Feline Hypertrophic Cardiomyopathy / Hypothyroidism / Allergies – 08/12/2010 – 09/06/2011

It is time for a full Skip update.  This last appointment has been trying for us, but mostly Skip.  Oddly enough, it was a combination of things and not just HCM that got us.

Since I last left you it’s been a year and 3 cardiologist appointments.  The first two appointments had no changes and therefore, I didn’t feel the need to write anything.  Skip’s labs were fine, meds stayed the same, and he acted perfectly normal.

This last appointment was a bit of a downer, but only slightly.  Basically, it has been 2 years since Skip was first diagnosed with Hypertrophic Cardiomyopathy (HCM) and I feel lucky for every moment that I spend with him.  HCM can be a killer because it is usually found so late.  We were lucky.

This last cardiologist appointment started like the rest.  I took Skip to his regular vet for his yearly regular checkup and labs for the cardiologist.  Skip’s furry uncles (Oreo and Mason) were visiting at the time.

At his regular vet, the vet noticed that his tartar build up on his teeth was getting bad again (My boy absolutely hates to have his teeth cleaned at home).  It needed to be removed.  I told them, that I would schedule an appointment after getting approval from the cardiologist.

You see, getting Skip’s teeth cleaned isn’t as easy as it is for a normal cat.  With HCM, putting Skip under is more risky. The regular vet is awesome about being aware of Skip’s HCM and she does her best to make sure that he isn’t under any longer than he needs to be.

A couple of weeks later, I took Skip to his scheduled cardiologist appointment.  After they spent a couple of hours looking him over, I got the news I had been dreading since learning about HCM.  Skip had a teeny tiny amount of fluid in his lungs.  This is the first sign of congestive heart failure (CHF).

She said what was happening is that the heart is working harder than it needs to.  The capillaries are under stress and they leak fluid into the lungs for relief of the pressure.

The cardiologist said that it wasn’t enough for Skip to notice, but that she needed to make some changes in Skip’s meds.  She increased the evening enalpril to 3/4 of a tablet and added 1/4 tablet of furosemide.  The enalpril will help Skip’s heart to not work as hard and the furosemide will help remove the fluid from Skip’s lungs.

She needed to see him back in a couple of weeks to make sure that the fluid was gone from his lungs and do some labs to make sure that everything looks good with the addition of the new medicine.  Until the recheck, the teeth cleaning was not approved.  His lungs needed to be clear first.

I was disappointed.  I didn’t want to hear that the HCM had progressed at all.  But…as the cardiologist told me, this is just a little blip.  We’ve been lucky for 2 years and since we are on top of it, we were able to catch the CHF early.

I made up two weeks of Skippy pills.  I use the #3 pill capsules, and added the furosemide to the evening pill since I actually have room in that one.  The morning pill is very full.

Shortly after the cardiologist appointment, Skippy’s furry uncles returned for a longer visit.  It’s always a fun week when they visit.  While I think Skip gets a bit more stressed when they visit, I do think he enjoys having them around some of the time.  I figured that this would be a good test of the furosemide.

Once the two weeks were up, I took Skip back to the cardiologist.  They took a look at his heart and lungs plus took the labs.  The good news is that the fluid in his lungs was gone.  After getting the labs back, they said that Skip’s potassium was low.  The cardiologist was expecting this.  I guess the potassium is expelled along with the fluid, so they wanted to put him on half a 550 mg potassium tablet.  They want to see him again in 4 months to make sure that he is stabilized and the HCM has not progressed further. He was approved for his teeth cleaning as well.

Whew!  I was relieved.  It’s never a good thing to hear about fluid in anyone’s lungs let alone your beloved pet.  I called the regular vet and made his teeth cleaning appointment.  I made it such that we would be able to watch him over the 3-day Labor Day holiday weekend.  My other thought on doing it so soon was that as of right now is we know where his heart and lungs are at.

So, two days later, I loaded Skip up and took him to his regular vet for his teeth cleaning.  Poor guy had two vet appointments in one week. His vet did the teeth cleaning and called me once he was done.  They said he had a lot of tartar build up, but they got it all and he was doing just fine.  Because they only had him under for the minimum amount of time, I got to pick him up early.  This was nice because it gets him out of a stressful situation.  I guess he really didn’t like the dog that was next to him. 😉

Now Skip plus anesthesia is a funny thing when he gets home.  He gets ravenous while still loopy, he can’t walk a straight line, and he won’t lay still.  His poppa and I kept a close eye on him on Thursday.  I kept feeding him a little bit of canned food at a time and kept the hard food from him for a day.  His teeth/gums were tender on that first day, so I wanted him to just eat the canned food.  No sense in having the big chicken become afraid of hard food. LOL

On Friday, we gave him his hard food, but kept up with feeding him the canned food.  All day long.  Morning, noon, evening, and night.  Skip was in heaven. 🙂  So, everything goes normal on Friday, and Skip and I head to bed.

Saturday we get up at 7:30 am for Skip’s heart meds.  I put him on the counter and what do I see while still groggy?  Skip with a swollen right eye that he is keeping closed.  Well, swelling this time of year is nothing.  Skip has allergies and allergies can equal swelling.  So, I gave him 1/2 a tablet of antihistamine, but made a note to check him later on in the morning.

Well, I lost track of time, and at noon ran in to check him.  Yep, I still had a one-eyed bandit.  I had a decision to make…this was a holiday weekend which means if it’s something serious and I don’t take him in, we may be taking a trip to the emergency clinic which equals more cost.  But what if it’s not something serious? Am I a helicopter mom with my kitty?

I made a quick decision.  Something was wrong and I knew it in my gut.  Mommy’s know their babies best and should always trust their gut.  I called the vet and they said to bring him up.  It’s a good thing I did.  Skip had a scratch that was pretty big on his eye.  They gave us some antibiotics and eye pain meds to take home.  Plus his regular vet wanted to see him again on Tuesday to make sure his eye healed correctly.

I have to say it was nice to see the other doctor in the practice.  She’s the one who initially found the HCM and to whom I will always be indebted to.  We always see the other vet because of the urine sample.

Skip was miserable on Saturday.  Between his teeth and his eye, he just wasn’t feeling good.  I did cut back on the canned food on Saturday as well which probably added to his discomfort.  He needed to start eating his hard food again whether he wanted to or not.  He would go into the kitchen and eat apiece of hard food. Then would come out and look at me with only one eye open.  It was like he was saying, “Please mother feel sorry for me and give me the canned food.”  I didn’t relent and he went back to eating the hard food.

Skip was better on Sunday.  There was drainage from both eyes which we thought was odd.  And then on Monday Skip was playing with his toys again and acting normal.

On Tuesday, much to Skip’s protests we headed back up to his regular vet.  Hooray!  Skip’s eye was healed.  We were to continue the antibiotics in both eyes for the rest of the week, but Skip didn’t need eye surgery to fix his scratch.  The reason for the antibiotics in both eyes was just in case his allergies were starting an infection in the other eye.

During this whole week, I spent my evenings making up 428 pill capsules which will get us to December.  428!  That is a lot of pill capsules!  The problem is that the potassium pills are HUGE.  I have to cut the pill into eighths.  I called the cardiologist and asked if I could give him a quarter in the morning and a quarter in the evening.  She said that it would be fine to split it.

So the makeup of the pill capsules is as follows:

Morning Pill #1:
– 1/4 Plavix
– 1/2 Thyroid tablet
– 3/4 Enalpril

Morning Pill #2:
– 2/8 of a Potassium pill (It is actually cut into eighths)

Evening Pill #1
– 1/2 Thyroid tablet
– 3/4 Enalpril
– 1/4 Furosemide

Evening Pill #2:
– 2/8 of a Potassium pill (It is actually cut into eighths)

Once Sunday gets here, we’ll be down to two pill capsules in the morning and two pill capsules in the evening.  It’ll be nice to be back to normal. 🙂

To sum it up, after two years Skip’s HCM progressed a bit and we countered with upping one med and adding two new ones.  Here’s hoping for two more years of the same-o, same-o. 🙂

Herrow? Plus a Quick Skip Update

Boyfriend several years back moved into my condo with Skip and me.  The condo is a bi-level and one of those where when you walk in you decide to go up or down immediately.

One day boyfriend walked in and yelled “Hello!”  I replied with “Hello!” This became our Marco-Polo game when we came home.  It was our way of determining where the other was when walking in the door.

Well, little did we know Skip was listening and learning.  He figured out what we were doing by calling out to each other.  He is a smart cat when he wants to be.

One night boyfriend and I headed to bed and we forgot to make sure Skip was with us.  A little while later we hear “Herrow!” from downstairs.  We both looked at each other and at the same time called back “HELLO!”

Skip came running up the stairs and jumped on the bed with a look of “It worked!”  Of course we praised him to let him know that we were pleased.  Then we all fell fast asleep with one of us purring.

Thinking back on it, maybe encouraging him to call out wasn’t a great idea.  Skip however liked the game and would play it quite often even in the middle of the night after heading down for food.

Skip will even use it when we leave him with his grandparents when we travel.  I had told mom about it and she knew to call back “Hello!”  Mom said that Dad was surprised to hear “Herrow” from Skip and even asked if Skip was trying to say “Hello”.  But hey even Dad knew what he was saying, so it’s not like we parents are making up what it sounds like Skip says.

So, if you ever visit our house or my parents house when you are in town and hear “Herrow!” please reply with “Hello!” and you will have a kitty probably come running to you. 🙂

Just a quick update on my little nutcase (That’s just one nickname for him): Skip is doing awesome!  We are a year and half after the first diagnosis of HCM and you’d never know he has a HCM or hypothyroidism.  I can’t say the same for food allergies because ice cream is a weakness of ours.  He loves it so much that it is hard to tell him no, but he is allergic to milk.

While on vacation, Skip stayed with his grandparents.  I got a report from mom that Skip didn’t like her timing on giving him his pills.  You see at home, Skip gets his pills before I do my hair.  Mom was trying to do it afterwards.

Mom said that he would come and sit outside her bathroom and stare at her.  She asked him for just a bit more time, and he would leave.  She said that he was serious the second time around though.  If she didn’t comply, he would just go and lay down somewhere thinking he wasn’t getting his medicine.  Then she’d have to go find him to give him his pills.

The next day on his second time around the house, she dropped what she was doing and followed him to the kitchen.  He was more than happy to take his pills.  Skip had his grandma in training. 😉

Skip is doing great and it looks like he has gained a bit of weight back since Thanksgiving which is a good thing.  He looks healthy and happy which is saying a lot.  He still willingly takes his pills while sitting on the kitchen counter which he jumps up on.  I hope that this will always be the case.

A full update on Skip will be available once he goes to his next cardiologist appointment in February.  I truly hope that other pet owners are as lucky as we were with our vet finding the HCM in its early stages.  This is just another reason to get your pets checked regularly by a vet.

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 / Hypothyroidism / Allergies – 8/31/09 – 07/15/2010

So far, Skip has been put on medicine for Feline Hypertrophic Cardiomyopathy (HCM) and he has been treated for Feline Hyperthyroidism. Now we are just waiting for October to come, so that we can find out how fast the HCM is progressing and find out if he can get his teeth cleaned or not.

We are in a daily routine of 3 pills in the morning and 1 pill in the evening.  Skip is doing pretty well with taking his pills.  I only have trouble when I miss the target for the Plavix.  All I can say is it must be real bitter pill to swallow. 😉

Leading up to September 2009, I noticed that Skip started to get a whistle when he breathed.  He wasn’t in distress, but breathing in caused a whistle.  Of course I thought that this was a bad sign.  I was just thinking of fluid filled lungs.  I took Skip to the appointment to get the blood work completed prior to his appointment with the cardiologist.  Skip’s Vet is awesome.  They get the blood work returned and fax it to the cardiologist, so that she can evaluate the numbers prior to Skip’s appointment.

In early October 2009, I took off work and hauled Skip up to see the Cardiologist at the Care Center.  I feel really lucky that I live in an area where the Cardiologist is fairly close.  There were people from New Jersey in that day to see her.  You may ask how I remember this; let’s just say these days are carved into my memory.

I asked again if I could go back into the back with him, but again I was denied.  I really don’t understand why they don’t allow it.  Skip does really well when Mommy is there and I feel it would keep his heart rate down and keep him from being stressed.

Once the cardiologist finished, I got to talk with her.  She gave me GOOD NEWS!!  Skip’s heart had barely changed and she could barely see any change in the thickness of his heart walls.  I took a sigh of relief. 🙂  It felt great!  She did want to tweak his medicine to get rid of the whistle while he breathed, but other than that she said he should have a fairly long outlook. 🙂

The cardiologist said that it was ok for Skip to get his teeth cleaned and that she needed to see him again in early February to check the thickness of the heart wall.  I was off with new prescriptions and extremely happy.  I can’t explain the relief that was felt when I heard the news.

BTW, it is a real pain to cut these pills up.  Skip takes a 1/4 Plavix and 3/4 and a 1/2 of Enalpril.  It takes what seems like forever to cut them.  Boyfriend tried once on the cheaper of the two (Enalpril) and gave up after he butchered what he thought was too many of them.  He wouldn’t even try on the really expensive ones.  I have since found an awesome pharmacy that will cut the pills for me.  I even offered to pay them more for the service; that is how much of a pain cutting these pills are.

I made Skip’s teeth cleaning appointment and they had to remove two of his teeth.  I think he felt much better once the gums healed.  The whistle while breathing went away after a week or two of the medicine adjustment.

Time flew by and in early January I noticed my baby didn’t have as much energy.  He still looked fine and was breathing fine; he just started sleeping a lot.  Since we were close to his next cardiologist appointment I started the steps to get his next checkup.

When I scheduled his blood work to be done, I also scheduled an appointment for him to be checked by the vet.  He had a lump behind his ear and his head would get red from time to time.  His doctor said that the redness in his head were more than likely allergies.  Since it was January, those allergies were more than likely caused by food.

The doctor took a sample from his lump behind his ear.  I got to help by holding his head.  They seemed real impressed that he didn’t even flinch when she took the sample.  I kept telling them that he does better when mommy helps hold him because he trusts me.  I think I made some head way in this area.

Skip’s doctor put him on some special diet food that does not have any additives and told us that he was to get no table scraps at all and only this food.  The goal is to isolate him to one type of food and see if the redness in his head improves after 6-8 weeks.

A funny thing happened while they were getting all the food collected.  I was out in the lobby letting Skip walk around on his leash.  It gives him something to do and actually keeps him calmer when the door opened and there was a big dog.  I just asked the person to hold for a second.  She gave a command to the dog who promptly sat.  I picked up Skip and said we’re good.  Then I realized that it was the other vet in the practice.  🙂 She was the original vet who found the heart murmur and she was happy to see Skip wandering around.

She is the one who called me on Monday with the biopsy results which wound up being an enlarged polyp due to the food allergy.  The vet said that she was very impressed with how well I have handled everything and how well Skip is doing.  She was very nice about letting me know I was doing a good job.  I was elated to hear it.  Sometimes it is just nice to get that kudos to let you know you are doing well.

She also gave me news that Skip’s Thyroid numbers were a tad low and was probably the cause of the lethargy.  The vet wanted to wait until Skip visited the Cardiologist before treating to ensure that the HCM wasn’t the cause of the lethargy.

In February, I took Skip up to the Care Center to see his cardiologist.  I was a little ticked off for a bit there.  The cardiologist changed her schedule to where all of the cats are dropped off at the same time and then picked up around the same time.  Since I drive 45 minutes to get there, I really don’t want to turn around and head home and then do it again in the afternoon.  It is a royal inconvenience for out-of-towners I would imagine.

But since that is the game, I will play it.  I would think the cardiologist would want to take the pets one at a time, so that their owners can get them out of the high stress environment as soon as possible.  We are talking about pets that have a heart condition after all.

I digress. Luckily I had taken my laptop up there, so I could work while waiting.  It is really distracting to try and work there plus I was wondering what my baby was thinking and doing.

Finally, I get called back for the results.  Everything is the same.  There was very little change in the thickness of the heart wall.  My baby was fine once again.  Woohoo!

I asked her about the thyroid results and the cardiologist said that he needs to be placed on a thyroid medicine to increase the numbers.  She said that around 10% of cats that have the I-Cat treatment done go the opposite direction, but that it is better to supplement the thyroid than have it produce too much.

The cardiologist asked about how the pills were going.  I told her that Skip really didn’t like the Plavix.  She said it is real bitter and to put it in a pill capsule which you can buy from a pharmacy.

I was speechless.  My first thought was that I wished I had known about pill capsules sooner.  I have an awesome pharmacy now that cuts the pills up and provides me with pill capsules. All that I have to do is put all the pills into the capsules.

We have two containers.  One is labeled morning pills and consists of 1/4 tablet of Plavix, 1/2 tablet hypothyroidism medicine, 1/2 tablet of Enalpril and 1/4 tablet of Enalpril which are all crammed into the smallest pill capsule available.

The second is labeled evening pills and consists of 1/2 tablet hypothyroidism medicine and 1/2 tablet of Enalpril.  This pill capsule is extremely easy to fill.

That is the current status of Skip.  He still has HCM, but we caught it early, so he should have a long outlook.  The hyperthyroidism has turned into hypothyroidism which is better for a cat with HCM and can be easily treated with pills.  Of course we had the I-Cat treatment to avoid more pills, but what can I say? Other than I’d rather it be Hypo- than Hyper- because Hyper- is bad for the heart.  Skip is still on “special-buy-it” from the vet only food for his food allergies.  The lump has gone away and his head only gets irritated when he gets into something he shouldn’t.

Our future is filled with twice a year blood tests and ultrasounds to keep on top of the HCM, but my baby’s outlook is filled with plenty of years of loving his parents and keeping us laughing at things like his fear of spiders and his inability to control his tail. 🙂

Feline Hypertrophic Cardiomyopathy / Hyperthyroidism – 7/9/09 – 8/31/09

We pick up where we left off in the previous post on HCM.  I was waiting for the blood test results to return to see if Skip had Hyperthyroidism which can be a cause of HCM.

Skip had two pills to take in the morning and one in the evening.  Luckily he is fairly easy to pill, but the problem we had was that one of the pills in the morning was very bitter.  If I missed, he would taste it and then wouldn’t want to take any more pills.

I made it a point though to give Skip his pills at the same time every morning and within a 2 hour window in the evenings.  The key to any medicine is consistency.  Plus like most cats, Skip loves routine.  The more you stick with a routine, the more willing he is to participate.  Now Skip wakes me at 5:30 am to remind me that it is about time for the morning routine to start.  In the afternoons he starts around 5:30 pm (sometimes earlier) to let us know that it is about time for his afternoon routine.  The morning wake up call can be a pain, but you know I’d rather he do that than I over sleep and had forgotten to set the alarm.

After a weekend of holding my baby constantly, Monday finally came.  I received a call from the I-Cat vet who gave me the results of the tests.  The reason the I-Cat vet was calling me personally instead of an assistant was that Skip’s primary Thyroid level was still within the normal levels, but his Free T4 was not.  They cannot diagnose Hyperthyroidism based just on the Free-T4 number, and need clinical signs as well.

The I-Cat vet asked me some questions about Skip’s behavior.  Basically, for the past 6 months boyfriend and I noticed that Skip had started hollering at nighttime.  Usually, Skip is the kind of cat to go to bed with you and be real quiet.  Plus Skip would have these bursts of energy and go running through the house.  Trust me Skip used to be the calm kind of cat, so running through the house was unusual.  Skip had also been chowing down on the food.

The I-Cat vet said that’s enough for him to make the diagnosis and that Skip was indeed a candidate for the I-Cat therapy.  He explained there were 3 treatments: pills, surgery, or I-Cat treatment.  My thinking was that Skip takes enough pills now and that we don’t need any more.  With surgery, there could be complications and more recovery time and there was no guarantee they’d get it all.  Plus it was expensive.  If I spent just a bit more, Skip would not have to be opened up and would just receive a shot which in most cases gets rid of the tumor.  To me it was a no brainer to go with the I-Cat Treatment.  I was then contacted by his assistant and got Skip in for the next I-Cat date July 31st.

You’re probably wondering what in the world an I-Cat Treatment is.  Here is a link to their website: http://www.i-cat.info/index.html . Basically, most of the time Hyperthyroidism is caused by a tumor in the Thyroid.  I-Cat vets inject radioactive I-131 into the cat (this is also a treatment for humans) which only attacks the tumor in the Thyroid and eradicates it which brings the Thyroid levels back to normal.

I felt that we had caught the hyperthyroidism fairly early.  Only about 6 months had gone by since the first clinical symptoms.  Granted, this was plenty of time for damage to be done to Skip’s heart, but my mind said we caught it early enough for Skip to live for many years.

Skip had to stay the night at the Care Center and then we could pick him up the next day in the afternoon. I worried about him stressing out overnight because he’s never stayed any where other than Grandma’s house on the off chance I go out of town without him.

It was a real long night and a real long day waiting for the phone call to come that his I-131 levels were low enough for him to come home. Once the call came, we headed to PetSmart to get the required kitty litter and off to pick him up.

It was funny at the Care Center a guy came out with Skip in a box. We couldn’t see him in the box, so I asked if we could open the top; just so that I could make sure it was my baby in there.  I knew due to the radioactivity that they would not want him to expose everyone there.  I just wanted to see him.  It would really stink if we drove 45 minutes home to find out they gave us the wrong cat. 🙂

It was Skip, and so we packed him up and headed home.  They give you all kinds of literature saying what you can do and what you can’t do due to the I-131 radioactivity.  One thing you have to change to is using flushable kitty litter.  Let me just say…gross, but safer for you, so that you do not have radioactivity sitting in your trash can.  They also say to limit petting to 5 minutes and wash your hands right afterward.

Plus I was to not get his saliva on my hands.  Let me ask…how in the world do you pill a cat without getting saliva on your hands?  He needed his heart medicine.  I made sure I thoroughly washed my hands afterwards.  At the time, I was down due to knee surgery, so boyfriend was doing the cooking.  We did also make sure Skip stayed off kitchen counters.  That was tough.

The one that got me was the no sleeping with Skip until a couple of weeks had passed. This was the one rule I ignored.  My baby had just been traumatized overnight and they wanted to tell him he couldn’t be held for hours on end or sleep with him.  His feelings would have been hurt.  I know he’s just a cat, but cats have feelings too.

My background is that I worked at a company that determined if cancer was caused by exposure to radionuclides, so I was willing to risk that I-131 wasn’t going to hurt me at the level it was given.  Higher levels would have caused more concern.  I don’t recommend everyone doing this.  I’m simply explaining a tiny bit of my thought process for ignoring the last directive.

Since I was working from home due to my knee surgery, it helped me to keep an eye on Skip.  He seemed calmer.  He got to where he really liked having mommy at home.

One concern that came up was where they shaved Skip’s back; he could just reach the shaved portion with his tongue which is really rough.  He licked it so much he caused a core to appear.  I called the Care Center and they said to go out and buy baby t-shirts and put on him.

Not that was fun.  How do you know what size a cat wears?  Skip is a rather long and tall cat.  We found that the 12 and 18 months old t-shirts were what fit best.  Skip was rotten though, he figured out how to step on the end and then walk straight out of the t-shirt.  We actually watched him do it.  It took him around two minutes to get it off the last time. 🙂  The little brat.

All that you have to do is make sure that the t-shirt is long enough to cover the shaved patch (plus an inch) and cut the bottom off.  Once we did that, he couldn’t walk out of it.  I have to say Skip was stylin’ in his t-shirts.  He didn’t really care for him, but he looked real good in the red t-shirt.  While I would never make my pet wear clothes without a good reason, I can to a certain small degree see why people dress their pets up.

After 3 weeks, I had to take Skip to my vet to get a blood test to see if his Thyroid levels were back to normal.  On Monday August 31, 2009 his results returned and his Thyroid levels were fine.

Hooray! Now all we needed was to get the next ultrasound results in October to find out how fast his HCM was progressing.  I imagine a lot of people might ask why I would spend so much money on I-Cat treatment when you had no idea about the HCM.

My response is that I believed that the Hyperthyroidism was causing the heart condition to progressively get worse.  Yes, I could have done pills until October, but that’s not an exact science and Skip already had to be conditioned to taking his heart meds and I didn’t want to add another one.

This is another good place to stop.  I will write the next part soon and it will probably cover up until today.

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. 🙂