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.