Urinary Block Or Diuretic?

[Weasel21]

Milo, 7.5 year old male, has congestive heart failure (dilated cardiomyopathy) and is also currently being treated for a kidney infection (finishes a 2 week course of clavamox tomorrow). He’s on a really high dose of furosemide already (25 mg in AM, 12.5 mg midday, and 25 mg evening) to keep his lungs clear. A few minutes after I gave him his evening meds, the smoke alarm went off from my partner cooking, it made Milo’s heart race and fluid built up in his lungs, so I gave him another 12.5 mg of furosemide intramuscularly because he needed quick diuresis (the pills take about 2 hours to have an effect). He urinated once about half an hour after the injection. And now, about 3 hours post injection, I just caught him in the litter box trying to pee but not producing any urine. Emergency vet is a 1.5 hour drive, and a vet visit is what triggered the CHF to start, so a trip to the vet is not an option and I have to wait until morning to get a vet for a house visit. Any thoughts on whether this is just because of the extra diuretic or whether this is a urinary blockage?
He didn’t act like he was in pain in the litter box, and the clavamox seemed to be working (was going to bring a urine sample to the vet tomorrow to confirm). I’m trying not to freak out. He’s been more lethargic for a few days and breathing harder and uncomfortable at night. I was hoping that would improve after he got off clavamox because it upsets his digestive system quite a bit. If this is a urinary blockage on top of a worsening heart condition... well, I don’t even want to think about it.
If he pees again tonight with no problem, do I still need to be worried about a blockage?

 

[Weasel21]

He just went to the litter box again and peed normally this time. Maybe I just walked in and interrupted last time? Normally that wouldn’t bother him. Will a cat with a blockage struggle to urinate every time, or just some of the time?

 

[FeebysOwner]

Hi. Sorry no one responded to your post. What is going on now?

 

[Weasel21]

No worries. It's a bit of a complicated question. His UA came back clean, so the kidney infection appears to be gone so it wouldn't have been a blockage. He is still not doing great though (labored breathing and congestion), even with increasing his diuretic to 4x a day now and increasing the benazepril. So sadly I think I need to keep a close eye on him now to decide when the time is right to euthanize if he declines further.

 

[FeebysOwner]

Good news - and not so good news. Has he been on the upped dosage of diuretic long enough that you should be seeing a difference? If not, I hope it helps. Keep us posted, if you want.

 

[Weasel21]

It's been increased since Wednesday. Maybe it needs more time, but I feel like I should be seeing a difference by now.

 

[FeebysOwner]

Just two days...maybe he needed a day or two of the increase dosage to get things rolling. Hoping anyway...

 

[Jem]

I know you said the last vet visit caused the heart issues, but when my kitty had CHF the vet drained his lungs (tapped his chest) to drain the fluid built up. Our kitty did not respond well the the diuretic because the fluid he produced was very "cellular" (that was the term the vet used), I wonder if yours would benefit from having his chest drained.

 

[Weasel21]

Jem , unfortunately the fluid cannot be drained because it's from pulmonary edema, fluid inside of the lungs, rather than pleural effusion, fluid outside of the lungs.

 

[Jem]

I'm sorry that it wouldn't work. I know I was pretty devastated when the medications stopped working for mine. Hopefully a few more days, and, he'll start to improve. Sending you good thoughts!!!

 

[calico man]

No worries. It's a bit of a complicated question. His UA came back clean, so the kidney infection appears to be gone so it wouldn't have been a blockage. He is still not doing great though (labored breathing and congestion), even with increasing his diuretic to 4x a day now and increasing the benazepril. So sadly I think I need to keep a close eye on him now to decide when the time is right to euthanize if he declines further.

Poor Milo! I can't give any medical advice but I do hope everything works out for the both of you. I know that when our kitties are not feeling well it is VERY hard for the owners. Keep us posted!

 

[Weasel21]

Just thought I would drop in with an update... Milo has been breathing comfortably again since Sunday. He is, however, losing more muscle mass (mainly in his back legs and is often shaky when standing) and sleeps a lot. I still think we're getting close to the end, but we're not there yet and I'm cherishing every moment I get to spend with him in the meantime.

 

[FeebysOwner]

Hi. Such a sweetie...thanks for the pic - and the update. Is the back leg muscle mass and weakness normal for his condition? Just hoping for something else could be given to him to help with that.

 

[Weasel21]

FeebysOwner , yes, it's called cardiac cachexia. In humans it may be linked to hormone and immune imbalances that result from heart failure. Part of the muscle loss was due to decreased appetite when he was on the clavamox. He's eating more now, but I don't think he'll regain the muscle. His brother wasted away very quickly after he went into congestive heart failure.

 

[Weasel21]

Put my sweet boy to sleep a short while ago. His lungs had filled with fluid again. The vet came over yesterday afternoon and we switched to a different diuretic. His lungs started to clear but he went downhill fast

 

[Weasel21]

Sorry, I stopped writing in the middle of the update and somehow accidentally posted. Even though his lungs were improving, he threw a clot later that night and the vet came back and we let him go. She thought his heart was on the verge of giving out too. I'm so heartbroken. The house is so empty with both of my boys gone.

 

[Jem]

I'm so sorry for your loss. You gave everything you could have, including love and compassion in his final hours. I know it's hard, I've been there. I hope everyday your heart heals a little bit more. He will always be with you.