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#1
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TK's heart murmur. Bad to worse.
Nomen Nescio wrote: -----BEGIN PGP SIGNED MESSAGE----- Well, I have a diagnosis on TK's condition. I've known for a couple of days but couldn't bring myself to post an update. snip Don't kick yourself. HCM is commonly genetic as well. Many, many cats live YEARS with it. You did a good thing, taking him off the streets. -L. |
#2
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"Nomen Nescio" ] wrote in message ... -----BEGIN PGP SIGNED MESSAGE----- Well, I have a diagnosis on TK's condition. I've known for a couple of days but couldn't bring myself to post an update. At an age of about 2 y.o., TK has moderate Hypertrophic Cardiomyopathy. I watched the echocardiogram being done and it was obvious even to my untrained eye. Prognosis: He could die tonight or he might live up to another 6 years. Treatment: He's getting an aspirin (81 mg) twice a week. Although the vet admitted that if you had 100 cats that you knew would die of a blood clot within a year and gave them all aspirin, 95 would still die. Speak to a cardiologist about Nattokinase- its a new fibrinolytic enzyme that comes from the vegetable cheese natto. It not only dissolves clots, but might even prevent them. And he's getting 30 mg of Diltiazem ER daily, mostly to lower his heart rate but there are other potentially positive effects. Did your vet tell you long-term use of Diltiazem has *reversed* myocardial hypertrophy in many cats with HCM? Diltiazem also has antiplatelet activity in cats. Here's a direct quote from Mark Kittleson: "It appears that the incidence of systemic arterial thromboembolism in cats with hypertrophic cardiomyopathy has decreased since the advent of using diltiazem." And he should lose 3 lbs to bring his weight down to about 11 lbs. Cause: This is the tough part. One of the first questions that I asked the vet was "Could I have done something to cause this...chemical, environmental.... ?" He shook his head and said "No" but then in further discussion 2 points jumped out at me. 1) He pointed at the chart of cat weight conditions (the one that every vets office has on the wall) and indicating the picture of the slightly underweight cat said that "You rarely see heart problems in a cat like that". and 2) He also said that "You rarely see heart disease in an outdoor cat" Your vet must know something Mark Kittleson, John Bonagura, and Philip Fox don't know- and they're feline cardiologists and the three leading authorities in feline hypertrophic cardiomyopathy. HCM is a *genetic*- not an acquired disease- although hyperthyroidism causes myocardial hypertrophy that might be similar to HCM. http://maxshouse.com/hypertrophic_cardiomyopathy.htm Well, TK isn't obese, but he is overweight. He was about 10 3/4 lbs last year when we took him in. And he was an outdoor cat. So here's my take on the situation: Last year I adopted a wild cat with the intent of treating the bite wound on his butt, and giving him a good home where he would be well loved and well fed. And what did I really do? Take a cat that was perfectly happy living outdoors and visiting us for food and a little play. Then I locked him in the house, cut his balls off, made him fat and lazy, and gave him heart disease. All the while thinking how much I LOVE the little guy and how I want the best for him. I feel like such an ASSHOLE, right now. Your vet is the asshole, not you, for laying a guilt trip on you. You had *absolutely* nothing to do with TK's HCM- do you understand that? *NOTHING*. TK would probably be dead by now if not for you- and he probably would have fathered many kittens who would have developed HCM later in life. You not only saved TK's life, you did a great thing for the feline species and all of Catdom! Dump your vet. Go to http://www.acvim.org/Kittleson/search.htm and do a search for an internal medicine Diplomate/Cardiologist in your area-- American College of Veterinary Internal Medicine Diplomates are about the best there is. If you can't find an ACVIM specialist in your area, my second choice would be an ABVP Diplomate/Feline Specialist (American Board of Veterinary Practitioners). Go to http://www.abvp.com/diplosearch1.htm http://www.abvp.com/ With the proper treatment, cats with HCM can live near-normal lifespans. Lose the vet and guilt and keep the faith! Best of luck, Phil |
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Nomen Nescio wrote:
snip So here's my take on the situation: Last year I adopted a wild cat with the intent of treating the bite wound on his butt, and giving him a good home where he would be well loved and well fed. And what did I really do? Take a cat that was perfectly happy living outdoors and visiting us for food and a little play. Then I locked him in the house, cut his balls off, made him fat and lazy, and gave him heart disease. All the while thinking how much I LOVE the little guy and how I want the best for him. I feel like such an ASSHOLE, right now. Some wives feel like you do about their husbands ... and for the same reasons. ;-) |
#4
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Nomen Nescio wrote: So here's my take on the situation: play. Then I locked him in the house, cut his balls off, What you need is a uctimmy. (That's like on Lassie, whenever things got foggy for the little fella, Timmy's mom would sit him and explain to him she'd say... You see Timmy, anyone can count the seeds in an apple, but no-one can count the trees in a seed. |
#5
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#6
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On Fri, 20 May 2005 08:50:04 +0200 (CEST), Nomen Nescio
] wrote: So here's my take on the situation: Last year I adopted a wild cat with the intent of treating the bite wound on his butt, and giving him a good home where he would be well loved and well fed. And what did I really do? Take a cat that was perfectly happy living outdoors and visiting us for food and a little play. Then I locked him in the house, cut his balls off, made him fat and lazy, and gave him heart disease. All the while thinking how much I LOVE the little guy and how I want the best for him. I feel like such an ASSHOLE, right now. At least you can be sure no one will track you down without an armload of subpoenas and signed warrants and advanced cryptanalysis skills. That's worth something. But seriously, you have done nothing wrong. Tomcats lead short, brutal lives. Maybe your cat will lead a short, happy life in your house. You apply your best judgement, act accordingly, and accept that you cannot forecast or control the result with any degree of precision, because the mathematics of nature don't allow it. Charlie |
#7
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"Nomen Nescio" ] wrote
So here's my take on the situation: Last year I adopted a wild cat with the intent of treating the bite wound on his butt, and giving him a good home where he would be well loved and well fed. And what did I really do? Take a cat that was perfectly happy living outdoors and visiting us for food and a little play. Then I locked him in the house, cut his balls off, made him fat and lazy, and gave him heart disease. All the while thinking how much I LOVE the little guy and how I want the best for him. I feel like such an ASSHOLE, right now. Don't feel bad at all!! Without you, TK would have died outside. Read Phil P's post. As far as I know, HCM is genetic. Most of the cats I've known with it dropped dead as kittens/ very young adults. TK is lucky, and very lucky to have you. You are a wonderful cat daddy! A weight gain of a few pounds is not going to cause a cat to suddenly develop HCM. Should he lose some weight? Probably, but that's not going to cure it either. Your vet is a dick for making you feel like it's your fault. I may be wrong, but aren't you in Newburyport? There's a feline-only practice in Salem, MA. I don't know much about them, but from what I've heard feline-only vets are usually much more in tune with cat healthcare. And yes, I've seen heart problems in underweight cats. Dash did not develop a murmur until she was severely underweight from her multitude of health problems. -- -Kelly |
#8
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It's sad that TK has such a condition. That kind of thing has to be
genetic. I can't believe that it has anything to do with being an indoor or outdoor cat. Many in this group have indoor cats and, neutered, too, and they don't have this condition. It's so wonderful that you are giving TK a home and good care. Best of luck with all this, -- Barb Of course I don't look busy, I did it right the first time. |
#9
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"Nomen Nescio" ] wrote in message ... -----BEGIN PGP SIGNED MESSAGE----- Well, I have a diagnosis on TK's condition. I've known for a couple of days but couldn't bring myself to post an update. At an age of about 2 y.o., TK has moderate Hypertrophic Cardiomyopathy. He's so young! How heartbreaking. I watched the echocardiogram being done and it was obvious even to my untrained eye. Prognosis: He could die tonight or he might live up to another 6 years. Treatment: He's getting an aspirin (81 mg) twice a week. Although the vet admitted that if you had 100 cats that you knew would die of a blood clot within a year and gave them all aspirin, 95 would still die. And he's getting 30 mg of Diltiazem ER daily, mostly to lower his heart rate but there are other potentially positive effects. And he should lose 3 lbs to bring his weight down to about 11 lbs. Cause: This is the tough part. One of the first questions that I asked the vet was "Could I have done something to cause this...chemical, environmental.... ?" He shook his head and said "No" but then in further discussion 2 points jumped out at me. 1) He pointed at the chart of cat weight conditions (the one that every vets office has on the wall) and indicating the picture of the slightly underweight cat said that "You rarely see heart problems in a cat like that". 2) He also said that "You rarely see heart disease in an outdoor cat" Sorry, but I think this is because they generally do not live long enough to present, having been hit by cars, poisoned by sociopaths, or eaten by coyotes. Well, TK isn't obese, but he is overweight. He was about 10 3/4 lbs last year when we took him in. And he was an outdoor cat. So here's my take on the situation: Last year I adopted a wild cat with the intent of treating the bite wound on his butt, and giving him a good home where he would be well loved and well fed. And what did I really do? Take a cat that was perfectly happy living outdoors and visiting us for food and a little play. Then I locked him in the house, cut his balls off, made him fat and lazy, and gave him heart disease. All the while thinking how much I LOVE the little guy and how I want the best for him. I feel like such an ASSHOLE, right now. I know you love your cat, but I think you are dead wrong. Many, if not most heart problems that present in youth are a result of a congenital predispostion, in both cats and humans. |
#10
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"Nomen Nescio" ] wrote in message ... -----BEGIN PGP SIGNED MESSAGE----- Thanks, Phil. I appreciate the slap in the face to bring me back to reality. Sorry, I didn't mean to be harsh- its just that I think I know enough about you to *know* how much you love your cat and how well you care for him. I was ****ed at your vet because I got the impression he somehow made you feel TK's HCM was your fault- which is absolutely impossible. I've got to get through the shock, denial, panic, and guilt phases and move through acceptance, and action. In all fairness to the vet, he went out of his way to stress the fact that genetics are the major factor. But in discussing things, I latched on to two sentences that pointed some of the responsibility in my direction. He was just covering all the angles that he's seen as related to HCM.....at my request. He never really said anything like "You did this to your cat". Now you tell me! ;-) . Everything you mentioned applies to almost everyone's cat in this newsgroup! If there's was any truth to it, we'd have an HCM epidemic. I had decided that the best thing thing to do, since the follow-up vet visit showed that the murmur was still there and seemed to have moved from from a 2-3 to a solid 3, was to bring TK up to Tufts U. and have a specialist in feline cardiology do the echo. He was very good. Asked the right questions in the pre-exam interview, explained what he was seeing as he did the ultrasound quite clearly, and took the time to detail his findings and thoughts in the post exam consultation. Did he give you the measurements of TK's heart? If you have a print out, look at the measurements (mm) next to "IVS" (interventricular septum) and "LVPW" (left ventricular posterior wall). These measurements tell you the degree of hypertrophy. Cats aren't considered HCM unless the IVS or LVPW or both are at least 6 mm. Let me know what the measurements are. So I really have no complaints with him. After I got home, I was searching for more information to try to get a better understanding of TK's condition and was surprised to see the cardiologist's name either referenced in, or as a co-author of, many papers on feline heart disorders. You may know a lot more about the guy than I do. His name is Dr. John E. Rush. As a matter of fact, I do! He's an ACVIM Diplomate- board certified cardiologist. TK is in good hands. From: "Phil P." Speak to a cardiologist about Nattokinase- its a new fibrinolytic enzyme that comes from the vegetable cheese natto. It not only dissolves clots, but might even prevent them. No, I don't think he mentioned it. As a clot preventative, we discussed aspirin (recommended), Coumadin (risky, as Dr. Rush put it "We have a name for that around here.....rat poison"), and Heperin (2 injections a day, not indicated at this time). Coumadin (warfarin) is very tricky stuff when used in cats. You must use *both* warfarin *and* heparin in cats for the first few days because warfarin also has *pro*coagulant effects that occur *before* the anticoagulant effects start. Also, the anticoagulant properties of warfarin seriously increases the risk of spontaneous hemorrhaging- especially in cats because they love to run, jump and climb. Some cats must be caged or confined to reduce the risks of slight injuries that can cause hemorrhaging. A thrombus usually forms in the left atrium *if* the atrium becomes enlarged. When the LA becomes enlarged, blood flow slows down (like a river slows down when passes through wider areas) and blood factors start to clump together and forms a thrombus. The fact Dr. Rush feels anticoagulant therapy isn't necessary is a pretty good indication that the LA isn't enlarged significantly! ;-))) Diltiazem also has antiplatelet activity in cats and improves LA hemodynamics (speeds up blood flow). So, the combination of the antiplatelet properties of diltiazem and the antiplatelet activity of aspirin should drastically reduce the risk of thromboembolism. Did your vet tell you long-term use of Diltiazem has *reversed* myocardial hypertrophy in many cats with HCM? Yes. With the proper treatment, cats with HCM can live near-normal lifespans. I'm hopeful. And since we were lucky enough to catch the problem before he developed outward symptoms, the prognosis is certainly better. Oh, hell yeah!! You caught it early enough for treatment to really work! The diltiazem has a better chance of reversing myocardial hyperthrophy if the walls aren't very thick-- which in turn reduces the risk of LA enlargement and thromboembolism. I'm just glad that instead of just bringing him to the vet's and getting his booster shot, we opted to get him a full checkup even though the annual was not due until August. I'm glad you did, too! Lose the vet and guilt and keep the faith! I'll work on the guilt, try to keep the faith, but for now, Good man! I'd tend to keep the cardiologist. Now that you clarified the situation and I now know who your cardiologist is- I wholeheartedly agree. My wife and I just love this little guy so much that the thought that we might have hurt him in even the slightest way is just sickening. How do you think he'd feel if he knew you were blaming yourself for something you had absolutely no control over? He'd probably hit you with a left paw! ;-) Thanks. And as always, your thoughts and observations are greatly appreciated. Keep the faith- I really mean it. Best of luck, Phil. |
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