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View Full Version : Ping Phil P: Newly diagnosed HCM


yngver
May 15th 07, 04:33 PM
Phil, you know so much about HCM and I'd like to get your advice. I am
heartsick to have just been told that our nine year old cat has early
HCM. My experience at the vet's was upsetting because I never got to
see the cardiologist so everything was filtered through some new vet I
never met before and I don't think she is very up to date on
treatment. Please email me directly if you are willing and have time.
Thanks so much.
-yngver

yngver
May 15th 07, 07:48 PM
On May 15, 12:40 pm, Nomen Nescio > wrote:
> -----BEGIN PGP SIGNED MESSAGE-----
>
> From: yngver >
>
> >I am
> >heartsick to have just been told that our nine year old cat has early
> >HCM.
>
> I felt the same way when TK was diagnosed 2 yrs ago.

Thanks for your response. I am sorry to hear about TK, but glad to
hear he/she is doing well.
>
> >My experience at the vet's was upsetting because I never got to
> >see the cardiologist so everything was filtered through some new vet I
> >never met before and I don't think she is very up to date on
> >treatment
>
> My first suggestion is that you should ask for a copy of the FULL
> report from the cardiologist (I assume that an ultrasound was done
> to make the diagnosis.....if not, get one done).

Yes, diagnosis was by echocardiogram. They have a mobile cardiologist
who visits the various cat clinics (and dog clinics too I guess) every
few weeks. I will ask for the report when I go back next week. I don't
know if they will give it to me. They have not been too great in the
past about sharing medical records.
>
> My second suggestion is DON'T PANIC, which is easier said than done.
> My wildcat is still doing fine after 2 years and is still a wildcat.

That's good to hear. I'm not exactly panicking, but I am still
hearbroken. I was praying her heart murmur was innocent. She is
asymptomatic, which I know is a good sign, and by x-ray there was no
heart enlargement as yet. The echo showed some slight thickening of
the ventricular wall and I think she said of the septum too, but since
I was in shock and they never gave me anything in writing, it's hard
to know if I got it straight. Also some mitral regurgitation (I think)
which she said was producing the murmur. It was a grade 1 and the vet
thought it was grade 2 now--which is why the echo was ordered.
>
> I'm not as knowledgable as Phil P., but I've learned quite a bit about
> HCM from Phil and discussions with a first rate cardiologist. So I could
> help you out, a bit, in figuring out what the situation is if Phil is unavailable.

I very much appreciate your advice.
>
> What treatment has been prescribed?

Atenolol, twice a day. I asked if she should be on anti-coagulants and
they said there was no "swirling"--you probably know what that means--
and that she was not at risk for blood clots at this point. I think
that means no left atrial enlargement? The vet I talked to was trying
to use lay terms, I guess assuming most people won't understand the
terminology or don't want to know.

Her heart rate was 200 and I have read that the prognosis is not as
good if the HR is that high. But how much of that is from being scared
at the vet's? Our other cat has occasionally had that high a heart
rate at the vet's office and she doesn't have a heart problem.

Her blood pressure was low normal, 100/60 I think they said. I know
the top number was 100. I am worried the atenolol might make her blood
pressure too low.

I think the cardiologist is okay but I would rather be in a position
to talk to her directly myself, so I am thinking of trying to find a
cardiologist that sees you directly.

Any advice is much appreciated.
-yngver

yngver
May 16th 07, 04:52 PM
On May 16, 5:10 am, Nomen Nescio > wrote:
> -----BEGIN PGP SIGNED MESSAGE-----

> He's doing REAL well. His last echo was in October and the HCM
> seems to be somewhat in remission. The cardiologist at Tufts said
> that although the heart dimensions are still out of the "normal" range
> (more normal than the first echo), TK, functionally, is not suffering from
> HCM.
>
Wow! That's really great news. Do you attribute the improvement to the
diltiazem? I have read that in studies, it can reverse some of the
damage. I don't think the same is true of atenolol.

>
> She's your cat, you paid for the echo, you're entitled to a copy of
> the report. The full report should be a couple of pages with 20 - 30
> dimensions. I've encountered reluctance to provide the full report,
> also. The usual line is "You wouldn't understand it".
> Just don't take "No" for an answer. Eventually, they'll get you a copy
> just to get you to go away. :) My vet won't even wait for me to ask,
> anymore. They FAX me a copy of any test results as soon as they get
> it.

Okay. I will insist. My regular vet, who wasn't there that day, is
usually pretty reasonable and I think he will give me more details
when I see him Tuesday. On the other hand, he's the one who told us
the heart murmur was probably innocent, especially since the x-rays
showed nothing abnormal.
>
>
> Just from what you're saying, it sounds like you caught it very early.
> I'd have to see some of the numbers, but it does not seem all that bad.
> TK developed a grade 4 murmur in less than a year.

This was over about six months. We had noticed our cat was favoring
one leg and having trouble climbing stairs and jumping up to the cat
tree (now I wonder if her heart might have had something to do with
it) and our vet diagnosed degenerative joint disease. At the same
exam, he said he thought he heard a very faint heart murmur but wasn't
positive. Since he was going to do x-rays of her spine and legs
anyway, he also did several veiws of the heart. The x-rays showed
loose bits of cartilege in her knee (stifle) joints so we have
naturally assumed that her reluctance to jump was due to that. She has
responded very well to Cosequin. This spring at her exam the vet said
the murmur was easier to hear and that's why he ordered the echo.

Our vet put him
> on aspirin immediately. Good thing, too. When we got him in for his echo,
> he had some serious mitral regurgitation. I was there when they did the
> echo and the cardiologist didn't even have to tell me how bad it was. I
> could see from the doppler that we had a big problem.

The vet said there is some mitral regurgitation which causes the
murmur, but isn't that what causes any heart murmur in an HCM cat? I
wish they would have let me be there for the echo, but the vet said
the cardiologist wouldn't allow it so I had to sit in the waiting room
and wait for the vet to come out and tell me what the cardiologist
said.

I am a little concerned that our cat wasn't prescribed aspirin
therapy. She said it wasn't necessary, but like you are saying, I'm
not sure I trust what the vet conveyed to me without seeing the actual
report.
>
> >Atenolol, twice a day.
>
> Ok, she's getting a beta blocker. TK gets diltiazem which is a calcium
> channel blocker. They both have a similar effect on the heart by slowing
> it down and relaxing the heart muscle. I'm not sure why they would choose
> Atenolol over diltiazem. Especially since her blood pressure is normal
> (I believe diltiazem does not lower blood pressure all that much). You may
> want to inquire about that at the next opportunity.

I certainly will. She goes back Tuesday for another blood pressure and
heart rate check. I was told the cardiologist prescribed atenolol to
lower her heart rate. Will diltiazem also do that?
>
> >I asked if she should be on anti-coagulants and
> >they said there was no "swirling"--you probably know what that means--
> >and that she was not at risk for blood clots at this point.
>
> It sounds pretty mild. It's the turbulence (swirling?) that starts the blood
> cells clumping together.

Okay, thanks for explaining. The vet said that is specifically
something the cardiologist would look for on the next u/s and if she
saw anything she would prescribe an anticoagulant.
>
> >I think
> >that means no left atrial enlargement?
>
> Not necessarily.

Okay, I guess I just assumed because she didn't mention it--just left
ventricle and septum or septal wall, not sure of the exact wording.
>
That always irritates me. Generally, if you tell the vet that you
want the
> details, they'll take the time to explain it to you.

I did want to know, but when you are in shock it's hard to take it all
in. I had to write it down when I got home so I remembered even what
did sink in. I wanted them to give me something in writing but all the
discharge instructions said were "your cat has some very mild heart
enlargement which can be controlled by medication." Really vague and
not very helpful when I was trying to explain all this to my husband.
>
> >Her heart rate was 200 and I have read that the prognosis is not as
> >good if the HR is that high. But how much of that is from being scared
> >at the vet's? Our other cat has occasionally had that high a heart
> >rate at the vet's office and she doesn't have a heart problem.
>
> TK's heart rate is always pushing 200 at the vet. I've got a $30
> stethoscope that I check his heart with regularly. At home, he's doing
> about 120 beats/min awake and about 80 - 90 when I catch him
> sleeping. It goes up to about 150 when he decides that the stethoscope
> is a cat toy.

Okay, I am going to buy a stethoscope. I could never find a pulse on
our cats, even the skinny one, but I had been counting respirations. I
can tell that her breathing is a little slower now but it was around
20 per minute at rest even before, and I had read that 20-30 is
normal. I am glad to hear that even with heart rate getting up close
to 200 at the vet's, TK is doing fine.
>
> >Her blood pressure was low normal, 100/60 I think they said. I know
> >the top number was 100. I am worried the atenolol might make her blood
> >pressure too low.
>
> I'd be a bit concerned about that, also.

They all said that was good, that her b/p was low but I wonder if that
means the heart is not pumping so well.

I have been watching her like a hawk on the atenolol to see if I see
anything alarming but she seems her normal self so far.
>
>
> If you're willing to pay for another exam, I think it would be a good idea.

What I'm thinking of doing is instead of waiting six months for her
next echo, I might make an appt. with another cardiologist--if I can
find one who will actually see patients instead of just consulting
with your regular vet--and have the echo done again in a couple or
three months. Or do you think I should do it sooner? My husband will
object to paying another $400 for the echo but I don't mind.


> I think most cardiologists would rather have you give them the cat and
> go away.

Yes, just from doing a search in our city, that seems to be how the
cardiologists operate. I can only find three listed anyway, and one is
the mobile cardiologist that just did this exam.

My wife and I always insist on being there for the exam and
> pick up quite a bit of information just listening to the discussion between
> the cardiologist and the assistant. I try not the bother them during the
> exam, but always try to ask questions right after, when things are still
> fresh in the cardiologists mind.

I would want to do that. After all, if it were me or my husband having
the echo I'd want to know every last detail. When I was younger I even
talked one vet into allowing me to be there for my cat's dental--it
was my previous cat and she was older and I was terrified she wouldn't
wake up from the procedure. I don't know why I thought being there and
watching him clean her teeth would make a difference, but he allowed
it.

We take TK to Tufts University (Grafton, Mass.)
> It's a teaching hospital and we feel that that's the best place to get
> "cutting edge" technology and treatment. Well worth the 2 hr drive, although
> TK might disagree since he always gets a little extra poking and handling
> by a student.
> Do you have a good veterinary hospital in you area?

You are so lucky to be located close to Tufts. I am in Chicago. The
closest veterinary hospital would be University of Illinois which is
about three hours or more. I don't know how cutting edge they are,
however.
>
> >Any advice is much appreciated.
>
> I could tell you quite a bit more if I could see some of the numbers from the
> echo. If you happen to have a FAX machine, you might be able to persuade
> them to send you a copy.

I am going to ask for it in person Tuesday when I go back. Even if
they say they have to charge me to make a copy. They were okay about
giving me our cats x-rays and records to bring to the orthopedic
surgeon for a consult, but then the surgeon's office didn't want to
give them back. Said they don't like to let patients have them. I
insisted.

>
> But, as far as I can tell, you've caught it, and started treating it, early. I would
> think her prognosis would be quite good.

Thank you. Vet said cardiologist listed her prognosis as good if the
meds stabilize her condition and fair if there is progression in six
months. She said if the next echo shows no progression than prognosis
would be upgraded.
>
> Hopefully, Phil P. will appear. He took the trouble to review TK's report (I
> scanned it and e-mailed it to him) when he was first diagnosed. At least
> half of what I know about HCM, I learned from Phil.

I know--I've been on this ng for years and Phil is certainly an
expert! I hope he reads this.
>
> When you get the report, let me know. We can go over some of the numbers.

Thank you so much. I intend to get it Tuesday. Like I said, just from
the vet telling me the cardiologist said it was very mild, I need to
see for myself. Our cat is asymptomatic that I can tell, so that's
good. She can't do as much as she used to because of the bad knees,
but I see her still run up the stairs on occasion and she doesn't get
out of breath. She has actually been more active since starting the
Cosequin--I know her knees were hurting her. She is only 9.5, though--
just seems to young to be having all these problems.

Thanks again. I'll be in touch when I get the report.
-yngver
>
> Best of luck

Phil P.
May 17th 07, 08:43 AM
"yngver" > wrote in message
oups.com...
>

Hi Yngver,

I'm sorry to hear about your cat and for the delayed reply. I'm knee deep
in ferals and kittens! Just finished TNR-ing a 40-cat colony. I thought I
take a break but it turns out that the 40-cat colony is actually part of a
huge 100+ cat colony that stretches between several strip-malls off the
highway. One of my partners saw a few cats we already TNR'ed from behind one
mall at another mall more than a mile from where we trapped them. There
goes my easy summer at the shelter...



> Yes, diagnosis was by echocardiogram. They have a mobile cardiologist
> who visits the various cat clinics (and dog clinics too I guess) every
> few weeks. I will ask for the report when I go back next week. I don't
> know if they will give it to me. They have not been too great in the
> past about sharing medical records.

You've got to get a print out of the echo for your own information so you
can monitor her condition and in case you want a second opinion or if she
needs emergency treatment..



> >
> > My second suggestion is DON'T PANIC, which is easier said than done.
> > My wildcat is still doing fine after 2 years and is still a wildcat.
>
> That's good to hear. I'm not exactly panicking,

That's good advice. You have to remain calm so you can make rational
decisions. With all the advancements in feline cardiology, manny HCM cats
are living near-normal lifespans- if its caught in the early stages-- which
you have. I know of few HCM cats that are still going strong >6 years
post-diagnosis- and these cats were't young when they were diagnosed- so,
keep the faith.


but I am still
> hearbroken. I was praying her heart murmur was innocent. She is
> asymptomatic, which I know is a good sign, and by x-ray there was no
> heart enlargement as yet.

Most asymtomatic cats in the early stages of HCM have notmal x-rays. Later
in the course of the disease the heart can start to look like a valentine
because the enlargement of the atriums and the LV that comes to a point.
Grade II isn't that bad at all. Most hemodynamically important murmurs are
at least grade III.


The echo showed some slight thickening of
> the ventricular wall and I think she said of the septum too,


The two ventricles are separated by a septum called the intraventricular
septum that's abbreviated on echo reports a "IVS". The IVS and ventricle
posterior wall can become hypertrophied (symmetrical) or the IVS or
posterior wall can be hypertrophied, but not both (asymmetric). A thickness
of over 6 mm of either the LV or IVS is considered hypertrophied. You need
to see the report so you'll know how much LV and IVS has hpyertrophied and
so you can monitor any progression. "Slight thicking" doesn't sound bad at
all.



but since
> I was in shock and they never gave me anything in writing, it's hard
> to know if I got it straight. Also some mitral regurgitation (I think)
> which she said was producing the murmur. It was a grade 1 and the vet
> thought it was grade 2 now--which is why the echo was ordered.


Mitral regurgitation can be caused by a hypertrophied IVS because it
interferes with the ejection of blood through the LV outflow tract (LVOT on
echo printouts). The LV needs to produce more pressue to move the blood
because of the obstruction caused by the IVS- the increased pressure
increases the velocity of the blood- which in turn creates a venturi that
pulls the mitral valve into the LVOT. Mitral regurgitation can cause
enlargement of the atrium.



> >
> > I'm not as knowledgable as Phil P., but I've learned quite a bit about
> > HCM from Phil and discussions with a first rate cardiologist. So I could
> > help you out, a bit, in figuring out what the situation is if Phil is
unavailable.
>
> I very much appreciate your advice.
> >
> > What treatment has been prescribed?
>
> Atenolol, twice a day. I asked if she should be on anti-coagulants and
> they said there was no "swirling"--you probably know what that means--
> and that she was not at risk for blood clots at this point. I think
> that means no left atrial enlargement? The vet I talked to was trying
> to use lay terms, I guess assuming most people won't understand the
> terminology or don't want to know.


Most clots are formed in the left atrium when it enlarges. When the atrium
enlarges blood flow through it slows down- like the water flow in a narrow
stream slows down when the stream widens. When blood flow slows down-
platelets can clump together and form clots (thrombi).


>
> Her heart rate was 200 and I have read that the prognosis is not as
> good if the HR is that high. But how much of that is from being scared
> at the vet's?

Prpbably at least 60 bpm.


Our other cat has occasionally had that high a heart
> rate at the vet's office and she doesn't have a heart problem.
>
> Her blood pressure was low normal, 100/60 I think they said. I know
> the top number was 100. I am worried the atenolol might make her blood
> pressure too low.

Atenolol is more effective than diltiazem in controlling sinus tachycardia
and LV outflow tract obstruction. But I think your cat's tachycardia was
probably caused more from stress than the condition. I'd get a second
opinion on the atenolol if I were you.


>
> I think the cardiologist is okay but I would rather be in a position
> to talk to her directly myself, so I am thinking of trying to find a
> cardiologist that sees you directly.

Absatively! You have to be able to communicate with the cardiologist
directly.

Keep the faith!

Best of luck,

Phil

Phil P.
May 17th 07, 08:44 AM
"Nomen Nescio" > wrote in message
...
>
> >Atenolol, twice a day.
>
> Ok, she's getting a beta blocker. TK gets diltiazem which is a calcium
> channel blocker. They both have a similar effect on the heart by slowing
> it down and relaxing the heart muscle. I'm not sure why they would choose
> Atenolol over diltiazem.

Atenolol is a little more effective than diltiazem in controlling sinus
tachycardia and LV outflow tract obstruction. The mitral rergurg is probable
caused by a hypertrophied IVS- so it might help. But I don't think 200 bpm
is all that high for a stressed cat. I have mixed feelings about atenolol.

I'm really happy that TK is doing well!

Phil

yngver
May 18th 07, 05:19 PM
On May 17, 2:43 am, "Phil P." > wrote:
> "yngver" > wrote in message
>
> oups.com...
>
>
>
> Hi Yngver,
>
> I'm sorry to hear about your cat and for the delayed reply. I'm knee deep
> in ferals and kittens!

Thanks for your response, Phil. I know you don't hang around this ng
too much anymore--neither do I--but I'm glad you still check in once a
while. Yes, I know spring is kitten time all right!


Just finished TNR-ing a 40-cat colony. I thought I
> take a break but it turns out that the 40-cat colony is actually part of a
> huge 100+ cat colony that stretches between several strip-malls off the
> highway. One of my partners saw a few cats we already TNR'ed from behind one
> mall at another mall more than a mile from where we trapped them. There
> goes my easy summer at the shelter...

Wow, that is a huge colony! Good luck with them. Thank goodness you
are helping these cats.
>
> > Yes, diagnosis was by echocardiogram. They have a mobile cardiologist
> > who visits the various cat clinics (and dog clinics too I guess) every
> > few weeks. I will ask for the report when I go back next week. I don't
> > know if they will give it to me. They have not been too great in the
> > past about sharing medical records.
>
> You've got to get a print out of the echo for your own information so you
> can monitor her condition and in case you want a second opinion or if she
> needs emergency treatment..
>
>
>
> > > My second suggestion is DON'T PANIC, which is easier said than done.
> > > My wildcat is still doing fine after 2 years and is still a wildcat.
>
> > That's good to hear. I'm not exactly panicking,
>
> That's good advice. You have to remain calm so you can make rational
> decisions. With all the advancements in feline cardiology, manny HCM cats
> are living near-normal lifespans- if its caught in the early stages-- which
> you have. I know of few HCM cats that are still going strong >6 years
> post-diagnosis- and these cats were't young when they were diagnosed- so,
> keep the faith.

Thanks for the info. I know some cats--some sources even say many
cats--can live five years or more after diagnosis if it is caught when
mild so I just hope our cat is one of them. She is only 9.5 so I just
wish if it had to happen, it hadn't shown up for a few more years. It
seems so unfair--I read that 85 percent of cats with HCM are males and
I also thought if it's going to show up, it usually develops when they
are younger than 9 but maybe with females it shows up later. I wonder
if there has been any study to show whether the females with HCM are
likely to have a milder form of the disease.
>
> but I am still
>
> > hearbroken. I was praying her heart murmur was innocent. She is
> > asymptomatic, which I know is a good sign, and by x-ray there was no
> > heart enlargement as yet.
>
> Most asymtomatic cats in the early stages of HCM have notmal x-rays. Later
> in the course of the disease the heart can start to look like a valentine
> because the enlargement of the atriums and the LV that comes to a point.
> Grade II isn't that bad at all. Most hemodynamically important murmurs are
> at least grade III.

Well, it was the vet who said he would judge it about a grade II. All
they told me about the cardiologist is "she was able to find the
murmur" which didn't strike me until later that maybe they were saying
it is still a pretty faint murmur. I won't really know how she graded
it until I get hold of the report, I suppose.
>
> The echo showed some slight thickening of
>
> > the ventricular wall and I think she said of the septum too,
>
> The two ventricles are separated by a septum called the intraventricular
> septum that's abbreviated on echo reports a "IVS". The IVS and ventricle
> posterior wall can become hypertrophied (symmetrical) or the IVS or
> posterior wall can be hypertrophied, but not both (asymmetric). A thickness
> of over 6 mm of either the LV or IVS is considered hypertrophied. You need
> to see the report so you'll know how much LV and IVS has hpyertrophied and
> so you can monitor any progression. "Slight thicking" doesn't sound bad at
> all.

No, what the vet who relayed the information to me said is "slightly
thicker than normal" but you're right, I have to read the report. In
sifting through my memories, I also *think* she said something to the
effect of fairly normal heart function, but I'm not sure. I was so
upset I was just hearing the fact that it was HCM and not so much
about how much she was stressing that it was very mild.
>
> but since
>
> > I was in shock and they never gave me anything in writing, it's hard
> > to know if I got it straight. Also some mitral regurgitation (I think)
> > which she said was producing the murmur. It was a grade 1 and the vet
> > thought it was grade 2 now--which is why the echo was ordered.
>
> Mitral regurgitation can be caused by a hypertrophied IVS because it
> interferes with the ejection of blood through the LV outflow tract (LVOT on
> echo printouts). The LV needs to produce more pressue to move the blood
> because of the obstruction caused by the IVS- the increased pressure
> increases the velocity of the blood- which in turn creates a venturi that
> pulls the mitral valve into the LVOT. Mitral regurgitation can cause
> enlargement of the atrium.

So if there is a murmur caused by mitral regurgitation, is that what
they call obstructive HCM?
>

>
> > > I'm not as knowledgable as Phil P., but I've learned quite a bit about
> > > HCM from Phil and discussions with a first rate cardiologist. So I could
> > > help you out, a bit, in figuring out what the situation is if Phil is
> unavailable.
>
> > I very much appreciate your advice.
>
> > > What treatment has been prescribed?
>
> > Atenolol, twice a day. I asked if she should be on anti-coagulants and
> > they said there was no "swirling"--you probably know what that means--
> > and that she was not at risk for blood clots at this point. I think
> > that means no left atrial enlargement? The vet I talked to was trying
> > to use lay terms, I guess assuming most people won't understand the
> > terminology or don't want to know.
>
> Most clots are formed in the left atrium when it enlarges. When the atrium
> enlarges blood flow through it slows down- like the water flow in a narrow
> stream slows down when the stream widens. When blood flow slows down-
> platelets can clump together and form clots (thrombi).

Thanks for explaining. Sounds like the cardiologist did not see any
slow-down of blood flow.
>
>
>
> > Her heart rate was 200 and I have read that the prognosis is not as
> > good if the HR is that high. But how much of that is from being scared
> > at the vet's?
>
> Prpbably at least 60 bpm.

Thank you for letting me know that. I realize now that I should have
bought a stethoscope and checked her heart rate at home back when they
first told me about the murmur. Then I'd know her normal resting heart
rate. She is always pretty scared at the vet's, and particularly this
time since they took her in back for the echo and I wasn't allowed to
be there with her. What really scares her is when the vet or a tech
comes and scoops her away to take her in back.
>
> Our other cat has occasionally had that high a heart
>
> > rate at the vet's office and she doesn't have a heart problem.
>
> > Her blood pressure was low normal, 100/60 I think they said. I know
> > the top number was 100. I am worried the atenolol might make her blood
> > pressure too low.
>
> Atenolol is more effective than diltiazem in controlling sinus tachycardia
> and LV outflow tract obstruction. But I think your cat's tachycardia was
> probably caused more from stress than the condition. I'd get a second
> opinion on the atenolol if I were you.

I am going to ask about it Tuesday when I go back to have her heart
rate checked again, and to get her report. I'd like to know
specificially why the cardiologist thinks atenolol is a better choice
in this case than diltiazem.
>
>
>
> > I think the cardiologist is okay but I would rather be in a position
> > to talk to her directly myself, so I am thinking of trying to find a
> > cardiologist that sees you directly.
>
> Absatively! You have to be able to communicate with the cardiologist
> directly.
>
> Keep the faith!
>
> Best of luck,
>
> Phil

Thanks so much, Phil. I will post the results when I get a copy of the
echo next week. I hope you will have time to take a look. I trust your
advice on HCM and I very much appreciate your explaining it all to me.
-yngver

Matthew
May 18th 07, 09:00 PM
"Phil P." >

Good luck Phil with the colonies. I have can see it will be a busy summer
for you

sheelagh
May 18th 07, 10:33 PM
On 18 May, 21:00, "Matthew" > wrote:
> "Phil P." >
>
> Good luck Phil with the colonies. I have can see it will be a busy summer
> for you

Same here Phil. I really do admire the work that you do, & appreciate
exactly how hard it can be sometimes. I hope that this spring/Summer
season isn't as hard as last year's, but If I am truely honest, I also
look forward to some of the magnificent photos that you manage to
scoop @ times of those feral colonies that you have reported to you.
Some of last years photos were truely amazing- Especially the ones
that were around the back of that restaurant...

My, they really were huge for strays!! They looked like they had dined
on better chow than we do!!

Good Luck & Best Wishes,

S;o)

sheelagh
May 18th 07, 10:37 PM
On 15 May, 16:33, yngver > wrote:
> Phil, you know so much about HCM and I'd like to get your advice. I am
> heartsick to have just been told that our nine year old cat has early
> HCM. My experience at the vet's was upsetting because I never got to
> see the cardiologist so everything was filtered through some new vet I
> never met before and I don't think she is very up to date on
> treatment. Please email me directly if you are willing and have time.
> Thanks so much.
> -yngver

I am ever so sorry to hear of your poor cats heart problems. it is
always hard to take on board what problems our cats develop & even
harder to cope with them..Yet we do because we love them so
dearly.....

I very much hope that things go ok for you, and that you can stay on
top of this problem for a few years to come...

Best Wishes,

S;o)

yngver
May 21st 07, 08:23 PM
On May 18, 4:37 pm, sheelagh > wrote:
> On 15 May, 16:33, yngver > wrote:
>
> > Phil, you know so much about HCM and I'd like to get your advice. I am
> > heartsick to have just been told that our nine year old cat has early
> > HCM. My experience at the vet's was upsetting because I never got to
> > see the cardiologist so everything was filtered through some new vet I
> > never met before and I don't think she is very up to date on
> > treatment. Please email me directly if you are willing and have time.
> > Thanks so much.
> > -yngver
>
> I am ever so sorry to hear of your poor cats heart problems. it is
> always hard to take on board what problems our cats develop & even
> harder to cope with them..Yet we do because we love them so
> dearly.....
>
> I very much hope that things go ok for you, and that you can stay on
> top of this problem for a few years to come...
>
> Best Wishes,
>
Thank you for your good wishes. It is especially hard I think when
younger cats have serious problems. Our cat is only 9. I read on the
feline heart board about cats diagnosed with HCM when they are 16, 17
years old and I just wish so much, if our cat had to get this, why
couldn't it have waited until she was old, when you expect things to
start going wrong?

However, since our cat acts about the same as she did before
diagnosis, it's easy sometimes to pretend there is nothing wrong with
her. She doesn't act like a sick cat. I don't think she feels as
though there is something wrong with her heart. I just hope she stays
at this stage for a long time.
-yngver