Collapsed cat

RE: Collapsed cat

Nhombokisheni — Tue, 05 Apr 2016 22:16:30 GMT

I suggest you desist from second guessing......diseases don't read books. Secondly by offering any treatment you risk mis-managing expectations...even raising an iota of hope when you are in the dark yourself can be considered unethical. I agree with those who say spell it out very slowly....either you do proper work-up or do the kind thing.

RE: Collapsed cat

nikki — Tue, 05 Apr 2016 21:35:49 GMT

There are various other forms of feline cardiomyopathy than the traditional HCM. I wouldn't let a normal thickness LV put me off a diagnosis of cardiac disease. However most cats with cardiac failure present with some kind of respiratory distress due to either pleural effusion or pulmonary oedema so it would be unusual to have cardiac disease bad enough to cause the other signs without respiratory signs. I would have done the ecg as part of my echo as can be included in price of echo then. However at this point if they point blank refuse any further investigation then I'd recommend euthanasia rather than just keep guessing at treatments as you really need more information to be able to treat this cat properly.

RE: Collapsed cat

Utlendigur — Tue, 05 Apr 2016 21:05:30 GMT

[quote user="Ashlea"]pale, no obvious pain, hypothermic and tachycardic[/quote]

I think above all you really need to do a PCV since otherwise you are not going to be able to tell whether the above is due to cardiac problems or anaemia.

[quote user="Ashlea"]His respiratory rate and pattern is normal, abdomen nothing abnormal [/quote]

Which to me doesn't entirely fit with a cat collapsed due to cardiac problems - no pulmonary oedema (epsecially if the LA is enlarged?), no pleural effusion, no ascites? Anaemia would also cause hypothermia, tachycardia, may also develop thrombosis if immune mediated disease.

But as others have said, if they can't/won't pay for the basics there isn't going to be a miracle.

RE: Collapsed cat

Robin Grimmer — Tue, 05 Apr 2016 19:58:54 GMT

[quote user="Ashlea"]

The owner's being very pragmatic about this and is aware that the prognosis is likely pretty poor, they're not being demanding but have just made it very clear that investigation will be limited and today I thought fluids and ultrasound the best use of the money available. I hadn't thought about fortekor - as contractility appears so poor I'm concerned about effects on output though.

[/quote]

How about pimobendan?

RE: Collapsed cat

Bob Russell — Tue, 05 Apr 2016 18:05:39 GMT

I started to post on this but did not finish because it sounded so negative!

Cardiac for whatever reason strikes me as most likely. They never seem to end well even if resources are available.

Clare is not the only one being miserable tonight!

RE: Collapsed cat

Clare Tapsfield-Wright — Tue, 05 Apr 2016 17:58:52 GMT

I agree with Gillian and Clive. If they don't want investigation then I can't see the point of trying to medicate a stroppy cat without a diagnosis. If they take it home they need to keep it in or it's going to come to grief or disappear and die and it sounds highly likely to be a middle of the night OOH emergency which will cost them more than the work up. I am a miserable cow tonight aren't I ?

RE: Collapsed cat

Gillian Mostyn — Tue, 05 Apr 2016 17:51:33 GMT

Agree with Clive Ansell

If the client can't afford basic diagnostics, then it is pointless, and perhaps cruel, to be just guessing in this case. After all, this isn't going to be a quick fix anyway....and if they can't afford a blood sample, they can't afford long term meds and health checks.

They need to decide between PTS and reaching a basic diagnosis.

RE: Collapsed cat

Clive Ansell — Tue, 05 Apr 2016 17:51:23 GMT

[quote user="Tricia Goulden"]I would do a PCV & a BP. You could do those FOC for interest covered by the revenue from the IV fluids & OOH. If the PCV is low & BP high & no further workup allowed > PTS [/quote]

Why on earth should you do anything free of charge?

If the PCV and BP are normal, what next if no money --> PTS?

RE: Collapsed cat

Tricia Goulden — Tue, 05 Apr 2016 17:43:21 GMT

I would do a PCV & a BP. You could do those FOC for interest covered by the revenue from the IV fluids & OOH. If the PCV is low & BP high & no further workup allowed > PTS

RE: Collapsed cat

Clive Ansell — Tue, 05 Apr 2016 17:30:42 GMT

[quote user="Anthony Dennison"]Yup. There is no magic injection. Of all the potential medications that could be used, they could cause further problems if you guess wrongly as to which medication to go for.[/quote]

We don't have the full story, but if the client is unable or unwilling to embark on the most basic of investigations so you can maybe reach a diagnosis, then the only injection needed is the blue one in the DD cupboard!

RE: Collapsed cat

Ashlea — Tue, 05 Apr 2016 17:28:44 GMT

RE: Collapsed cat

Clive Ansell — Tue, 05 Apr 2016 17:26:42 GMT

[quote user="Robin Grimmer"]So they can afford an ooh consult but can't do a T4[/quote]

Seen plenty of them; ill for days/weeks/sometimes years, no money, not been to a vet, then suddenly at 3am becomes an "emergency"

RE: Collapsed cat

Anthony Dennison — Tue, 05 Apr 2016 17:25:28 GMT

you need a minimum panel - as Clive says, basic biochem will show a raised ALt if the cat is really hyperT4.

[quote user="Robin Grimmer"]Cases like this never go well when the owner wants you fix it without spending any money.[/quote]

Yup. There is no magic injection. Of all the potential medications that could be used, they could cause further problems if you guess wrongly as to which medication to go for.

RE: Collapsed cat

Robin Grimmer — Tue, 05 Apr 2016 17:20:42 GMT

Cases like this never go well when the owner wants you fix it without spending any money. So they can afford an ooh consult but can't do a T4? If it's a case of a treatment trial I would maybe try Fortekor.

RE: Collapsed cat

Clive Ansell — Tue, 05 Apr 2016 17:19:12 GMT

Why can't you do bloods? at least a basic biochem panel, pcv and T4?