Hi Judy,

Firstly, I have to repeat what others have said ... you are an ANGEL to take
this poor cat on.

Now I don't know how feline medicine relates to human medicine, but I'm just
posting this for what it's worth.

You said:

"... he has so many of the symptoms that it doesnt make sense: He eats
ravenously, drinks  constantly, has severe weight and muscle loss, frequent
urination,  racing heart rate, etc...can a cat have a normal T-4 and still be 
hyperthyroid? "

This describes to an absolute T my closest high-school friend when she was an
undiagnosed diabetic.  These are ALL of the symptoms she had, every last one of
them.  So my question is ... has his urine been checked for ketones / have his
blood sugar levels been checked?

Found a website at http://www.felinediabetes.com/ so you might want to check
this out.

Hope this helps,

Catherine and the fearsome five
http://OzFree.it-net.com.au

Please forgive me for x-posting

I found a wet who is willing to rehydrate Aurora! And I've got a neighbour to
drive!!!
Were off in a about 30 minutes.
It is night by you in the States, but if any of you - or Europeans - are on the
web, please let me know if you think it is safe to take her, I am soooo afraid
that she will die at the vets clinic, that must not happen!
She has not been drinking today, and eating very little for a long time, but
some every day. Yesterday night and today a little babyfood licked first off her
nose and then from my fingers.

Thank you all!

Janne

[Non-text portions of this message have been removed]

PS
I wonder if she can be in severe liver failure, the last three, four days her
poop has been more yellowish and thin. (Earlier normal to more brown, due to
bilirubin?) And if so, can that heal? I forgot to ask the vet about this...

Janne

[Non-text portions of this message have been removed]

Janne,

A vet should know how to safely hydrate a cat, as long as he is aware of her
condition.

Please let us know how things go.  I will say a prayer for dear Aurora.

--
Jonathan Rosenberg
President & Founder, Tabby's Place
http://www.tabbysplace.org/


> -----Original Message-----
> From: Janne [mailto:ystano@...]
> Sent: Wednesday, October 01, 2003 4:54 AM
> To: hypertroptions@yahoo...; feline-hyperT@yahoogroups.com;
> feline-heart@yahoogroups.com; Feline-CRF-Support@yahoogroups.com
> Subject: [FH] AURORA, urgent!
>
>
> Please forgive me for x-posting
>
> I found a wet who is willing to rehydrate Aurora! And I've
> got a neighbour to drive!!!
> Were off in a about 30 minutes.
> It is night by you in the States, but if any of you - or
> Europeans - are on the web, please let me know if you think
> it is safe to take her, I am soooo afraid that she will die
> at the vets clinic, that must not happen!
> She has not been drinking today, and eating very little for a
> long time, but some every day. Yesterday night and today a
> little babyfood licked first off her nose and then from my fingers.
>
> Thank you all!
>
> Janne
>
> [Non-text portions of this message have been removed]
>
>
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>

Janne,

This can be a symptom of many things.  Can you call back & ask the vet about
this?

--
Jonathan Rosenberg
President & Founder, Tabby's Place
http://www.tabbysplace.org/


> -----Original Message-----
> From: Janne [mailto:ystano@...]
> Sent: Wednesday, October 01, 2003 5:06 AM
> To: hypertroptions@yahoo...; feline-hyperT@yahoogroups.com;
> feline-heart@yahoogroups.com; Feline-CRF-Support@yahoogroups.com
> Subject: [FH] AURORA, PS
>
>
> PS
> I wonder if she can be in severe liver failure, the last
> three, four days her poop has been more yellowish and thin.
> (Earlier normal to more brown, due to bilirubin?) And if so,
> can that heal? I forgot to ask the vet about this...
>
> Janne
>
> [Non-text portions of this message have been removed]
>
>
> ------------------------ Yahoo! Groups Sponsor
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> http://us.click.yahoo.com/mOAaAA/3exGAA/qnsNAA/Zh0wlB/TM
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>
>
>
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> http://docs.yahoo.com/info/terms/
>
>
>

Hi all,

I know that there have been a few folks asking how to find a feline
cardiologist, and I'm not sure if it's just me, but the link on our
site doesn't seem to be working.  I found this link the other day by
accident...hope it helps someone.


http://www.vetheart.com/bystate.htm

Hope everyone is doing well.

Sandy & Boo Kitty

I would recommend taking him off.

My cardio told me when Chase started taking Atenol last year to watch him
for ANY side effects.  Atenol is an interesting drug.

last year Chase was taking that with something else (I can't recall the
exact name) and he did the same thing.  Lost appetite, glassy eyed, little
response.  I took him to the vet and his liver was sky high.  This means
that the drugs were interacting and causing Liver Toxicity (which can be
fatal).

Now - he is back on Atenol, BUT with no other med and only a quarter tablet
1X daily.  Cardio said that I could work up to a half tab, but if I felt
more comfortable or Chase was more comfortable on a 1/4 keep him there.
Every pet responds differently to meds.

I decided to keep him on a 1/4 tab, because he responded beautifully and
moves around and lowers his appetite (which I'm glad for - he's a mouth
(18lbs.)).  however, I do notice that some days he just doesn't feel as
great.  So - I think 1/4 is perfect.

good luck!

-----Original Message-----
From: pugsleykall [mailto:lgowk@...]
Sent: Tuesday, September 30, 2003 6:37 PM
To: feline-heart@yahoogroups.com
Subject: [FH] Alternatives to Atenolol?


My cat has been taking 6.25 mg of Atenolol for 2 weeks, and is doing
horribly on it.  I feel like I'm giving him chemo for how sick it
makes him.  Prior to being diagnosed with HCM, his symptoms were
continuing weight loss and poor appetite.  The drug completely cuts
out his appetite, he has lost another pound, down to 8 pounds, from
12, and even though the cardiologist told me I could cut the medicine
to every other day if it affected his appetite, it's taking longer
than 2 days for him to start eating again.

Does this sound "normal" to you?  For the past day, he's holding his
body very rigid, not purring, and almost in a catatonic state.  Won't
eat, drink, anything.

Should I approach my vet about some other drug, or should we plod
ahead on this one?  I feel like he's better off without it, come what
may.  It's unbearable to see him this sick.

Thanks for any advice.
Lisa



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[Non-text portions of this message have been removed]

--- Jennifer Trendler <jennifert@...>
wrote:
> I would recommend taking him off.

Never discontinue beta-blockade suddenly.

From the Plumb Handbook of Veterinaty Drugs:

Contraindications/Precautions/Reproductive Safety

Atenolol is contraindicated in patients with overt
heart failure, hypersensitivity to this class of
agents, greater than first degree heart block, or
sinus bradycardia. Non-specific beta-blockers are
generally contraindicated in patients with CHF unless
secondary to a tachyarrhythmia responsive to
beta-blocker therapy.

(NOTE: based on human CHF trials this is no longer
true. See below for complete reference.)

They are also relatively
contraindicated in patients with bronchospastic lung
disease.

Atenolol should be used cautiously in patients with
significant renal insufficiency. It should also be
used cautiously in patients with sinus node
dysfunction.

Atenolol (at high dosages) can mask the symptoms
associated with hypoglycemia. It can also cause
hypoglycemia or hyperglycemia and, therefore, should
be used cautiously in labile diabetic patients.

Atenolol can mask the symptoms associated with
thyrotoxicosis, but it may be used clinically to treat
the symptoms associated with this
condition.

Adverse Effects/Warnings

It is reported that adverse effects most commonly
occur in geriatric animals or those that have acute
decompensating heart disease. Adverse effects
considered to be clinically relevant include:
bradycardia, lethargy and depression, impaired AV
conduction, CHF or worsening of heart failure,
hypotension, hypoglycemia, and bronchoconstriction
(less so with beta1 specific drugs like
atenolol). Syncope and diarrhea have also been
reported in canine patients with beta blockers.
Lethargy and hypotension may be noted
within 1 hour of administration.

Exacerbation of symptoms have been reported following
abrupt cessation of beta-blockers in humans. It is
recommended to withdraw therapy gradually in patients
who have been receiving the drug chronically.

From:
Management of Feline Cardiomyopathies
http://www.vin.com/proceedings/Proceedings.plx?CID=WALTHAMOSU2002&PID=2991

"Neurohormonal activation plays an important role in
heart failure. Thus, disruption of neurohormonal
activation represents therapeutic rationale for using
ACE inhibitors. The RAS plays a prominent role in
human HCM patients by influencing or regulating the
expression of myocardial hypertrophy. Inhibition of
RAS has a beneficial effect on extracellular
remodeling in CHF, and ACE inhibitors reduce
ventricular remodeling by blocking the tropic effects
of angiotensin II on myocytes. There is also survival
value provided by early use of ACE inhibitors in acute
human myocardial infarction. Many clinicians combine
an ACE inhibitor (usually enalapril) with furosemide,
with or without a beta-blocker or diltiazem,
particularly with recurrent heart failure. Enalapril
(0.25-0.5 mg/kg q24h PO) and benazepril (0.25-0.5
mg/kg q24h PO) are clinically well tolerated. Optimal
timing for ACE inhibitor therapy and the effects of
these agents on morbidity and mortality in feline
cardiomyopathy is undetermined."


From a question I asked on the vetlearning.com forum:

I asked the following question on the bulletin board
on vetlearn.com:

is there a downside to atenolol?
my question:
I have read Kittleson, Fox, Fuentes, Bonagura and
Nelson and I realize there is no proof that there is
any advantage to medicating asymptomatic HCM felines,
however my vet does believe in doing so based on his
own personal experience. Clinically I believe I have
seen a difference and certain ultrasound paramaters
are improved. However according to Plumb's Handbook of
Veterinary Drugs, CHF is listed as an adverse effect.
Is this more likely referring to propanol rather than
atenolol?

Re:
Submitted Thursday July 10, 2003 - 8:19:31pm by Alex,
DVM
Reply
I've not seen any cases of CHF that I felt were due
to atenolol. The referance may have been to propanolol
since it is a non-selective beta-blocker.

Susan (Rudy is on 12.5 mg atenolol for 1 year now)

>
> My cat has been taking 6.25 mg of Atenolol for 2
> weeks, and is doing
> horribly on it.  I feel like I'm giving him chemo
> for how sick it
> makes him.  Prior to being diagnosed with HCM, his
> symptoms were
> continuing weight loss and poor appetite.  The drug
> completely cuts
> out his appetite, he has lost another pound, down to
> 8 pounds, from
> 12, and even though the cardiologist told me I could
> cut the medicine
> to every other day if it affected his appetite, it's
> taking longer
> than 2 days for him to start eating again.
>
> Does this sound "normal" to you?  For the past day,
> he's holding his
> body very rigid, not purring, and almost in a
> catatonic state.  Won't
> eat, drink, anything.

>
> Should I approach my vet about some other drug, or
> should we plod
> ahead on this one?  I feel like he's better off
> without it, come what
> may.  It's unbearable to see him this sick.
>
> Thanks for any advice.
> Lisa
>
>

__________________________________
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Well - don't know what to say.  I saw Chase the way he was - and was told to
take him off completely and suddenly.

It worked and now he's fine.

-----Original Message-----
From: Susan [mailto:somnamblst@...]
Sent: Wednesday, October 01, 2003 6:48 AM
To: Jennifer Trendler; 'pugsleykall'
Cc: 'feline-heart@yahoogroups.com'
Subject: RE: [FH] Alternatives to Atenolol?



--- Jennifer Trendler <jennifert@...>
wrote:
> I would recommend taking him off.

Never discontinue beta-blockade suddenly.

From the Plumb Handbook of Veterinaty Drugs:

Contraindications/Precautions/Reproductive Safety

Atenolol is contraindicated in patients with overt
heart failure, hypersensitivity to this class of
agents, greater than first degree heart block, or
sinus bradycardia. Non-specific beta-blockers are
generally contraindicated in patients with CHF unless
secondary to a tachyarrhythmia responsive to
beta-blocker therapy.

(NOTE: based on human CHF trials this is no longer
true. See below for complete reference.)

They are also relatively
contraindicated in patients with bronchospastic lung
disease.

Atenolol should be used cautiously in patients with
significant renal insufficiency. It should also be
used cautiously in patients with sinus node
dysfunction.

Atenolol (at high dosages) can mask the symptoms
associated with hypoglycemia. It can also cause
hypoglycemia or hyperglycemia and, therefore, should
be used cautiously in labile diabetic patients.

Atenolol can mask the symptoms associated with
thyrotoxicosis, but it may be used clinically to treat
the symptoms associated with this
condition.

Adverse Effects/Warnings

It is reported that adverse effects most commonly
occur in geriatric animals or those that have acute decompensating heart
disease. Adverse effects considered to be clinically relevant include:
bradycardia, lethargy and depression, impaired AV
conduction, CHF or worsening of heart failure,
hypotension, hypoglycemia, and bronchoconstriction
(less so with beta1 specific drugs like
atenolol). Syncope and diarrhea have also been
reported in canine patients with beta blockers.
Lethargy and hypotension may be noted
within 1 hour of administration.

Exacerbation of symptoms have been reported following
abrupt cessation of beta-blockers in humans. It is
recommended to withdraw therapy gradually in patients
who have been receiving the drug chronically.

From:
Management of Feline Cardiomyopathies
http://www.vin.com/proceedings/Proceedings.plx?CID=WALTHAMOSU2002&PID=2991

"Neurohormonal activation plays an important role in
heart failure. Thus, disruption of neurohormonal
activation represents therapeutic rationale for using
ACE inhibitors. The RAS plays a prominent role in
human HCM patients by influencing or regulating the
expression of myocardial hypertrophy. Inhibition of
RAS has a beneficial effect on extracellular
remodeling in CHF, and ACE inhibitors reduce
ventricular remodeling by blocking the tropic effects
of angiotensin II on myocytes. There is also survival
value provided by early use of ACE inhibitors in acute
human myocardial infarction. Many clinicians combine
an ACE inhibitor (usually enalapril) with furosemide,
with or without a beta-blocker or diltiazem,
particularly with recurrent heart failure. Enalapril
(0.25-0.5 mg/kg q24h PO) and benazepril (0.25-0.5
mg/kg q24h PO) are clinically well tolerated. Optimal
timing for ACE inhibitor therapy and the effects of
these agents on morbidity and mortality in feline cardiomyopathy is
undetermined."


From a question I asked on the vetlearning.com forum:

I asked the following question on the bulletin board
on vetlearn.com:

is there a downside to atenolol?
my question:
I have read Kittleson, Fox, Fuentes, Bonagura and
Nelson and I realize there is no proof that there is
any advantage to medicating asymptomatic HCM felines,
however my vet does believe in doing so based on his
own personal experience. Clinically I believe I have
seen a difference and certain ultrasound paramaters
are improved. However according to Plumb's Handbook of Veterinary Drugs, CHF
is listed as an adverse effect. Is this more likely referring to propanol
rather than atenolol?

Re:
Submitted Thursday July 10, 2003 - 8:19:31pm by Alex,
DVM
Reply
I've not seen any cases of CHF that I felt were due
to atenolol. The referance may have been to propanolol
since it is a non-selective beta-blocker.

Susan (Rudy is on 12.5 mg atenolol for 1 year now)

>
> My cat has been taking 6.25 mg of Atenolol for 2
> weeks, and is doing
> horribly on it.  I feel like I'm giving him chemo
> for how sick it
> makes him.  Prior to being diagnosed with HCM, his
> symptoms were
> continuing weight loss and poor appetite.  The drug
> completely cuts
> out his appetite, he has lost another pound, down to
> 8 pounds, from
> 12, and even though the cardiologist told me I could
> cut the medicine
> to every other day if it affected his appetite, it's
> taking longer
> than 2 days for him to start eating again.
>
> Does this sound "normal" to you?  For the past day,
> he's holding his
> body very rigid, not purring, and almost in a
> catatonic state.  Won't
> eat, drink, anything.

>
> Should I approach my vet about some other drug, or
> should we plod
> ahead on this one?  I feel like he's better off
> without it, come what
> may.  It's unbearable to see him this sick.
>
> Thanks for any advice.
> Lisa
>
>

__________________________________
Do you Yahoo!?
The New Yahoo! Shopping - with improved product search
http://shopping.yahoo.com

The key point is that you were told by the vet to take him off.  The
original poster should consult with her vet and/or cardiologist and
follow their recommendations.

This is a great place to share experiences and knowledge, but one
thing we shouldn't do is tell someone to change their cat's
medication regimen.  This should only be done in consultation with
their vet.  The best we can do is relate our experiences with a
medication, which I think is extremely helpful, and then suggest
that the person consult with their vet about the medications that
their cat is on if they are having concerns or doubts about it.

Hopefully your post about your experience with atenolol will prompt
the original poster to speak to her vet about whether atenolol is
making her cat ill.  However, she should not discontinue the
atenolol or make any other changes to her cat's medication unless
instructed to do so by her vet.

--- In feline-heart@yahoogroups.com, Jennifer Trendler
<jennifert@n...> wrote:
> Well - don't know what to say.  I saw Chase the way he was - and
was told to
> take him off completely and suddenly.
>
> It worked and now he's fine.
>

For Nannygoatsf:

I am sorry Bogie is having these problems.  It breaks my heart when our
sweet kitties take so much medicine so willingly and then begin to fail.

My kitty, Happy, was on Enalapril twice.  The first time, she had the 2.5 mg
tab to which a baby aspirin was added after 5 days. She was OK for about 2
days, then she began to vomit several times at 3:00 AM, the last vomit at
6:30
AM had blood in it. She was taken off both Enalapril and aspirin and did
very well for some time on lasix and spironolactone.  The coughing began
again and her usual vet was on vacation.  We took her to the Veterinary
Specialists in Orlando and since her cardiologist had returned to the U. of
Florida to practice, she saw an Internist who was taking care of the
cardiologists patients.  She reasoned that it was the aspirin that Happy
couldn't tolerate, so she put Happy back on Enalapril [Happy's heart had
enlarged further.], 1 mg. Happy did beautifully for 7 days.  She seemed
almost normal again.  Then she began to stop eating, first the canned DM
[she's diabetic], then she stopped the dry DM. On the night she refused the
dry DM, I poached her a chicken breast. She drank most of the liquid and ate
a bite or two.  Her vet had returned from vacation and he increased her
lasix and added cyproheptidine, 1/2 tab BID. This is an antihistamine and
makes her sleepy but she has resumed eating--the dry DM, the chicken, but
not the moist DM.  We hope for the best, but fear for the worst.  Her vet
says that our other heart med options would probably not be any better.

Perhaps if you tried cyproheptidine Bogie might begin eating again.


Ann Hughes

Where do you purchase your drugs?  My vet put in automatic orders at
VetCentric and they are, pardon me, crooks.  $23 and $25 for 30 pills.
Medi-vet has for $9  100 tablets of enalapril. I'm gettin reamed!
I'm calling right now to stop my orders!!
--Lori

These meds are people meds and the best prices are at:

Target sells atenolol for $6, Walgreens is $10

I don't use enalapril so I'm not sure about that one.

Susan


--- l_a_fisher <icypaws@...> wrote:
> Where do you purchase your drugs?  My vet put in
> automatic orders at
> VetCentric and they are, pardon me, crooks.  $23 and
> $25 for 30 pills.
> Medi-vet has for $9  100 tablets of enalapril. I'm
> gettin reamed!
> I'm calling right now to stop my orders!!
> --Lori
>
>
> ------------------------ Yahoo! Groups Sponsor
>
> To unsubscribe from this group, send an email to:
> feline-heart-unsubscribe@yahoogroups.com
>
>
>
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> http://docs.yahoo.com/info/terms/
>
>


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The New Yahoo! Shopping - with improved product search
http://shopping.yahoo.com

--- brinkett <scrubbrush@...> wrote:
> The key point is that you were told by the vet to
> take him off.  The
> original poster should consult with her vet and/or
> cardiologist and
> follow their recommendations.
>


I agree. We need to realize that HCM is just a
catchall term for an extremely variable disease. I
posted the info from Plumb's Book of Veterinary Drugs
because not every symptom being attributed to
beta-blockade is necessarily a result of
beta-blockade.  Sometimes things that we think are
related are simply a coincidence. Anorexia and
lethargy are symptoms of the disease and may have more
to do with decompensation. No one here is in a
position to recommend any mode of treatment or
discontinuation of treatment. If you think your vet
may be wrong seek out another board certified ACVIM
veternarian. And always report any new symptoms to
your vet cardiologist or internist. JMHO.

Susan

=====
Rudy: Male DSH brown tabby, feral mom, diagnosed 09-2002 at 19 months of age
with idiopathic HCM: grade 2 murmur, hyperkinetic heart, borderline normal
thickening, considered asymptomatic, 12.5 mg Atenolol 1x day, 1/2 baby aspirin
2x week administered via pilling

__________________________________
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The New Yahoo! Shopping - with improved product search
http://shopping.yahoo.com

Bogie's renal values checked out fine this morning but he now has a
problem with fibulation. His heart condition has advanced such that
his heart now beats in an erratic fashion so we're going to add 1/4
cap of atenolol into his daily med mix and see if that might help.
Thanks to all for your support. I feel lucky to have found this
group.

Nancy

My vet calls them in to my family pharmacy (Walgreens).  I think the
last time I got the Atenelol it was $8 for 30 Atenelol (it's not a
cheap drug), but they provide the Lasix for me; and one of our other
meds needs to be compounded (which also is not cheap, but it's the
only way we can get it in Merlyn).

I would say you were getting ripped off from VetCentric; just be sure
to check Medi-Vet's records to be sure they're not like some phone-in
vet supply companies that have been proven to "water down" their
drugs.  Calling the Better Business Bureau should give you such info.

--Dana


--- In feline-heart@yahoogroups.com, "l_a_fisher" <icypaws@a...> wrote:
> Where do you purchase your drugs?  My vet put in automatic orders at
> VetCentric and they are, pardon me, crooks.  $23 and $25 for 30 pills.
> Medi-vet has for $9  100 tablets of enalapril. I'm gettin reamed!
> I'm calling right now to stop my orders!!
> --Lori

Hi Marcia,

My cat, Kit, was diagnosed in February 2002 with both HCM and
hyperthyroidism.  He collapsed in February 2002, and both conditions were
diagnosed as a result of his cardiac work-up.  It took a while to get the
medications and dosages worked out, but he is on 7.5mg of Diltiazem twice a
day, and 2.5mg of methimazole twice a day and doing very well.

Best to you and Morris.

Lorraine


> I wanted to ask if anyone had a cat who was diagnosed with >hyperthyroid
after being diagnosed with hypertrophic >cardiomyopathy?

VetCentric has a relationship with the vets (it's clear on their webster).
YOUR vet determines the price that they charges and gets money from the
sale; if YOUR vet wants more money, the price goes up.     I pay about
$10.00 for 30 atenolol from VetCentric with no shipping costs.   Yes, a bit
high, but reasonable.    My cardiologist offered to write a prescription,
but said that the Atenolol from VetCentric cuts easily (it does).    I don't
consider $10 for 4 months of pills expensive.

Linda


----- Original Message -----
From: "Dana Rulf" <drulf@...>
To: <feline-heart@yahoogroups.com>
Sent: Wednesday, October 01, 2003 6:52 PM
Subject: [FH] Re: purchasing Atelolol and Enalapril


> My vet calls them in to my family pharmacy (Walgreens).  I think the
> last time I got the Atenelol it was $8 for 30 Atenelol (it's not a
> cheap drug), but they provide the Lasix for me; and one of our other
> meds needs to be compounded (which also is not cheap, but it's the
> only way we can get it in Merlyn).
>
> I would say you were getting ripped off from VetCentric; just be sure
> to check Medi-Vet's records to be sure they're not like some phone-in
> vet supply companies that have been proven to "water down" their
> drugs.  Calling the Better Business Bureau should give you such info.
>
> --Dana
>
>
> --- In feline-heart@yahoogroups.com, "l_a_fisher" <icypaws@a...> wrote:
> > Where do you purchase your drugs?  My vet put in automatic orders at
> > VetCentric and they are, pardon me, crooks.  $23 and $25 for 30 pills.
> > Medi-vet has for $9  100 tablets of enalapril. I'm gettin reamed!
> > I'm calling right now to stop my orders!!
> > --Lori
>
>
>
> To unsubscribe from this group, send an email to:
> feline-heart-unsubscribe@yahoogroups.com
>
>
>
> Your use of Yahoo! Groups is subject to http://docs.yahoo.com/info/terms/
>
>
>

Hi Maggie and Mousey Tongue,

My kitty Urchin had three thoracocentesis procedures, so yes, it can
be done more than once, but you'll have to find a willing vet.  The
pleural effusion developed from his HCM/hyperthyroid condition and was
the beginning of his congestive heart failure.  Both oxygen and the
procedures seemed to help Urchin a lot, since the fluid build up
caused breathing difficulties.  He was on atenolol, lasix, and
methimazole.  The continued fluid build up was a problem for Urchin as
well--we had difficulty balancing higher doses of lasix against
dehydration (we did sub-cu fluids at home) and the fluid build up
continued to increase.  My vet said that the third one was the last
one he'd do, since Urchin was becoming weaker each time.  I don't
think that fluid build up can be reduced with anything other than
lasix and lung taps.

I wish I could give you better news, but my vet did say that as long
as his breathing wasn't labored (which it wasn't after the lung taps),
then he wasn't suffering.  My kitty passed away at home without
difficulty breathing, and I think the thoracocentesis procedures were
very beneficial to him in his last days.  If Mousey Tongue continues
to have fluid build up, I'd encourage you to seek another procedure.
However, in my kitty's case, the procedures became closer and closer
together--7 days between the first and second, 5 days between the
second and third, and he passed away less than a day after the third
one.  So the procedures may not help your kitty for very long *sniff*.

I wish you and Mousey Tongue many more good days ahead and hope you
know that there are others who have been in the difficult place that
you are now.  Sounds like your vet's doing everything s/he can for
your kitty and you are taking extra good care of him.

Best wishes--Jen and Urchin (angel kitty)

Hi Marcia and Morris,

My cat Urchin was diagnosed with HCM and hyperthyroidism in October
2002.  He was treated with methimazole (tapazole), atenolol, and
lasix.  His only symptom was rapid weight loss (from 11 pounds to 7-8
pounds).  We started on a higher dose of methimazole than you (5
mg/day) but Urchin's T4 was higher than your kitty's (10--off the
charts).  I think the vet tries to start them out at the lowest dose
possible to correct the thyroid levels, and weight comes into account
as well.  By the way, some pharmacies can compound the methimazole
pills into liquids or transdermal ointment (you rub it in his ear),
which can make your life a little easier (especially with multiple
pills).  We didn't have any difficulties with the heart rate getting
too low--just coped with irregularities more and more after Urchin
developed CHF.  You'll probably have to monitor the T4 levels to make
sure they aren't too high or too low--we had trouble with both hyper-
and hypo-thyroidism over the year that Urchin took the meds.  We
checked the levels monthly.  Urchin really bounced back for a while
after starting methimazole--gained weight, improved activity levels,
etc.  Unfortunately, he developed CHF about a month ago and passed
away about two weeks ago.  However, he did very well for almost a year
on the meds and had a good quality of life.

Hope Morris does well on the new meds--sounds like you're very
prepared.  (Wish I had gotten a stethoscope--I just took my kitty into
the vet's to have his heart rate checked.)  You're doing a great job
taking care of him.

Best wishes, Jen and Urchin (angel kitty)

Anybody who knows the possible reason of teary eyes? Not running eyes, just
watery.
Thanks

Janne

[Non-text portions of this message have been removed]

Hello Maggie,

       I'm so sorry you both are having to go thru this...we all know
how scary this journey can be sometimes.

    Firstly let me say that I am not a vet and your question is a very
good one that deserves careful consideration by a professional...that
said, I can share my experience, limited as it is.

      Have you taken Mousey Tongue to a cardiologist? The reason I ask
is that most of the HCM kitties that I know of are usually on some
additional meds from the ones you mentioned. These meds usually assist
the heart in pumping more efficiently and/or dialating the blood
vessels to make it easier on the inefficient heart's pumping
production. I am surprised your kitty is not on any of these meds yet.
A cardiologist would also be the best one to ask about these meds.
      When my kitty was first dx with HCM I asked for details about all
the possibile paths we might go down. Pleural Effusion was one
possibility and at the time my vet said that they always hope that the
patient will respond favourably with drug treatment and many/most do
but sometimes it takes several trys to get the balance just right. But
that sometimes fluid still builds up and often needs to be removed
manually. (BTW, fluid can also build up in the abdomen and this is
called "Ascites" though this is less common)
     Manually removing fluid is a difficult procedure and has some risks
to it so my vet gave me the impression that it was best done very
infrequently and only when absolutely necessary. She gave me the
impression that depending on the amount of time between procedures,
she really did not think it was a good idea to do a thoracentesis more
than once or twice, three times was possible, but at that point the
treatments might be too invasive and if the need was coming frequently
then it might be sending a message.She also said that sometimes when a
kitty's condition changes from HCM into CHF (again, only a
cardiologist and an echocardiogram can verify this) that often
initially there is an initial event of fluid build-up that signals
this change in dx. and that after the initial even things stabilize
for awhile longer all on their own.
      Additionally, sometimes changing meds or dosing or reducing subQ
fluids (if kitty is taking these) will help stabilize the kitty after
the first event and things level out for awhile longer with no more
need to do a manual drain, something we all hope for...but this really
does vary from patient to patient.

      Since MT responded well to the extra O2, you might consider
creating some sort of an at-home O2 tent that he could relax in for a
few minutes/hours each day. It would be best to talk this over with
your vet and with other members here who have done this for their
kits....it is a nice way to support a CHF kitty but it is not always
possible/practical for caregivers to go this route. Also look into the
files and do a search here in these files for discussions on
CoQ10...you may want to consider adding it to MT's treatment plan.

     But again, all these questions are best fielded by your vet and a
cardiologist. Best wishes to you and Mousey Tongue...hopefully this
crisis will be behind you and with an update on his meds hopefully he
will make a better adjustment to his situation and you won't have to
do this again. Please keep us updated!

Best wishes,

Sally


--- In feline-heart@yahoogroups.com, "mouseytonguesmom" <mcoons@e...>
wrote:
>  Mousey Tongue was diagnosed with HCM in March.  He has previously
had
>  some episodes of fluid on his lungs that were remedied by changing
>  his dose of Lasix. Last week, he also had pleural effusion and
>  thoracentesis to drain 100 ccs of fluid.
>
>  If anyone has any experience with this procedure, I am wondering
>  whether this is a one-time procedure or can it be performed safely
>  more than once?  Mousey Tongue spent several hours in an oxygen cage
>  before the thoracentesis and seemed much better afterwards.
However,
>  fluid seems to be building up again. Before the oxygen and
>  thoracentesis last week, Mousey Tongue's vet indicated that Mousey
>  Tongue may not survive continued fluid buildup and it appeared to be
>  leading to congestive heart failure. I don't want him to suffer.
>  However, I want to give him every chance so long as his quality of
>  life isn't suffering, which it did seem to when the pleural effusion
>  was found.
>
>  Mousey Tongue get 0.7 cc Lasix twice daily, 1/4 Atenelol twice daily
>  and 1/2 aspirin every 72 hours.
>
>  If any has any suggestions on other ways to address the fluid
buildup
>  or any experience with similar symptoms, please help.
>
>  Maggie

Just wanted to send a post to say that Connor seems to be doing very
well.  I hope I'm not jinxing things by writing this!  He is
breathing well, eating well and although he ears are still red, it
seems that the itchiness he has been feeling has subsided quite a
bit.

Today is is last day of receiving lasix twice a day.  Tomorrow he
starts at once a day.

He runs from me when I have to give him the Flovent for the asthma.
But I follow it up with a treat, which he readily takes.

Thanks for the posts and thoughts on Connor's allergic reaction.
Maybe it really was a spider bite that just needed time?  Who knows.

JoAnn

--- Linda Fischbach <fischbl@...> wrote:
  My cardiologist offered to
> write a prescription,
> but said that the Atenolol from VetCentric cuts
> easily (it does).

Walgreens has Mylan brand of atenolol and Target has
Geneva brand. Geneva brand does cut a little neater (I
only need 1/2s) but I have had more problem with pill
spitting out with Geneva so I may go back to Mylan.
The Geneva brand seems like it is a taller pill with
beveled edges.

Susan

=====
Rudy: Male DSH brown tabby, feral mom, diagnosed 09-2002 at 19 months of age
with idiopathic HCM: grade 2 murmur, hyperkinetic heart, borderline normal
thickening, considered asymptomatic, 12.5 mg Atenolol 1x day, 1/2 baby aspirin
2x week administered via pilling

__________________________________
Do you Yahoo!?
The New Yahoo! Shopping - with improved product search
http://shopping.yahoo.com

I am absolutely devastated to inform you that my Pugsley died
yesterday.
Only 5 years old.  I got him to our vet, who informed me that he
suffered a
"shower embolism", where his body sent out a multitude of blood
clots, which
paralyzed him basically everywhere.   He only lived for a few hours
afterward.

Pugsley's condition was baffling even before his diagnosis, and he
seemed to
be atypical from other cats in his response to treatment.   The
thought that his
medication might have hastened his death is too difficult for my
broken heart
to even think about.

Thanks to all of you who tried to help us, with your advice and
information.
It's great to know that this forum exists, should we need it again.
  Best wishes
to all of you and your furry children.    He was truly my little son.


-Lisa

A few months ago, someone reported that in October a veterinary
heart study would be published. Does anyone remember WHEN or WHERE
or WHO is doing this study?

Dottie and Spike

I would like to know also

Mariane
Meowchi Maine Coons


[Non-text portions of this message have been removed]

--- dottieannwitter <dottie@...> wrote:
> A few months ago, someone reported that in October a
> veterinary
> heart study would be published. Does anyone remember
> WHEN or WHERE
> or WHO is doing this study?
>
> Dottie and Spike
>


It may have been me though I did not mention when.
Below is what a Dr. Lynne Nelson wrote in an email:

Hi Susan,
FYI- a long term study (~3years) on the variety of
therapies and the outcome in a fairly large group of
cats has recently become available- this year. It was
headed by Dr. Fox with a lot of other cardiologists
involved- and there are others ongoing. The problem is
that there are multiple questions- different types of
HCM and RCM and different stages which to assess
therapies. Dr Fox's study will be published very soon.
Best of luck,

Lynne Nelson
Washington State University, Veterinary Cardiologist

Our best bet is to ask our vet cardiologists.

The most recent thing I have found from Dr. Fox is:
Management of Feline Cardiomyopathies
http://www.vin.com/proceedings/Proceedings.plx?CID=WALTHAMOSU2002&PID=2991

He is mentioned in  May 2003 lecture notes:

http://www.dcavm.org/03may.html

There is also a good description of how atenolol helps
and what the rare adverse effects attributed to it
are:

"Beta-adrenergic Blockers. Prolonged activation of the
sympathetic nervous system may lead to cardiovascular
injury, disease progression, or arrhythmias. Since LV
diastolic function is very sensitive to increases in
sympathetic tone, by decreasing heart rate with
beta-blockers, diastole is prolonged and passive
ventricular filling and compliance may improve.
Prolonged diastolic filling also allows more time for
coronary blood flow and reduces myocardial ischemia.
Beta-blockers decrease myocardial oxygen requirements
by reducing cardiac sympathetic stimulation, heart
rate, LV contractility, systolic myocardial wall
stress, and systemic blood pressure. Dynamic LV
outflow tract obstruction and related pressure
gradient is often reduced or abolished with
beta-blocker therapy. Propranolol (5 - 10 mg q8 - 12h
PO) or atenolol (6.25-12.5 mg q12 - 24h PO) are
commonly used agents. Adverse reactions are uncommon
but include lethargy or hypotension."

Susan





=====
Rudy: Male DSH brown tabby, feral mom, diagnosed 09-2002 at 19 months of age
with idiopathic HCM: grade 2 murmur, hyperkinetic heart, borderline normal
thickening, considered asymptomatic, 12.5 mg Atenolol 1x day, 1/2 baby aspirin
2x week administered via pilling

__________________________________
Do you Yahoo!?
The New Yahoo! Shopping - with improved product search
http://shopping.yahoo.com

--- In feline-heart@yahoogroups.com, "pugsleykall" <lgowk@h...> wrote:
Dear Lisa,
    I am so sorry about your dear, sweet Pugsley.  It's absolutely
devastating when they die so young.  My cat Checkers was only 18
months old when he died and it was a shower of clots that took his
life as well.  Checkers was never diagnosed until after death and his
symptoms, even in the end, did not readily point to HCM.  He suddenly
couldn't breathe one night and then went on to show terrible,
neurological symptoms (sudden blindness and seizures).  He never
demonstated even a heart murmur, even when he needed oxygen to
breathe. It was my understanding that young cats can mask the early
symptoms extremely well and that when they are struck down, it's
usually from a very aggressive form of HCM.  You did everything you
could for Pugsley.  I know how hard it is to lose a young one this
way.  You will truly be in my thoughts during this difficult time.
Take care.
Love,
Petey

> I am absolutely devastated to inform you that my Pugsley died
> yesterday.
> Only 5 years old.  I got him to our vet, who informed me that he
> suffered a
> "shower embolism", where his body sent out a multitude of blood
> clots, which
> paralyzed him basically everywhere.   He only lived for a few hours
> afterward.

Thank you to those who have shared their experience about thoracentisis for
pleural effusion.  Since several of you mentioned medicine changes may make a
difference and that a cardiologist might be helpful at this point, I called
around to find a cardiologist and one nearby had a cancellation for tomorrow,
when usually it takes a month to get an initial appointment.  So, it looks like
this is Mousey Tongue's lucky day!

Mousey Tongue had another chest tap yesterday (his second in a week). The vet
got 100 ccs from the right side of his chest. The last time, a week ago, he got
100 ccs total from both sides of his chest. Mousey Tongue has been sleeping
peacefully since then. He seems much better to me after the chest taps than he
has for months, but I hope I am not getting false hope, and twice in a week
sounds like a lot. Mousey Tongue's condition has been such that I am afraid he
could go any time, but suddenly, he's purring more and doing cat-like things
again after the chest taps. For those whose cats have gone through chest taps,
is this normal?

If anyone has any suggestions for what to ask the cardiologist or anything I
should know before we go, please email me as soon as possible. Thank you for all
of your help and support.

Maggie
   ----- Original Message -----
   From: Sally J.Smith (by way of diane)
   To: feline-heart@yahoogroups.com
   Sent: Thursday, October 02, 2003 6:05 AM
   Subject: [FH] Re: Thoracentesis for Pleural Effusion


   Hello Maggie,

         I'm so sorry you both are having to go thru this...we all know
   how scary this journey can be sometimes.

      Firstly let me say that I am not a vet and your question is a very
   good one that deserves careful consideration by a professional...that
   said, I can share my experience, limited as it is.

        Have you taken Mousey Tongue to a cardiologist? The reason I ask
   is that most of the HCM kitties that I know of are usually on some
   additional meds from the ones you mentioned. These meds usually assist
   the heart in pumping more efficiently and/or dialating the blood
   vessels to make it easier on the inefficient heart's pumping
   production. I am surprised your kitty is not on any of these meds yet.
   A cardiologist would also be the best one to ask about these meds.
        When my kitty was first dx with HCM I asked for details about all
   the possibile paths we might go down. Pleural Effusion was one
   possibility and at the time my vet said that they always hope that the
   patient will respond favourably with drug treatment and many/most do
   but sometimes it takes several trys to get the balance just right. But
   that sometimes fluid still builds up and often needs to be removed
   manually. (BTW, fluid can also build up in the abdomen and this is
   called "Ascites" though this is less common)
       Manually removing fluid is a difficult procedure and has some risks
   to it so my vet gave me the impression that it was best done very
   infrequently and only when absolutely necessary. She gave me the
   impression that depending on the amount of time between procedures,
   she really did not think it was a good idea to do a thoracentesis more
   than once or twice, three times was possible, but at that point the
   treatments might be too invasive and if the need was coming frequently
   then it might be sending a message.She also said that sometimes when a
   kitty's condition changes from HCM into CHF (again, only a
   cardiologist and an echocardiogram can verify this) that often
   initially there is an initial event of fluid build-up that signals
   this change in dx. and that after the initial even things stabilize
   for awhile longer all on their own.
        Additionally, sometimes changing meds or dosing or reducing subQ
   fluids (if kitty is taking these) will help stabilize the kitty after
   the first event and things level out for awhile longer with no more
   need to do a manual drain, something we all hope for...but this really
   does vary from patient to patient.

        Since MT responded well to the extra O2, you might consider
   creating some sort of an at-home O2 tent that he could relax in for a
   few minutes/hours each day. It would be best to talk this over with
   your vet and with other members here who have done this for their
   kits....it is a nice way to support a CHF kitty but it is not always
   possible/practical for caregivers to go this route. Also look into the
   files and do a search here in these files for discussions on
   CoQ10...you may want to consider adding it to MT's treatment plan.

       But again, all these questions are best fielded by your vet and a
   cardiologist. Best wishes to you and Mousey Tongue...hopefully this
   crisis will be behind you and with an update on his meds hopefully he
   will make a better adjustment to his situation and you won't have to
   do this again. Please keep us updated!

   Best wishes,

   Sally


   --- In feline-heart@yahoogroups.com, "mouseytonguesmom" <mcoons@e...>
   wrote:
   >  Mousey Tongue was diagnosed with HCM in March.  He has previously
   had
   >  some episodes of fluid on his lungs that were remedied by changing
   >  his dose of Lasix. Last week, he also had pleural effusion and
   >  thoracentesis to drain 100 ccs of fluid.
   >
   >  If anyone has any experience with this procedure, I am wondering
   >  whether this is a one-time procedure or can it be performed safely
   >  more than once?  Mousey Tongue spent several hours in an oxygen cage
   >  before the thoracentesis and seemed much better afterwards.
   However,
   >  fluid seems to be building up again. Before the oxygen and
   >  thoracentesis last week, Mousey Tongue's vet indicated that Mousey
   >  Tongue may not survive continued fluid buildup and it appeared to be
   >  leading to congestive heart failure. I don't want him to suffer.
   >  However, I want to give him every chance so long as his quality of
   >  life isn't suffering, which it did seem to when the pleural effusion
   >  was found.
   >
   >  Mousey Tongue get 0.7 cc Lasix twice daily, 1/4 Atenelol twice daily
   >  and 1/2 aspirin every 72 hours.
   >
   >  If any has any suggestions on other ways to address the fluid
   buildup
   >  or any experience with similar symptoms, please help.
   >
   >  Maggie

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