Feline Hypertrophic Cardiomyopathy

[paschat]

Traci, I just received the Cardiologist's notes, I starred the names as I wasn't sure if we were allowed to post Dr's names on this board. This is what the Cardiologist has emailed me :

DR. ********, DIPLOMATE ACVIM (CARDIOLOGY)
PATIENT DISCHARGE & CASE SUMMARY

9 June 2008

Pet Name: Teddie L****
Referring Veterinarian: Feline Medical Clinic

Attn: Dr. G*****and Dr. K*****

CASE SUMMARY

History: Teddie presents for a recently ausculted murmur. He has no history of cardiovascular clinical signs.


Physical Examination Findings: HR 150-170bpm. There is an intermittent and seemingly heart rate dependant 1/6 murmur heard at the sternal border. Cardiac rhythm is regular. Femoral pulses are of good quality. Pulmonary auscultation is clear.


Results of Diagnostic Evaluation:


Echocardiograph: The murmur is associated with a very slight amount of mitral insufficiency. Thankfully, there is no chamber enlargement and no evidence of a cardiomyopathy at this time. Outflow patterns are normal. Systolic and diastolic functions appear normal.

Diagnosis: Mild compensated mitral insufficiency without current evidence of cardiomyopathy


Medications: None at this time


PATIENT CARE INSTRUCTIONS
I am happy to report that Teddie has only very mild cardiac changes. As we discussed, I would like to re-examine him in 9 months to gauge his degree of progression by looking at two points in time. I do not see a need for any diet or lifestyle changes right now. I feel that he should be able to undergo anesthesia without undo risk. In the unlikely event that you should notice progressive labored breathing, collapse, or paralysis of a limb prior to the time of the recheck, please give us a call, but I do believe that he should be fine in the short-run. Tel ******

Edited to remove Dr's phone number

[Traci]

That's a really favorable report! Much of the merit belongs to you, however, you've obviously taken excellent care of Teddie and regular vet checkups, he's so fortunate to have you. Now, what about a pic?

[paschat]

That's a really favorable report! Much of the merit belongs to you, however, you've obviously taken excellent care of Teddie and regular vet checkups, he's so fortunate to have you. Now, what about a pic?

Thanks Traci, the little guy has been through a lot. Here is Teddie's picture. He looks a little pudgy because he's fluffy, but he only weighs 12 pounds.

[Traci]

Oh what a cutie, look at those puddies!! Thanks for posting his pic, he's so precious!

[paschat]

Hi Traci, today Teddie had his dental. He had a teeth cleaning/polishing, six dental xrays and a cystocentesis/urinalysis while he was under anaesthetic. The vet called me this morning with the dental xray results and....well, I was surprised, but I'm in brace mode at the moment. I have always been extremely vigilant about feline dental hygiene and we always take the cats for a dental cleaning at least once a year or as the vet sees necessary, as we know that gingivitis can cause renal issues as well as pain. This year our local vet who does not have dental xray machines (he is the one we used for routine stuff like bloodwork and dental as he is closer and Feline Medical is over an hrs drive away so I use them for specialty things and complications) suggested we have dental x rays at Feline Medical for Teddie as last year they found a tooth that had broken at the gum line. Well, apparently Teddie needs 9 - YES NINE - extractions, as the xrays picked up lesions on his teeth that couldn't be seen by the human eye. I never even knew one could have feline dental xrays until my local vet told me about xrays this year (and I'm ashamed to say this is my own ignorance - I should have researched feline dental technology). Anyway it makes sense that there are issues with his teeth that cannot be detected unless an xray is done, much the same as human teeth.

The doctor went through each xray with me, and I could clearly see the problems within his teeth and a root that had 'fused' with the gumline. There is a dental specialist in Portland named Dr Frost who apparently lectures on feline dentistry, so we are trying to get Teddie in with her before the end of June. He will have to stay hopsitalized for the night due to the extensive dental work he needs.

I'm dreading what the other kittie's dental xrays will reveal. I have all their dental records from the last 5 years of cleaning, which I took with me to Feline Medical this afternoon for their files. I'm changing completely to Feline Medical Clinic, even for routine things, it's worth the long drive for my cats' health. Anyway the doctor at Feline Medical told me that cats can get lesions in their teeth even within 6 months, and that Teddie's are not severe but we have to do the surgery before they cause him pain.

Poor Teddie, he is such an angel and he's been through so much lately. He is home now, seems to be recovered from the anaesthetic and eating some food.

[Traci]

I'm confused, why did he have a dental today, when xrays revealed the need for extractions? Why wasn't this rescheduled so that the dental and extractions could be done at the same time? And isn't this vet you saw today experienced enough for extractions???

[paschat]

I'm confused, why did he have a dental today, when xrays revealed the need for extractions? Why wasn't this rescheduled so that the dental and extractions could be done at the same time? And isn't this vet you saw today experienced enough for extractions???

I asked them the same thing you just said. The vet told me they had to do the dental xrays while Teddie was under light anaesthesia. Because Teddie needs such major dental surgery they couldn't it do it yesterday, so they just did the cleaning/polishing and the xrays.

The vet told me she wanted the dental expert (who does not work at their clinic, she is in the city and travels to their clinic for surgery on a scheduled basis) to review all the xrays in case she missed anything - she said sometimes a dental xray expert can pick up things she, as a surgeon cannot. Apparently this is extensive surgery that will require a special anaesthetic and can take up to 3 hrs to do.

I don't know if it's against TOS to name the website of the clinic and the vet who I consulted with so I pm'd them to you. She's the owner of the clinic, and appears very experienced, however she says that although they do routine dental, Teddie requires specialist dentistry.