Treatment for Heart Failure

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marymartin

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My diabetic cat is being treated for heart failure, he is receiving a quarter tablet of Frusemide 40mg twice a day and one tablet of Fortekor 2.5mg once a day. His condition isn't improving and I have asked the Vet if I can increase the dosage or change the tablets. I was wondering what tablets and dosage other people have use to improve the condition of their cats suffering with heart failure. Mary
 
Well my kitty does not have diabetes but does have RCM. He gets 1/2 tablet Lasix twice a day, one half tablet Enalapril twice a day and 1/4 tablet Plavix once a day. He is doing remarkably well. He has his off days but has passed the one year mark since dx. They gave him 2 days to 2 months to live 13 months ago.

Waldo needs a new heart check up which I cannot afford so we are just plodding along. Our Vet understands this and refills his scripts when needed. Everyday is a blessing.
Hope this helps,
jeanne
 
Jeanne thank you for your reply it has given me some hope. My Vet said some cats don't respond to treatment and deteriorate rapidly while others do well. Felix was diagnosed with heart failure two weeks ago but seems to be getting a little worse every day. Did your cat respond straightaway to treatment or did it take some time. Mary
 
Mary, have you been to a Cardiologist? Heart failure is a broad term. Hope was dx'd 4 years ago with RCM and was immediately put on Sotalol b.i.d. and Enalapril s.i.d. There has been no further deterioration of her heart and it might be not only the meds but because it was caught early. She stopped needing insulin after over 4 years and I took her in for a full checkup. The vet heard a weird little extra tick in her heart so we went to the Cardio. She does get an echo and ekg about every 3 months, It used to be every 2 months because I was so nervous, and so far all is well. There are so many forms of heart problems and so many different meds to treat depending on the condition that IMHO no regular vet should treat a heart problem.
 
I've had several cats with heart problems along with fluid buildup. Does your kitty have fluid build-up around the heart? Why the lasix? Lasix is usually used to relieve fluid retention. It can be hard on the kidneys so I wouldn't give it without a reason. It can take several weeks for some meds to start working. My vet usually schedules a return visit in a couple month and to do another ultrasound to check for progress. Has your vet suggested an ultrasound?

There is a feline heart group at yahoogroups you might want to check in with for your questions also.
 
I absolutely agree your kitty should have an ultrasound and be seen by a cardiologist. Waldo has been seen by two and his US sent to specialist. They said he would have to be on these medicines for the rest of his life but at the time, I think they didnt expect him to last this long. I know he needs a check up and new US but we just cant afford it. We view each new day a blessing.

He responded quickly to the drugs and seems to be feeling fine. We even made him a zipline in the backyard so he can go out and enjoy the backyard. He even walks on a lead. It's like he "knows" he cant go out and cat around anymore and is happy with what he has.

Keeping you and your kitty in my prayers.
jeanne
 
Two weeks ago I took Felix to the Vet because he had reduced appetite and shortness of breath. He was breathing with his mouth slightly open. The Vet sedated him and x-rayed his chest. She found that his lungs were filled with fluid and his heart was enlarged. She removed 150cc fluid from his lungs by needle and syringe. The removal of the fluid didn't improving his breathing very much. She prescribed Lasix to remove more fluid from his lungs and Fortekor to improve the heart function. We are in the UK and I don't believe that the Veterinary treatment and facilities are as good as those you have available in the US. Thank you to everyone for their advice and prayers. Mary
 
Hopefully Jess and Earl see this post, she works for a veterinary cardiology specialist as a vet tech.

As Hope said, there are many kinds of heart problems. Each might require different drugs. The most common is Hypertrophic cardiomyopathy, which is what my Merlyn had. There is also Restrictive and Dilated Cardiomyopathy.

There is no way your vet could have withdrawn fluid from the lungs, more likely it was fluid around the heart and lungs. Fluid buid up in the lungs is Pulmonary Edema, fluid buildup around the heart and lungs is pleural effusion. Merlyn had fluid in the lungs, and was put on furosemide/lasix. He was also given a Calcium Channel blocker called Diltiazem, but Norvasc(amlodipine) is another. he was also on Fortekor/Benazepril, and Calcitriol (for his kidneys). We also very cautiously gave him sub qs for his kidneys because the lasix dehydrated him so fast, and he was on a small dose of aspirin (we dissolved it in water to get a smaller dose) Aspirin must be discussed with vet, too much is toxic to cats. Plavix is also being used for cats to prevent blood clots, instead of aspirin.

What a cardiac ultrasound will tell you is what kind of heart problem there is, and if there are other meds that might be suitable.

Jess said the same thing, some cats go on treatment and do well, and others fail quickly.. but I wouldnt give up if I were you. I am surprised that Felix isnt on a beta blocker or Calcium channel blocker, but perhaps without a cardiac u/s thats just as well.

Merlyn lived 2.5 years post heart diagnosis, with kidney disease which was stable. It was his heart that gave out first.

Sending lots of cyber hugs.
 
Thank you Lisa. Felix is failing fast, he is refusing to eat now and panting even at rest. I am grateful for all your prayers. Mary
 
If he is panting it may be from fluid buildup.. ask if you can increase his lasix or try another diuretic. It may also be that his heart rate is too fast, and needs something to control it. ((((((((((((((((((MARY))))))))))))))))
 
Felix made it through the night although I wasn't expecting him to. He is drinking and has eaten a small amount of food. I am just trying to keep him comfortable now. I am grateful to you all for your love, support and prayers. Mary
 
Aw, Mary, please call the vet and let them know what is happening. Maybe he needs to have more fluid pulled off or an increase in meds. Many prayers coming for Felix that if, it is his time to leave, he goes peacefully.
 
Hi Mary:
If he is having trouble breathing, get him to the vet or an emergency facility right now. Right now. It is dangerous physically and terribly upsetting mentally to struggle to breathe, and in the case of congestive heart failure the cat is quite literally drowning--there is water in and around the lungs causing suffocation. If your cat has pleural effusion (see Lisa's post for the definition), they can pull some of the fluid off immediately and help him breathe. Cats who are having such trouble breathing need treatment or (to be blunt) euthanasia -- no treatment is not a humane option. If he is struggling to breathe such that you don't know if he'll make it through the night, he needs to be at a hospital.

Most cats with congestive heart failure (CHF) benefit from hospitalization so that higher than normal doses of furosemide can be given IV. Was your cat diagnosed with heart disease with echo (ultrasound)? Is there a 24 hour referral facility in your area? There are definitely cardiologists in the UK but there may not be one located within a reasonable distance-- you can google to see if there is one in your area. If your kitty is not eating well on his own, he can become quite dehydrated quite quickly from the furosemide so it is essential that he eats or is hospitalized for monitoring.

Cats can get through a bout (or multiple bouts) of life-threatening CHF but they absolutely need aggressive and expert veterinary care. It isn't cheap but it can give the cat and his/her human additional high-quality time (months or even years).

Mary if he is having trouble, please get him to a veterinarian ASAP ok?
 
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