Feline Hypertrophic Cardiomyopathy / Hypothyroidism / Allergies – 07/15/2010 – 08/12/2010

The saga continues. 🙂  This episode will contain Skip’s latest vet appointment plus his latest cardiologist appointment.  We are now at a little over a year from when he was first diagnosed with Feline Hypertrophic Cardiomyopathy (HCM).

It was getting close to Skip’s cardiologist appointment, so I made an appointment to get his lab tests done as well as his regular yearly checkup.  I finally remembered to close off the area where his litter box is, so that he’d have a full bladder for the urine sample. 🙂

At the appointment, nothing new was found.  His teeth looked good and everything else was fine.  He was his usual happy go lucky self during the appointment.  He was a little mad at mommy once we got home due to the drawing of the blood and urine, but he quickly got over that.

The vet’s office called the following Monday and the lab tests came back just peachy. 🙂  His Thyroid T4 was at 1.5, so no worries there. We are all set for his August 3rd appointment…or are we?

On July 26th, I received a voicemail message stating that Skip’s cardiologist was no longer with the practice and Skip’s appointment was cancelled.  Huh? What?  You’re kidding?  Where’d she go? These were just a few of the questions that went through my head.

I immediately called the Care Center.  When I talked with the front desk, they stated that the cardiologist was still with the practice.  Huh?  What?  I told her what was in the voicemail that I received and she said she’d check to see if the appointment was still there.  It wasn’t.  She was confused, but sent me to cardiology voicemail.

I left a message asking where they were referring people.  I received no response, so I called again the next day asking the same question.  I had also been doing some research and had decided that if I couldn’t find his cardiologist that going back to my old stomping grounds while taking Skip to the Purdue Vet Clinic would work.  I left a message including Purdue’s information and my phone number, but there was still no response.

During this time, I had been in contact with Skip’s regular vet.  I told them what was going on to which they responded with…What?  Since I was receiving no response from the Care Center, I asked if the regular vet would mind referring Skip over to the Purdue Vet Clinic.  They said that they would take care of faxing all of the information over to Purdue.

Meanwhile, I called the Care Center and asked for 3 copies of Skip’s records and what the cost was for them.  Luckily, they provide them at no cost, so I e-mailed boyfriend and asked if he’d pick them up on his way home from work.  I have to say, when they provide records, they provide them all.  I even received cds with the results of tests like ultrasounds and echos.  I was impressed that it was all for free.  Of course I guess that’s the high cost of paying so much for the tests.

A little while later that day, I received a call from Skip’s regular vet that they had found Skip’s cardiologist and that she was still in the area; just with a different practice.  I found out later that the cardiologist had just received the fax from Skip’s primary vet with the lab tests prior to giving her notice.  She remembered it when she walked out the door and made a point to call them and let them know where she was going.  Just as an FYI, it was the Care Center that would not allow her to give a two weeks notice like she wanted.

I told my primary vet that I would call over to the new location and see what’s up.  The new place said that they would begin scheduling appointments later on in the week for the following week and took down my name and number.  They were really nice on the phone and did call me back.  I made the appointment for the first appointment of the following Thursday.

I’d like to get up on a soap box and say that the Care Center handled the whole process of the cardiologist leaving poorly.  There were some extenuating circumstances that I won’t go into that seem to have made some hard feelings.  When I called, they had not even informed their front desk that the cardiologist had left.  I also found out later that the Care Center is referring people to a cardiologist in Columbus instead of Skip’s cardiologist.  I guess there were some hard feelings when notice was given by the cardiologist.  It tells me that the Care Center was not interested in Skip getting the needed care, but rather the money from that care.  If they cared about the pets, they would have put aside their differences and given me the needed information.  Skip’s cardiologist is the only one in Cincinnati, so it’s not like the Care Center could provide me with an alternative solution.  So, my impression of the Care Center has gone down a notch. I am climbing down off my soap box now.

So, whew! There for a week, I was stressing as to how to get my baby checked out.  HCM is already a stressful condition whenever you have to go in for a checkup, so the added stress was not needed.

The day of Skip’s appointment arrived, and I drove up to the cardiologist’s new location which is a lot closer.  I will not currently comment on the new vet’s office as they are starting the process to remodel and were clearly getting everything put into place at their new location.  I will however say that the staff thus far has been extremely nice and willing to work with us parents who have furry kids with a disease of some type.

It took awhile to get called back to the room due to computer issues.  Once we got back there, I found a familiar face.  One of the cardiologists’ techs came with her.  She told me that she was switching over to Oncology, but was helping out on Thursdays to get used to the new building.

I handed over all of the records that I got from the Care Center along with the disks…oh and Skip too.  We went through the sheet I was supposed to fill out, but the front desk forgot to give me…remember a new location and department for them, so no biggie.

One thing I had noticed was that expelling air when purring looked like it took effort.  She noted that and I said that’s all I’ve got.  She went through the cost sheet.  I just told her that as long as they do what is needed to check Skip out and the price is roughly the same, I’m good.  It’s all expensive, so what’s a difference of $20?  I don’t remember what the difference was, but it was inline with what I expected, so I was ok.

Then the waiting…it takes them roughly a couple of hours to check him out.  I worked while I waited a nice perk from work.  The vet tech came out and asked for Skip’s carrier.  I gave it to her and asked if she just wanted to bring him out.  She said he was a little cranky and might be happier in the carrier. 🙂 I think actually as soon as he saw Mommy that he would have been fine.

I was called back to talk with the cardiologist.  It was really nice to see her.  She said Skip’s HCM is unchanged!!!  Woohoo!!  That’s good news in my world.  She said the left ventricle is still a tad enlarged, but unchanged from our last visit and that we were going to continue the same treatment as before.

The cardiologist told me that she saw no fluid in the lungs and his echo was fine.  She said that most cats give a lot of effort to expel air when purring and that is perfectly normal.  Skip has lost a little weight, so that probably contributed to me actually noticing it.  Plus when ever we get near his checkup, I get nervous and more observant.

I asked about the grumpiness I heard about, and she said that she can do anything with him she wants except take an x-ray of his chest.  She has to lay him on his side to do so, and he fights her on it.  I told her that only Mommy is allowed to put him on his side, so I wasn’t surprised.  I told her that I do that all the time at home without any argument from Skip.  That’s because he fully trusts me though.

Poppa says there is a double standard in our house.  Poppa can’t hardly move Skip one iota when holding him unless he wants to hear from Skip whereas I move Skip however I want him without much complaint.  🙂  I just tell Poppa that I have 6 extra years with Skip.

I asked if he growled and hissed.  She said yeah and he was going to take a nip from her.  I laughed (probably shouldn’t have but hey my calm boy was sticking up for himself), and said that the command is “Skip! No Bite, Be Nice” in an extremely serious tone that says I’m not happy with your behavior right now. She kind of gave me a look like “You’re kidding right? How often does this happen?”  I said that sometimes Skip shows his displeasure by using his teeth, but never breaks the skin.  Then she saw I was perfectly serious and said that she would keep that in mind the next time and to remind them.

Skip and I checked out and headed home.  We’ll go back in 6 months and do it all again as this is our life now.  I’m just happy that Skip is getting to live a full life. 🙂  If anything significant happens before 6 months I’ll post an update; otherwise the next update will be in 6 months.

I pondered about this part over and over, but I have to help the others in Cincinnati who need to take their pets to a cardiologist and there is no sense in driving all the way to Columbus.  So, here’s the info: Dr. Kathy Wright (I don’t know all the acronyms after her name) is now with MedVet which is off the Red Bank Expressway in Cincinnati.  The MedVet website is http://www.medvet-cves.com/ .  They haven’t updated the website, but trust me she is at the Cincinnati location.

Feline Hypertrophic Cardiomyopathy – 06/27/09 – 07/09/09

I said I would tell you why Skip has to take so many pills, well the title says it all.  He has Feline Hypertrophic Cardiomyopathy (HCM).  HCM is a very serious heart condition.

Last year, I noticed that Skip’s breath smelled and I knew that he needed his teeth cleaned and probably a couple pulled.  So, I scheduled Skip an appointment with his vet to get a checkup, so that they could determine if he needed to get his teeth cleaned.

I was standing there chatting with the vet tech while the vet was listening to Skip’s heart.  Usually the vet only listens for a bit, but she kept listening and listening. I stopped talking to the vet tech because I knew something was wrong.

The vet stopped and looked at me and said I hear a heart murmur.  At first, I was like, a heart murmur? No problem.  Both my mom and my grandpa have a heart murmur and they are just fine.  I said, “OK, so what does that mean.  Will he be ok?”

She gave me the gravest of looks and said that at this moment she did not know.  Skip’s vet said that cats are great at hiding a heart murmur and usually by the time that they can hear it; it is too late and that many cats will pass away within months of the diagnosis.  She said, “One thing you need to know is that you may come home from work to find he passed away during the day without any warning, but we are getting ahead of ourselves.  We first need to do an x-ray to see how bad it is.”  I looked at Skip and other than his teeth, Skip seemed perfectly normal to me which is the problem with this disease.

I immediately approved the x-ray.  After what seemed like agonizing minutes of waiting for the x-ray to be taken and developed, the vet came in with the x-ray and was happy there was no fluid in his lungs.  She also made note that the heart itself did not look bad.  She told me that she hoped she was wrong, but that I needed to go and see a feline cardiologist.

She also said that Skip needed his teeth cleaned and probably two pulled, but that she could not operate until we knew the situation with his heart.  She then wished me good luck.  I was devastated.  I held it together in the vet office, but once I got home, I lost it.

For me, Skip is my kid.  I’ve been with him since he was 4 weeks old and to hear that he might have a disease that could take him in the next few months…whew! That is tough to hear.  That was a lot to take when I thought all we needed was a teeth cleaning.

For the two weeks until the appointment with the cardiologist, I held Skip every chance I got.  I babied him and made him feel special.  My heart just wanted him to be OK and the only way I could keep an eye on him was to keep him in sight at all times.  It wasn’t too hard because he usually follows us around anyway.  What he didn’t expect was to constantly be picked up by boyfriend or myself when ever we saw him sitting alone.

Skip and I went up to the specialty clinic to see the cardiologist.  They took my poor baby in the back and shaved his chest for an ultrasound and an echo-cardiogram.  The cardiologist returned and told me that she sees a thickening of the heart wall and that he has HCM, but that currently the electrocardiogram looks fine.  I had no idea what HCM was, so I asked what it was and what it means for Skip.  Basically, the heart wall thickens until the blood flow slows and blood clots form.  Those blood clots can dislodge and block the flow of blood.  When the heart is no longer able to pump the blood or if a blood clot blocks the blood from flowing, the body will no longer function.

Here is a link to a pretty good document regarding HCM:
http://mysite.verizon.net/jachinitz/hcm/hcmbr1008.pdf

The cardiologist also said that she felt that Skip’s thyroid was enlarged and that he could have hyperthyroidism.  Hyperthyroidism can be a cause for the thickening of the heart walls because the heart is working overtime.  She took some blood from Skip to determine the thyroid levels, but we had to wait for the results.  The cardiologist put Skip on the medicines enalpril and plavix.  She said that based on what she sees that we need to use plavix as a beta blocker.  She explained it all out as to why Skip was on each medicine.

Let me just say for those who cats are diagnosed with HCM, your pocketbook is going to take a hit.  From the tests to the medicines, everything is expensive.  For me, I don’t really care about money.  I just want my baby to get well.

I then asked what his outlook was, and she said that she needed to see us back in October and that she would answer that question then because she said some cats pass away within months and that she has a couple that are 5 years past their diagnosis.  Basically, what she will do is compare ultrasounds to see how much worse the heart walls thickened and then she can make a short term prognosis.  She said no matter what, we have to keep on top of disease and work in six month increments.  I could see in her eyes that she was worried about Skip and that this was very serious.

She also told me that he needs to stay calm and to keep him out of stressful situations until we know more.  Basically, she did not want his heart being overworked any more than it needed to be.  Then she also said no table food at all and no treats.  We are OK with no table food.  He rarely received table scraps, and he rarely asked for them.  However, no treats?  Wow!  Skip is in for a lifestyle change.  She said that the treats for cats are filled with salt to make them taste good.  Too much salt is bad for the heart and we do not need anything contributing to make his condition worse.

The cardiologist said that if Skip started having trouble breathing or if he had numbness in his back legs, to go straight to the vet.  Either Skip’s own vet or to drive up to their emergency clinic would be fine, but that either condition needed attention immediately.

I left with a couple of prescriptions, a cat that was exhausted from his ordeal, a paper print out that the cardiologist makes for every client explaining every thing she just explained, and myself mentally tired.  I took Skip home and went up to the pharmacy and got his scripts filled.

Now I had to wait for the results of the thyroid test which were going straight to the I-Cat vet to discuss my options regarding the thyroid.

I hate waiting for the results of tests…so dear reader even though this happened months’ ago, you must wait as well because this is a good stopping point. 🙂