Wednesday, August 16, 2006
Today we went to the kitty cardiologist
Today was tough.
Seamus was so good though. I am SO proud of him!!! So we got there and were checked in and taken back fairly quickly by a 4th year. She did an H&P and I saw she had ranked his murmur as a 2-3 (out of 6, his primary care vet ranked it just a 2) then went to go pass on what she learned to the cardiologist while the tech came in to do another bp. Last time he had it checked it was 140-145ish (in kitties they only do the top number, and normal for them is the same as normal for us) and that was good, high normal, but for a vet they consider it great. Today it was 175. High, but not scary high, and could have been stress induced. FINALLY the cardiologist came in and she was very nice. Seamus liked her alot. She said I could come for the echo, but not for the xray because that's in another area, and shed come get me when it was echo time, but they had 3 docs and one echo machine so we didnt know how long it would be. She kept him back there because she said she'd sneak the chest xray in when she could.
So I go out to the waiting room with THE MOST UNCOMFORTABLE seats ever. Let me tell you, this was not a fun place for the most part. I did make a friend though. She was sitting there sniffling and crying a wee bit and I offered her a tissue. I told her Id listen if she needed to talk and leave her alone if that's what she wanted and after about 3 minutes of crying she was ready to talk. Her pup, Hershey, was just diagnosed with Lymphoma. She said that she's single and he is her family. I totally understand that! He was back there having a bone marrow biopsy to determine how widespread it was, and he was to have his first chemo today too. She then started crying again and they took her in the back.
I was in the waiting room for 2 hours and watched all sorts of stories. I saw everything from a woman bringing in her other doggie to say goodbye to the one who was in ICU, and that broke my heart. I saw another woman who will be getting her little pup fitted for a wheelchair/cart because his doggie arthritic knees cant handle running anymore. I saw people come in and out thrilled to see their healthy animals, and crying because they werent getting good news. It was the hardest stuff to watch.
Then the cardiologist finally came out and said they had a few emergencies, and that's why it was so long, but Seamus was doing great, just hanging out watching everything, and if I would be ok with not being there for the echo she'd get it done quicker, but since I couldnt be there with other patients around, if we waited, itd be 5pm before he'd be done. I let her do it without me. About 30 minutes later my 4th year brought my cute little shaved baby back out to me.
So then a few minutes later the cardiologist came back out and brought us back to the humans only room (im impressed he was allowed!)She went over the echo with me (the actual images on the computer) and xray and he got his diagnosis and treatment plan.
The xray showed prominent caudal lobar arteries, which can be consistant with pulmonary hypertension or heartworm disease. However, he did not have the heart changes on his echo to suggest either of these, and she said either this is his normal, or it could be early signs of PHT. He also appeared to have mild asthmatic changes.
The echo was consistant with moderate hypertrophic cardiomyopathy. he also had "remodeling" which is basically kitty ischemia. His murmur was upgraded to a 3-4 :(
What does this all mean? Well he will be taking a beta blocker 2x a day for the rest of his life. (thank GOD he's a good pill taking kitty!) The good news is that his right atrium is still within normal limits, so the common risk of a blood clot that comes along with this disease is unlikely for him. He is at a great risk for going into CHF, but as long as I get him swift treatment, he can be ok with that. We go back in 6 months for a followup echo and bp check for stability and to make sure the atenolol is doing it's job. (basically we want the heart to not have to work so hard which should stop the progression of the ischemia)
He can live many many years with this problem. Or drop dead at a moments notice. We choose choice A.
So the diagnosis was what I expected, but slightly worse than I had expected. We were thinking mild, not moderate based on how quickly we caught the murmur. I dont know if it progressed that much in the 2 months it took me to get this appointment, or if thats just him.
The other bad news is he's gained 3 more pounds. He is now almost 23lbs. About half of the dogs I saw today weighed less than that.
The good news is that he's a good pill taker, he had his first dose tonight and took it with no problem.
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Sounds like one heckuva day. I hope you're enjoying a Take 5, the best candy bar EVER. And I hope darling Seamus responds to treatment and lives a long, healthy life.