Giving heart meds to a fractious cat

RE: Giving heart meds to a fractious cat

Emily Rainbow — Wed, 21 Mar 2018 15:09:21 GMT

[quote user="Kate Richardson"]

I took Emily's meaning as if there is LVOTO present there will be a murmur, rather than the way you have interpreted it?

[/quote]

yep thats the interpretation!

RE: Giving heart meds to a fractious cat

Lucy Fleming — Wed, 21 Mar 2018 15:05:48 GMT

[quote user="Kate Richardson"]

[quote user="robloxley"]

[quote user="Emily Rainbow"]or no murmur audible if you’re unsure of your echo as obstruction = mumur[/quote]

Does a murmur always mean LVOTO?

[/quote]

I took Emily's meaning as if there is LVOTO present there will be a murmur, rather than the way you have interpreted it?

[/quote]

me too (to put it another way, absence of a murmur means no obstruction, but murmur does not automatically mean outflow tract obstruction)

RE: Giving heart meds to a fractious cat

Kate Richardson — Wed, 21 Mar 2018 13:50:47 GMT

[quote user="robloxley"]

[quote user="Emily Rainbow"]or no murmur audible if you’re unsure of your echo as obstruction = mumur[/quote]

Does a murmur always mean LVOTO?

[/quote]

I took Emily's meaning as if there is LVOTO present there will be a murmur, rather than the way you have interpreted it?

RE: Giving heart meds to a fractious cat

Rob Loxley — Wed, 21 Mar 2018 13:41:43 GMT

[quote user="Emily Rainbow"]or no murmur audible if you’re unsure of your echo as obstruction = mumur[/quote]

Does a murmur always mean LVOTO?

RE: Giving heart meds to a fractious cat

David Mills — Tue, 20 Mar 2018 21:41:38 GMT

[quote user="Emily Rainbow"]Much better vs Aspirin. [/quote]

Careful. The only evidence is on preventing recurrence of ATE not preventing it in the first place.

[quote user="Emily Rainbow"]Heparin not useful[/quote]

How so?

[quote user="Emily Rainbow"]Pimobendan only if no outflow obstruction present[/quote]

Not supported by evidence alas e.g.

https://www.ncbi.nlm.nih.gov/m/pubmed/25148095/?i=7&from=Pimobendan%20cats

I like Kirean but he does overreach sometimes. Just need to apply the same critical eye to cpd as to everything else, even if the "take home message" seems nice and clear.

RE: Giving heart meds to a fractious cat

Emily Rainbow — Tue, 20 Mar 2018 20:26:28 GMT

Had a feline cardiology day with Kieran today! He’s a brilliant lecturer - and very practical with his advice!

He uses Fruseol (might be spelt wrong) liquid furosemide as allows accurate dosing and is sweet flavoured and palatable.

also use the summit clopidogrel tablets whole rather than splitting human tablets as they’re very bitter. Much better vs Aspirin. (Heparin not useful)

Pimobendan only if no outflow obstruction present (or no murmur audible if you’re unsure of your echo as obstruction = mumur.)

RE: Giving heart meds to a fractious cat

Kate Richardson — Tue, 20 Mar 2018 13:46:12 GMT

[quote user="Lucy Fleming"]given that the cat's survival may not be massively increased by meds, stress on the cat or the owner trying to give them is likely to be worse than no meds at all. [/quote]

Monitor resp rate and effort at home. Diuretics if needed- I use Libeo tablets for dogs as supposedly palatable and easy to divide giving better accuracy. Kieran Borgeat speaks regularly for ISFM and says he doesn't even get these cats back for rechecks unless it is clinically essential as the stress of bringing them in can kill them, so best managed as distantly as possible

RE: Giving heart meds to a fractious cat

David Mills — Mon, 19 Mar 2018 19:56:25 GMT

For your case in particluar:

Ideally stop meds. There is no direct evidence that the meds being given have beneficial effects for your case.

If you want to persist with the prescribed meds, things that spring to mind -

Injectable pimobendan given daily sc (pimobendan only needs sid admin in the cat)? This is way off licence obviously.

Lmw heparin or normal heparin given sq daily sid?

Your cat will probably die of a thrombus or a fatal arrhythmia, never of which imo are preventable.

I think beta blockers might have a place in some of these cats. No evidence. You can get atenolol in oral syrup form. They're the only drug that reverses hypertrophy in people.

RE: Giving heart meds to a fractious cat

Martin Atkinson — Mon, 19 Mar 2018 18:54:14 GMT

We had a cat with acute CHF due to HCM which would not take its meds. The owner is a human anaesthetist so is up to speed with the consequences of not taking the treatment and didn't want it die a horrible death so elected to have it PTS. Sometimes this is the kindest action both for cat and owner.

Ironically, it's brother has been on pre-emptive treatment for about 5 years after we discovered it had HCM (it had a murmur and was investigated whereas she didn't so we didn't investigate her), he is easy to pill and is still going strong

RE: Giving heart meds to a fractious cat

Jill Butterworth — Mon, 19 Mar 2018 18:37:47 GMT

I seem to remember someone doing an elective project about number of doses and survival and it was questionable to stress these very sick cats as they're so ultra fragile. I've seen one keel over like that having it's temperature taken.

RE: Giving heart meds to a fractious cat

Virginia Campbell — Mon, 19 Mar 2018 17:02:24 GMT

[quote user="roland bulkyn-rackowe"]

Plavix is vile when split! Give it a break for now. I've found once cats get a taste of the clopidogrel they become very suspicious. Summit reformulates clopidogrel as 18.75 mg tablets if you want to continue with it. Give the tablets whole (it looks like it has a film coating).

[/quote]

I'll say. The first time I gave it was to a partial saddle thrombus - cat not overly sore and Os wanted to treat. Doing Ok on pain meds etc. I thought we may as well start the clopidogrel in clinic while cat still an inpatient. Split the tab, pilled the (very amenable and easy to pill) cat. He was fine for a few seconds, then caught the taste of the tablet, started hypersalivating like mad.....then threw his head back, keeled over, stretched out and died the fastest cardiac death I've ever seen.

Good to know about the Summit tabs thanks!!!

RE: Giving heart meds to a fractious cat

Roland Bulkyn-Rackowe — Mon, 19 Mar 2018 15:34:27 GMT

Sorry to turbo post: the other thing I sometimes ask owners to do is s/c frusemide injections rather than tablets.

RE: Giving heart meds to a fractious cat

Roland Bulkyn-Rackowe — Mon, 19 Mar 2018 15:33:17 GMT

RE: Giving heart meds to a fractious cat

Lucy Fleming — Mon, 19 Mar 2018 11:56:41 GMT

You could try these? I had a frail hyperthyroid patient a few years back that was very similar, and he loved them so much that he tried to break in to the cupboard where they were kept. Certainly never noticed his tablets hidden in them.

https://www.amazon.co.uk/FELINE-GREENIES-POCKETS-Treats-Salmon/dp/B000JOE224

Otherwise I tend to agree, given that the cat's survival may not be massively increased by meds, stress on the cat or the owner trying to give them is likely to be worse than no meds at all.