Fluid in lungs & around heart

KellyMac

KellyMac

Member Since 2022
Hey,
My cat Harry is 14.5 years, he is in late State 2 CKD based on recent blood work.
Currently on Lantus insulin, Cabergoline, Telmisartan, Epakitin, Miralax , B-12 pill, Cosequin (joint), solensia injection

The vet suggested starting Sub-Q fluids. I went in Friday and they gave him 350ml. The dose suggested was every day for 3-5 days and discuss how he's taking it.
I came home and did my dive into this site and the CKD site and very much agreed that was way too much. So skipped Saturday, Sunday 100 ml, Monday 100ml.

He began breathing hard yesterday, I called the vet they said he might just be irritated from the poke, no open mouth breathing, and it did subside to not as intense.

12:30am today I woke up and he was breathing hard again. peed, pooped, ate, laid on the Couch. Called 8am and brought him into the Vet right away.

X-Ray showed fluid in and around the lungs, contributing to Heart Failure. He's currently in an oxygen chamber.
They said due to the extensive issues it might be time.
Obviously, I believe the overload of fluids contributed to this. I said I'd like to try a diuretic, and he had a dose of that. I'm waiting on a call to see how he's doing.
He was legitimately so stable and solid (all things considered) prior to the start of the fluids.
Is this 100% the cause? An 'over the edge' contributing factor? I don't want to make him suffer but this feels like an incident caused by xx factor.
He OCCASIONALLY in the past had heavy breathing, like after a flea pill, or in his sleep, but it would pass very quickly and he goes regularly to get checked out.
A mild heart murmur of a skipped beat was detected this last week during his blood draw as well*.

Help! I know he's old, borrowed time, but wow I can't just give up after keeping him stable for years after an Acro diagnosis! They gave me a year without doing radiation, I found you all, got him on the Cab and he's been a rock and a trooper for almost FOUR YEARS. HELP PLEASE

Kelly
 
@Wendy&Neko
@Sienne and Gabby (GA)

I'm sorry Harry is so ill. I've tagged a couple of members with experience with acromegaly and it's complications. That was a lot of fluids for your vet to give when they know acro often leads to heart problems and your cat has a known murmur.
 
Thank you for Tagging!
They called me and said he is 'stable' his breathing has improved but not fully back to normal, and the diuretic has helped it seems?.
She suggested Furosemide, Enalapril and Plavix.
Also she said 'congestive heart failure is likely a complication of the acro' , which I can see, but also this is all very sudden and too coincidental.
 
Glad he's doing better! Ask about vetmedin (pimobendan) when you next speak to the vet- it's not helpful in all heart failure but it's a fantastic drug when it's appropriate.

That much fluids wouldn't put a cat without pre existing heart issues into heart failure. CHF is really common with acro which is why they should have been much more careful with fluid loading!
 
Sorry to hear Harry is at the vet with heart issues. I know too well how woried you probably are.. :bighug:

That much fluids more than likely caused the CHF. Neko was only getting 100ml every other day, and she already had HCM and it sent her into heart failure. Any chance you have a cardiology vet nearby. Neko's cardio vet saved her life and her intrernal medicine vet saved my sanitiy. She was on Vetmedin, Plavix, and benazapril (similar to enalapril) already for her CKD. They gave her some bolus Lasix (furosemide) when she was in the hospital, but didn't have her on it full time as it is really hard on kidneys. Balancing kidney and heart is hard! The IM vet helped me prioritize what she needed. The cardio vet can tell you if Vetmedin is appropriate, it isn't in all heart cases.

If they haven't you already, you need to monitor his resting respiratory rate (RR) at home. Count the number of complete in and out breaths in a minute, when he's at rest. I used the timer on my phone. The number should be between 20 and 30. For Neko, normally around 20-21, anything over 26 signalled trouble.
 
Thanks for the added info!
There are a bunch of specialists at the University a little over an hour away.
My vet seemed to be at the 'lets see if he can bounce back a bit' stage currently.
I know it will be a balance for sure with the kidneys, deciding what is best and what to dial back.
I'm super disappointed in the sub-q situation and I guess I should have been more on top of the possibility of a heart issue developing with the Acromegaly.
I will look into the specialists though, I hope to make it a bit longer with this guy!
Thank you again for your feedback.
Kelly
 
I was lucky that the specialists were 10-20 minutes away, depending on traffic. Specialists at University, if a teaching hospital, will likely be more cost effective. Might want to see if they do phone consults too, but the cardio vet would likely want to do an echocardiogram so at least one hands on visit.
 
I'll definitely do further research to see if there's anything closer, but the brief glance was leaning towards that as the most popular choice for people around here. 10-20 min would definitely be ideal.
He seems to be relaxed and ok currently. fingers crossed!
 
KellyMac said:
Thanks for the added info!
There are a bunch of specialists at the University a little over an hour away.
My vet seemed to be at the 'lets see if he can bounce back a bit' stage currently.
I know it will be a balance for sure with the kidneys, deciding what is best and what to dial back.
I'm super disappointed in the sub-q situation and I guess I should have been more on top of the possibility of a heart issue developing with the Acromegaly.
I will look into the specialists though, I hope to make it a bit longer with this guy!
Thank you again for your feedback.
Kelly
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Please don't blame yourself, you're doing a fantastic job with Harry. If anything I wrote came across as that it shouldn't have. I was throwing side eye at your vets though😒
 
No no worries I really appreciated your imput. And I agree, I think I'm on my 4th vet since he's been diagnosed, I did move to a different State in that timeframe, but two of them just didn't want to work with me or hear me out like with the Cabergoline, so hard to find a good fit. I def think the hours we all spend researching and reading has given all our cats more time than they'd have without groups like these.
 
KellyMac said:
No no worries I really appreciated your imput. And I agree, I think I'm on my 4th vet since he's been diagnosed, I did move to a different State in that timeframe, but two of them just didn't want to work with me or hear me out like with the Cabergoline, so hard to find a good fit. I def think the hours we all spend researching and reading has given all our cats more time than they'd have without groups like these.
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Did the bloodwork you received have Albumin and Globulin levels, and what do the other blood values look like? This may be completely off base since I haven't seen the other bloodwork and don't know your cat's history, but has FIP been considered?

Symptoms per Merck Manual can include:
-Fluid in abdomen (my cat showed this)
-Potentially fluid in/around lungs
-Potentially fluid around heart heart
-Difficulty breathing
-Loss of appetite (my cat showed this)
-heart murmur (my cat showed this)
-fever
-weight loss
-depression
-occasionally major organ failure i.e. kidneys/liver
-possible inflammation in kidney, liver, spleen, pancreas, and/or lymph nodes

My cat came down with FIP 9/30/2025. I have been fortunate enough to have an extremely good vet I trust already, but even he was blindsided by our diagnosis and had not considered FIP. It was an ER vet assisting with getting us a transfusion for worsening anemia that noted the fluid and made a presumptive diagnosis, and that quick thinking saved my cat's life. If your kitty came from a shelter/previously lived on the streets, they are at increased risk of exposure to the virus that can mutate into FIP.

Even if not FIP-related, there is a site with a non-exhaustive list of vets who will treat it, and I would expect those vets would also be open to non-traditional treatments and complicated health cases. It may be a worthwhile resource to find a vet you trust better. FIP Friendly Vet website here
 
Albumin and Globulin were both within normal range, all the Blood count tests were also within normal.

The high values were:
ALT (SGPT) at 294 (range 10-100)
Urea Nitrogen at 65 (range 14-36)
Creatinine at 2.8 (range 0.6-2.4)
SDMA at 32.7 (range <15)
Amylase at 1567 (range 100-1200)
Precision PSL at 49 (range 8-26)
Protein 2+, in Aug it was 3+

the SDMA was the biggest change because it was at 19 in August. Everything else on that list was outside the normal ref range then as well, but didn't change drastically.

It's so tough these symptoms for all these possibilities all look the same! But his appetite and attitude throughout his diagnosis have remained good.
I'll do some reading on that though, Thank you!
 
Wendy&Neko said:
I hope Harry is doing better today.
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Aw thank you. He seems to be.
He spent a lot of time relaxing in the sunshine on the Catio.
I may have hovered over him a bit too much hahaha but he definitely seems to be feeling better. Thank you for checking in!
Kelly
 
KellyMac said:
Aw thank you. He seems to be.
He spent a lot of time relaxing in the sunshine on the Catio.
I may have hovered over him a bit too much hahaha but he definitely seems to be feeling better. Thank you for checking in!
Kelly
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Fantastic that he's home and doing better 🥰
 
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