Moderate Hcm Diagnosis And Need Some Advice

[UnderneathTheStars]

Today we took Mousse in to see the dental specialist because my vet suspected stomatitis. Also, we had her see the cardiologist to figure out what her heart murmur is from. Previous owner said she knew of it but never investigated it. The dental specialist said it wasn't stomatitis and that we'd need to remove some teeth due to gingivitis. That was the only good news we got today.

The heart ultrasound showed moderate HCM as the cause of the heart murmur. We couldn't do the extraction because of it. The vet said he would start Mousse on medication and do a re-check in a month or so to see if the disease has progressed or not. He said we might be looking at quality of life and making her comfortable. He could not give me a prediction as to how long she will live. He said it might be 1-2 years or less but that the disease isn't predictable. He said there's no fluid on the lungs right now but it might progress to that eventually.

Needless to say, this was one of my worst fears and I cried a lot in front of both specialists. They sent us home with buprenorphine for her oral pain, and azithromycin for her sinus problems and because last time she was on it her gum swelling went down. For the heart, we got atenolol (but we can only start it in a week when she gets her blood pressure checked again). We also got Fortekor to lower the blood pressure (I think) and Apo-clopidogrel which is for blood thinning. We are starting those in the morning.

I feel like all of this has been thrown at us and we haven't had a chance to really digest it. I was listening to the vet but I also felt kind of numb and like I was hearing words without really fully grasping things due to the stress of the situation and all the emotions. So, question time.

1. Does anyone here have a cat with moderate HCM who lived past the 1-2 year prognosis? If so, did you use the same medications?

2. Is there anything we should avoid giving her or doing with her? Since we've found out we have been kind of scared to handle her like we were before. We aren't sure whether we should still allow her to chase her toy, bring her to the groomer, or let her run around and jump on furniture, etc. I almost feel like she's made of glass now.

We feel so crushed.

 

[betsygee]

I'm so sorry--how difficult to hear a diagnosis like that. I don't have any experience with this myself. A search of our website brought up several threads about it. Until someone more knowledgeable comes along, perhaps one of these threads can give you some insight:

Search Results for Query: HCM | TheCatSite

I wish the best for you and your kitty.

 

[UnderneathTheStars]

I'm so sorry--how difficult to hear a diagnosis like that. I don't have any experience with this myself. A search of our website brought up several threads about it. Until someone more knowledgeable comes along, perhaps one of these threads can give you some insight:

Search Results for Query: HCM | TheCatSite

I wish the best for you and your kitty.

Thank you so much!

 

[babiesmom5]

I am so sorry to hear about Mousse and can well understand your fears and stress. Please do not despair prematurely. Take a deep breath and know that while HCM is a progressive disease and cannot be cured, it can be effectively managed. Mousse may well have years of quality life ahead as I can attest.

I too had a cat who was diagnosed with HCM after a routine vet visit detected a Grade 111 heart murmur. A Cardiologist referral confirmed that she had "Severe HCM". Like you, I was devastated as she already had CKD and Diabetes. But with good veterinary care, proper medications and lots of TLC, she lived another 4+ years and passed away at the ripe old age of 20, and her kidneys gave way before her heart.

Although her HCM was severe at diagnosis, the cardiologist said that while her left ventricle (the heart's primary pumping muscle) was 75% closed, she was well compensated by the right ventricle. You might ask your cardiologist if your cat's heart is "compensated" as this can make a difference in prognosis.

At first, since her HCM was well compensated, she was not put on any medications, but breathing rate and blood pressure were monitored closely.

When blood pressure begun to rise, she was put on Benazepril (mild anti-hypertensive). Later Amlodopine (another anti-hypertensive) was added.

About a year later, in the wee hours following a dinner party at our house, she suffered a stroke. She made a full recovery in about two weeks. Atenolol (which slows the heart rate) was then added in order to keep her heart rate at a max of 160 beats/minute.

In answer to your question regarding activity level, I would let Mousse do whatever she likes to do, or feels up to doing. They kind of "self regulate" according to how they feel, but I would watch their responses closely. Watch for things like any open mouth breathing, respiratory difficulties, lethargy, weakness,
panting, or flattening themselves chest down on the floor(which eases their heart). Also watch for any limb paralysis (stroke), and especially hind limb paralysis. Cats with HCM are prone to "throwing a clot" (Saddle Thrombosis) as I was cautioned by my cardiologist.

Knowing what I know now, I would keep stress and noise levels down in the cat's environment. Keeping them calm and relaxed is key. I even had a C/D of soothing harp music that I would play for her.

I really believe that with regular checkups by your cardiologist, adjusting type and amount of medications as needed to control heart rate, alleviate lung congestion and prevent blood clots, along with your good care, that Mousse has lots of quality life left.

I wish you and Mousse the very best...and I hope my experience with HCM has provided a bit of optimism.

 

[UnderneathTheStars]

I am so sorry to hear about Mousse and can well understand your fears and stress. Please do not despair prematurely. Take a deep breath and know that while HCM is a progressive disease and cannot be cured, it can be effectively managed. Mousse may well have years of quality life ahead as I can attest.

I too had a cat who was diagnosed with HCM after a routine vet visit detected a Grade 111 heart murmur. A Cardiologist referral confirmed that she had "Severe HCM". Like you, I was devastated as she already had CKD and Diabetes. But with good veterinary care, proper medications and lots of TLC, she lived another 4+ years and passed away at the ripe old age of 20, and her kidneys gave way before her heart.

Although her HCM was severe at diagnosis, the cardiologist said that while her left ventricle (the heart's primary pumping muscle) was 75% closed, she was well compensated by the right ventricle. You might ask your cardiologist if your cat's heart is "compensated" as this can make a difference in prognosis.

At first, since her HCM was well compensated, she was not put on any medications, but breathing rate and blood pressure were monitored closely.

When blood pressure begun to rise, she was put on Benazepril (mild anti-hypertensive). Later Amlodopine (another anti-hypertensive) was added.

About a year later, in the wee hours following a dinner party at our house, she suffered a stroke. She made a full recovery in about two weeks. Atenolol (which slows the heart rate) was then added in order to keep her heart rate at a max of 160 beats/minute.

In answer to your question regarding activity level, I would let Mousse do whatever she likes to do, or feels up to doing. They kind of "self regulate" according to how they feel, but I would watch their responses closely. Watch for things like any open mouth breathing, respiratory difficulties, lethargy, weakness,
panting, or flattening themselves chest down on the floor(which eases their heart). Also watch for any limb paralysis (stroke), and especially hind limb paralysis. Cats with HCM are prone to "throwing a clot" (Saddle Thrombosis) as I was cautioned by my cardiologist.

Knowing what I know now, I would keep stress and noise levels down in the cat's environment. Keeping them calm and relaxed is key. I even had a C/D of soothing harp music that I would play for her.

I really believe that with regular checkups by your cardiologist, adjusting type and amount of medications as needed to control heart rate, alleviate lung congestion and prevent blood clots, along with your good care, that Mousse has lots of quality life left.

I wish you and Mousse the very best...and I hope my experience with HCM has provided a bit of optimism.

I'm so happy to hear your kitty is doing well with the HCM. I hope I'm that lucky. I'll basically just let her do whatever she wants but I'll keep an eye on her breathing. It's 20 - 30 breaths per minute which is normal, right? We got a blood thinner to avoid clots and something to lower blood pressure. We also got atenolol but the vet doesn't want us to start it yet. He said to see our regular vet in a week for a blood pressure check and then they will tell us whether or not to start the atenolol.

I'm getting a pill organizer because I'm super paranoid about missing a dose or somehow messing something up. The medications seem so harsh and scary to me. I've medicated cats before with small things like prednisone, antibiotics, and gabapentin but never something as serious as a heart condition. It took me forever to cut her pill into 1/4 this morning because I'm scared of not getting it 100% exact and then she gets a little more or a little less than she needs.

Your story has helped me feel better, though. I kept waking up last night worried that she'd passed in her sleep. Today, she seems good. She's bright-eyed and ate all of her breakfast and took her meds easily. The car ride back from the specialist (3.5 hours) was a bit annoying for her because she kept meowing and wanting to come out of the pet carrier. When we got home she drank some water, used her little, and went to sleep in a sun-spot.

 

[UnderneathTheStars]

UPDATE: Specialist called us back about Mousse's senior blood panel and nose secretion swab.

Happy to say all values for blood work are within normal range. The nose secretion swab showed calicivirus, herpes virus, and mycoplasma bacteria. The vet said we will continue with azithromycin for the mycoplasma and saline nose drops. He wants to hold off on anti-virals because Mousse already has a lot of medications and there are side effects for the anti-viral medications. He said we will revisit this when her medications are all stable.