. It was probably heart failure.
 
Squeaker has Restrictive cardiomyopathy, 2/6 murmur, and is in chronic renal failure. One big tip is to ask about sodium restriction. There is a food list showing commercial cat foods and the sodium content at crf.org. The vet will recommend rx foods but these are very high in carbs so I wouldn't recommend using them; some as high as 32%. There is a feline heart group on yahoo: https://groups.yahoo.com/neo/groups/feline-heart/info.
Also ask about pimobendan. It is a tremendous help.
If you are not doing so yet, it is a good idea to begin getting a copy of your cats bloodwork every time it is tested. I have been doing this for 18 months and keep it in a spreadsheet. I find it helpful for comparing the values across time as heart issues can cause kidney values to increase across time and you'll need to monitor the potassium value if a diuretic is in use for an extended period. I also keep a journal for questions I might think of between appointments and daily issues that arise.

Anita and Squeaker
 
Thanks everyone. I do know his heart is not enlarged and the fluid was around his lungs. His blood work was unremarkable, which for a 25 lb cat is good news. We have an appointment Wednesday at 1 for an echo. His appetite is better today, but BG is still over 500. I upped him to 3 units, so hopefully he come down soon.
 
Ideopathic Hypotrophic Cardiomyopathy. He's on lasix & another med, plus an aspirin. Good news the rest of his organs looked ok--she said his pancreas isn't enlarged, it's slightly swollen. His liver was good, so were his kidneys.
 
Thanks Debby. His Lantus cartridge isn't that old, but I'm tempted to start a new one to see if that makes a difference. I'm kicking myself for not buying Levemir, but now that I've got the $$ invested in Lantus I don't want to switch just yet.
 
So Lasix is significantly upping his BG. I'm calling the vet later when I'm home to see if there are alternate meds we can try. I'm up to 3 1/2 units and his AMPS was480. UGH!!!
 
I doubt lasix is upping the BG since it is just a diuretic. The difficultly breathing and other problem are more likely causing the elevated BGs
 
I agree with Larry and Kitties. Lasix shouldn't be upping his BG. What I found with Maggie is there were times she felt bad (trouble breathing, heart working a little too hard, etc.) that made her BG erratic. All the lasix should do is make her pee more to get rid of the extra fluids.
 
Hi Laura,

I've only just seen this thread. I'm sorry to hear about Heff's diagnosis. I've no experience with any of this so can't suggest anything to help, but I will keep you both in my thoughts and prayers. I hope Heff will feel better soon, and I'll be watching for updates.

(((Laura and Heff)))
 
According to many websites I've read that Lasix ups BG's & should be used carefully with diabetic patients and that you may need to adjust the diabetes meds. His breathing is perfectly back to normal, so he's not laboring. He's actually pretty normal which makes me happy. I've been sick with the flu, so I haven't been able to update his spreadsheet.
 
We are now having issues with lack of appetite & constipation--both listed as side effects in lasix. Many of the drug interaction sites say use with caution in diabetic cats. His insulin dose is doubled now and #'s are still in the 300's. One of the ladies in the facebook group mentioned her cat became Acro after being on lasix. It looks like it's our only option though to deal with the fluid in his chest. I guess we'll have to look at appetite stimulants maybe.
 
Lasix is unlikely to have caused the acromegaly. It merely became identified as causing part of the diabetes.
 
Yes, by definition Lasix should cause constipation since it draws water out of the body into the urine. My Mitten also had inappetence and I had to syringe feed her.
 
For the constipation, pop over to Feline Constipation to read about the feline GI tract, how it works, and options for managing.
One option is to use 1/8 to 1/4 teaspoon of plain psyllium powder in the canned food to help hold water in the GI tract and soften the feces.
 
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