Congestive Heart Failure + Hypertrophic Cardiomyopathy (hcm) + Fluid In And Around Lungs - Help????

MishaTheCat

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We had my cat Misha spayed on November 24th, 2017. She is only two years old.

She recovered quickly and never showed any signs of discomfort or pain. Her incision still has a scab and the place where she was microchipped lost hair, and now has turned blue.

However, last night, we rushed her to the emergency vet as she was breathing very heavy and quickly. She wasn’t consistently rattling but would have spurts of rattling (very brief - one second). She looked very sad but was walking fine and had just had something to eat and drink before this happened.

I did notice her purr was much louder in the morning but that was it.

At the vet, we were told she had a heart murmur (a level 6 out of 6) and went in to have X-rays. Immediately after discovering the heart murmur via stethoscope, the vet already thought it was hypertrophic cardiomyopathy (HCM).

She was able to have one out of three X-rays done but she needed to be put under for the final two. This is because Misha gets very stressed and panicky at the vets, she doesn’t like strangers either.

The vet showed us the pictures and explained that she had fluid in and around the lungs and even though her heart looked normal - she had hypertrophic cardiomyopathy and congestive heart failure. She told us Misha only has months at most to live.

She also said Misha had very high blood pressure.

She was prescribed diaretic and blood pressure medicine. She was injected with laciryx (might be an incorrect spelling - sorry).

Despite being a little out of it (as a result of the sedation) she came for a brush and her breathing already seemed normal again.

Today, she is back to her old self. She’s running around, playing, cuddling, purring, chirping at/watching birds, jumping, playing in her cat tree, eating snacks, peeing normally, eating, drinking, napping, etc. Completely normal.

My question is - is her diagnosis correct?
We are absolutely devastated and are so concerned for our little Misha but her diagnosis just doesn’t make sense. I understand it happens at random and can affect any age but she only had the one symptom and already appears to have recovered. Please let me know what you think and any suggestions to prolong her life and make her as happy as possible would be greatly appreciated.

(Also a bit odd but probably not related - the vet didn’t seem to understand that Misha was a girl but mentioned her spay....)
 

Kieka

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I think I'd see about a second opinion before getting too far in treatment. Definitely don't stop the medications but see another vet for a second opinion ASAP. Preferably one without connection to the first.

It is possible she had a bad reaction to the spay or microchip. It could have triggered something that was underlaying or it was some sort of allergic reaction. That would explain why the symptoms subsisted. It could also be that the medications are controlling it, causing the improvement you've seen.
 
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MishaTheCat

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Thank you for your quick response.
She already seemed better (with normal breathing) after only having the lacryix/diuretic which was injected last night around 9-10PM. She didn’t have any more medicine until around 1:00.

We are booking an appointment with an alternate vet for next week.

I think I'd see about a second opinion before getting too far in treatment. Definitely don't stop the medications but see another vet for a second opinion ASAP. Preferably one without connection to the first.

It is possible she had a bad reaction to the spay or microchip. It could have triggered something that was underlaying or it was some sort of allergic reaction. That would explain why the symptoms subsisted. It could also be that the medications are controlling it, causing the improvement you've seen.
 
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MishaTheCat

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Sorry, just to clarify.

She didn’t have any additional medicine until 1:00pm today and already seemed better before 1:00pm today.
 

Kieka

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If she hasn't had really much beyond the diuretic then it is possible that something else triggered a reaction. Hopefully a different vet can bring a new set of eyes who may see something different.
 
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MishaTheCat

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If she hasn't had really much beyond the diuretic then it is possible that something else triggered a reaction. Hopefully a different vet can bring a new set of eyes who may see something different.
That’s what we’re hoping but we also can’t get our hopes up. This is so tough
 

Boris Diamond

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If she has HCM, at least you caught it at a young age. That is very good. I have a cat with HCM. It was diagnosed at the age of two years and eight months. He had an incident similar to the one you described. He was put on Vetmedim, Salix and enalapril. He has responded very well, and in fact, at the last appointment in November, the vet was surprised at how well he is doing. She said that since he is responding so well he might make it a long time.

I had another cat that had to be euthanized hours after he had a bad incident. Different cats have differing degrees of illness and respond differently to treatment. So don't give up hope! A cat with HCM can make it for years.
 
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MishaTheCat

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If she has HCM, at least you caught it at a young age. That is very good. I have a cat with HCM. It was diagnosed at the age of two years and eight months. He had an incident similar to the one you described. He was put on Vetmedim, Salix and enalapril. He has responded very well, and in fact, at the last appointment in November, the vet was surprised at how well he is doing. She said that since he is responding so well he might make it a long time.

I had another cat that had to be euthanized hours after he had a bad incident. Different cats have differing degrees of illness and respond differently to treatment. So don't give up hope! A cat with HCM can make it for years.
Thank you.

That's why I'm a little confused in regards to the vet's prognosis. She couldn't find any evidence of enlargement in the heart and did not keep her overnight or do anything beyond one injection of a diuretic. Why is the prognosis so severe? Only a few months at most? It doesn't make sense.
 

Boris Diamond

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It does seem that the prognosis you got was extreme. Perhaps she was trying to prepare you for the worst, but I think the truth is best.

I think Kieka Kieka 's suggestion of seeking a second opinion is good and I am glad that you are seeing another vet. Misha could be having a reaction to the chipping or something else. Vets are only human and they can make mistakes too. The vet I have for my HCM cat is an internal medicine specialist and has the reputation for being the best in the area.

I'm pulling for Misha and I hope things turn out for the best.
 

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If it were my cat, I would not simply go to another vet for a second opinion. I'd go to a 'specialized' animal hospital with board-certified vet specialists and have the cat evaluated by a vet cardiologist.

I have such a hospital about an hour away from me, and I've had good experiences that convinced me that anything beyond basic care is worth seeking a specialist.
 
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MishaTheCat

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It does seem that the prognosis you got was extreme. Perhaps she was trying to prepare you for the worst, but I think the truth is best.

I think Kieka Kieka 's suggestion of seeking a second opinion is good and I am glad that you are seeing another vet. Misha could be having a reaction to the chipping or something else. Vets are only human and they can make mistakes too. The vet I have for my HCM cat is an internal medicine specialist and has the reputation for being the best in the area.

I'm pulling for Misha and I hope things turn out for the best.
If it were my cat, I would not simply go to another vet for a second opinion. I'd go to a 'specialized' animal hospital with board-certified vet specialists and have the cat evaluated by a vet cardiologist.

I have such a hospital about an hour away from me, and I've had good experiences that convinced me that anything beyond basic care is worth seeking a specialist.
We're back from her vet appointment with the other vet. They said she definitely has a problem with her heart and have referred us to the cardiologists in the next city over (at a world-renowned vet uni), but they said the HCM diagnosis had no real proof and agreed the diagnosis may have been fueled by $$$. The vet said she could live to be twelve years old even with her heart problem.
 

Kieka

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I am sorry it did turn out that she has a heart problem. Hopefully the specialist will have good news, plenty of cats live long lives with properly controlled heart problems. But it being less severe than originally thought is a good think.
 
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