Seeking Support for Persian Cat with HCM and IMHA | Urgent

[Bishop1985]

Dear Feline Community,

I am writing to seek your collective wisdom and experience in managing a complex health case with my furball. My 9-year-old Persian cat, Bishop, has recently been diagnosed with both hypertrophic cardiomyopathy (HCM) and immune-mediated hemolytic anemia (IMHA).


He was diagnosed with HCM, a concerning condition affecting his heart in the first week of this year. Shortly thereafter, he experienced a significant drop in hemoglobin levels, necessitating a blood transfusion of 40ml on 5th Jan. While this intervention stabilized his immediate condition, his hemoglobin and hematocrit (HCT) values remained below optimal levels.

Following thorough investigations, including a ruled-out Mycoplasma infection, the veterinary team is currently focusing on managing Bishop's IMHA. This autoimmune condition unfortunately attacks his red blood cells, further complicating his already compromised cardiovascular health.

Since January 5th, Bishop has been diligently adhering to a prescribed medication regimen:

• Atenelol and Envas for regulating his heart rhythm
• Furosemide for managing fluid accumulation
• Prednisolone for suppressing his overactive immune system
• Doxycycline for addressing potential underlying infections
• Rentac for supporting his gastrointestinal health

While his initial blood test on January 12th indicated some improvement, with Hemoglobin at 9.8 g/dl and HCT at 29.8%, a subsequent test today revealed a disheartening decline in both values (Hemoglobin 8.1 g/dl, HCT 23.5%).


Therefore, I humbly reach out to this community seeking guidance and support for Bishop. If any of you have encountered similar situations with your feline companions, particularly those involving HCM and IMHA, I would be immensely grateful for your insights and recommendations. Any information on treatment approaches, supportive care measures, or personal experiences navigating such challenges would be invaluable in aiding Bishop's recovery.


Sincerely,
Rahul

 

[silent meowlook]

Hi. I am sorry you and your cat are going through this. Is your cat under the care of a specialist? If not, that would be the most important thing to do. This is far to complex for a regular veterinarian.
Do they have any idea of the cause of the IMHA? As I am sure you already know, no vaccines or anything that could stress the immune system,
I a m sorry I don’t have any great advice here. I am glad the transfusion went well. I hope he doesn’t need another.
I am sure they have done an abdominal ultrasound.
If at all possible, he should eat canned food and no dry. Encourage as much drinking of water that you can. The medications can be hard on the kidneys. You need to make sure he stays hydrated.
I wish I had more to add but I just dont.

 

[Bishop1985]

Hi. I am sorry you and your cat are going through this. Is your cat under the care of a specialist? If not, that would be the most important thing to do. This is far to complex for a regular veterinarian.
Do they have any idea of the cause of the IMHA? As I am sure you already know, no vaccines or anything that could stress the immune system,
I a m sorry I don’t have any great advice here. I am glad the transfusion went well. I hope he doesn’t need another.
I am sure they have done an abdominal ultrasound.
If at all possible, he should eat canned food and no dry. Encourage as much drinking of water that you can. The medications can be hard on the kidneys. You need to make sure he stays hydrated.
I wish I had more to add but I just dont.

Thank you so much for your response. Bishop has been undergoing treatment at Cessna (I'm based in Bangalore, India), and we've left no stone unturned in terms of diagnostic tests – ECG, ultrasound, you name it. The diagnosis of HCM came through, and the low hemoglobin led to suspicions of either a Mycoplasma infection or IMHA. The PCR test ruled out Mycoplasma, so it's likely leaning towards an IMHA case.

Interestingly, when I initially sought to adopt a cat, I had my eyes on a different one. However, a friend suggested adopting him, the runt of the litter, predicting he might not find another home easily. I'm grateful I chose him; I brought him home when he was just a tiny thing, and it's heartbreaking to see him like this. I'm determined to do whatever it takes to help my little purr machine!

Currently, I'm reaching out for insights while faithfully following the vet-prescribed medication. I'm exploring if there are any alternative or innovative suggestions from others that I could consider. Your response means a lot—thank you for your support!

 

[fionasmom]

Delayed-release rapamycin halts progression of left ventricular hypertrophy in subclinical feline hypertrophic cardiomyopathy: results of the RAPACAT trial - PubMed
This post reference a very new medication called rapamycin which has been part of a study called RAPACAT. I have an HCM boy who is not faced with the complications that Bishop is; so, while I understand the condition I have not ever investigated this new medication. I know that you are in India; in the US it is not FDA approved yet.

The original link was posted by TCS member E EnelradSedir70

 

[Tstroyer]

My cat had severe anemia and was found to also be chf. Everything was ruled out and he wasn’t getting better until I started him on B12 shots. He’s no longer in chf but does have hcm. Just be aware that doxycycline can interfere with b12 absorption. I