Smokey has had a wet cough for about 6 days now. It sounded like he was trying to cough up a hairball without success. I took him to the vet today. She found an audible heart murmur. I'm not sure of the grade but one is present. He had an EKG done and bloodwork (CBC and chem profile).
In addititon, and a whole body Xray done. He was not positioned straight so the heart appears enlarged. Needless to say, the Xray may need to be repeated. There appeared to be some density noted in the kidneys which warrant watching. No obstructions were noted.
All results will be availble Friday and she will then determine the course of initial treatment. Another vet will look at the Xray in a few weeks. She is r/o round worm migration, heartworm (which is very rare in cats, I understand) and determining whether he is asthmatic.
As for the heart murmur, since this is new, it is possible that he has cardiac myopathy. She mentioned him potentially seeing a vet who specializes in cardiology nearby and potentially needing to have an ultrasound performed.
Smokey is 7 years old and is 8 months post p/u. Thankfully, he is urinating successfully. He has been eating and drinking okay. He is a bit irritable..and was quite nasty and put up a heck of a fight today. Maybe that's good news. He has been through so much this year.
I'm going out of town again so he will stay at the vets Thursday evening and potentially until Monday, depending on his course of treatment and safety. They will attempt to get a stool sample.
What types of questions should I ask? Does anyone know where I can get reliable information. I may be jumping the gun, here, but I did not expect this..
Thanks in advance for your help.
Vet found a heart murmur in Smokey
Vet found a heart murmur in Smokey
Lisa, Angel Smokey and little Caz
Re: Vet found a heart murmur in Smokey
Without a clear x-ray film, I would hesitate to comment much, Lisa, for fear it was totally viewed improperly. I wonder why a second film was not done immediately? (was Smokey too stressed at the time?) Viewing the heart and lungs on a clear film are crucial when ruling out cardiomopathy or congestive heart failure (including asthma rule-out)
Unless Smokey has access to the outdoors, roundworm is unlikely. A snap heartworm test can be performed, but if your vet is hesitant, she can send out for an antigen specific if she feels heartworm is a potential. (do you have a lot of mosquitos, again does Smokey have outdoor access?)
As for the heart murmur, try not to jump the gun just yet. Not knowing the grade, impossible to comment further. It may only need to be monitored at this point, but getting a further workup on the heart will be necessary to rule out potential cardiomyopathy. In kidney failure, cardiomyopathies are common associations. But, I presume Smokey is not in kidney failure, this would of course be to his favor.
In any event, until you know more about the murmur and ruling out cardiomyopathy, try to keep his stress level reduced at all times, and absolutely no rigorous exercise or strenuous activity. This can put an overload on the heart and cause wheezing, increased heart rate and respiration problems.
Hang in there, Lisa, take one day at a time (I too, have two kitties with murmurs, one with CRF, so far the murmurs are simply being monitored)
Unless Smokey has access to the outdoors, roundworm is unlikely. A snap heartworm test can be performed, but if your vet is hesitant, she can send out for an antigen specific if she feels heartworm is a potential. (do you have a lot of mosquitos, again does Smokey have outdoor access?)
As for the heart murmur, try not to jump the gun just yet. Not knowing the grade, impossible to comment further. It may only need to be monitored at this point, but getting a further workup on the heart will be necessary to rule out potential cardiomyopathy. In kidney failure, cardiomyopathies are common associations. But, I presume Smokey is not in kidney failure, this would of course be to his favor.
In any event, until you know more about the murmur and ruling out cardiomyopathy, try to keep his stress level reduced at all times, and absolutely no rigorous exercise or strenuous activity. This can put an overload on the heart and cause wheezing, increased heart rate and respiration problems.
Hang in there, Lisa, take one day at a time (I too, have two kitties with murmurs, one with CRF, so far the murmurs are simply being monitored)
..........Traci
Re: Vet found a heart murmur in Smokey
Thank you so much for the honest advise Traci. It's good news to hear you are experiencing this and monitoring is only necessary. I know treatment is individual but it's a glimmer of hope.
Smokey was very stressed out by the X-ray, so another one was not taken today. He fought and urinated (quite a bit) on the table. His lungs looked good..(can't remember exactly what was said, but they appeared well aerated). I never thought of asking about the murmur grade, but I do know she initially did not hear the murmur when she performed a quick exam this morning. I left him at the office so the work-up could be done at their convenience. She listened again before I took him home (when he was less stressed) and it was still audible.
He does have access to the outside. I let him out sometimes for a few hours. I let him out much less than in the past..but anything can happen during those brief periods. Another good reason to make sure cats stay inside. As for the heartworm testing--the bill says its an occult test.. I don't know if quick test was done or it was sent out.
No problems with his kidneys at this time. Something positive..
I know I just have to wait and see. It could be anything right now. He coughed only once while at the vet and it was witnessed by the vet techs. I was told it sounded like a wet hairball cough but I understand it's cause can still be asthma-related.
I will probably have him seen by the vet cardiologist and have an ultasound done for both our benefits.. I'm fotunate enough to be in a position to put it on my charge card and deal with it later. I only want the best for both my guys.
My house is very low-keyed. It's just me and the boys. He'll only get stressed when it's off to the vets we go.
I'll update when I get more info.
Thank you again Traci for sharing your expertise and being there...
(I apologize for the long posts)
Smokey was very stressed out by the X-ray, so another one was not taken today. He fought and urinated (quite a bit) on the table. His lungs looked good..(can't remember exactly what was said, but they appeared well aerated). I never thought of asking about the murmur grade, but I do know she initially did not hear the murmur when she performed a quick exam this morning. I left him at the office so the work-up could be done at their convenience. She listened again before I took him home (when he was less stressed) and it was still audible.
He does have access to the outside. I let him out sometimes for a few hours. I let him out much less than in the past..but anything can happen during those brief periods. Another good reason to make sure cats stay inside. As for the heartworm testing--the bill says its an occult test.. I don't know if quick test was done or it was sent out.
No problems with his kidneys at this time. Something positive..
I know I just have to wait and see. It could be anything right now. He coughed only once while at the vet and it was witnessed by the vet techs. I was told it sounded like a wet hairball cough but I understand it's cause can still be asthma-related.
I will probably have him seen by the vet cardiologist and have an ultasound done for both our benefits.. I'm fotunate enough to be in a position to put it on my charge card and deal with it later. I only want the best for both my guys.
My house is very low-keyed. It's just me and the boys. He'll only get stressed when it's off to the vets we go.
I'll update when I get more info.
Thank you again Traci for sharing your expertise and being there...
(I apologize for the long posts)
Lisa, Angel Smokey and little Caz
Re: Vet found a heart murmur in Smokey
Lisa, just wanted to wish you the best of luck with Smokey. I hope that everything turns out okay! Please keep us posted!
ashley
"Of all God's creatures, there is only one that cannot be made slave of the leash. That one is the cat. If man could be crossed with the cat it would improve the man, but it would deteriorate the cat." Mark Twain
"Of all God's creatures, there is only one that cannot be made slave of the leash. That one is the cat. If man could be crossed with the cat it would improve the man, but it would deteriorate the cat." Mark Twain
Re: Vet found a heart murmur in Smokey
Lisa, sorry to hear about Smokey's problems. 
rocky had a heart murmur once as well, but after monitoring it was determined to be related to stress at the time it was noticed.
really glad to hear about him urinating properly, i know all about that now!
rocky had a heart murmur once as well, but after monitoring it was determined to be related to stress at the time it was noticed.
really glad to hear about him urinating properly, i know all about that now!
Re: Vet found a heart murmur in Smokey
Heh, don't mind long posts, I love thoroughness, it really helps 
The occult was probably the snap test done right there in the office. Our clinic now automatically includes it when sending superchems out to another lab. While in cats, it is still considered rare, one important thing to mention is that it is often misdiagnosed, simply because in years before, it was so commonly recognized in canines. Now that we know it's more difficult (to treat) in felines, vets are taking extra precautions.
If heartworm is eventually ruled out, please, talk to your vet about heartworm preventative, it only takes one female mosquito to infect, I'd hate for your kitties to become statistics (no matter how infrequent you let them outdoors). Ruling it out completely however, would probably require an antigen assay to an outside lab. If other differentials provide more insight to the heart problem or congestion, your vet can then talk to you in greater detail about heartworm preventative.
Cuddles' and Charlie's murmurs are both grade IV, not what I was hoping for, but so far (knock on wood), no apparent problems. They're both getting a recheck soon, with x-rays to monitor heart size. Charlie is a little congested at the moment, and sometimes it scares me, but I know that the potential is there and I just take one day at a time, knowing I will treat however necessary for the time. Cuddles has CRF and I would have thought she would have the bigger problems, but she's a trooper and hanging in there with no additional problems.
It is really best to focus on the moment, and try not to think too far into the future during the diagnostic stage. If you fret and worry, you're not helping yourself or them.....just take it one day at a time and you will be better prepared to handle what comes your way, if anything. I know it's hard not to worry, heh, but keeping a positive attitude helps a great deal.
Thanks for elaborating on the event at the clinic. We generally do not like to perform too many radiographs on a stressed kitty. As you witnessed, the films can turn out really bad and are a total waste. It could also be that next time, you might have a more experienced and adept tech to get the x-ray shot perfectly clear (sometimes, it's pure luck ). You really do need clear x-rays though at this point to proceed further.
If you are truly in the position to get an ultrasound by a cardiologist, you will have more peace of mind, and of course, more expertise to guide you, but don't jump the gun just yet, wait for the remaining labs, r/o parasitic, etc and go from there.
I know it's scary, but you gotta hang in there. Smokey's a trooper, that's for sure.....keep us updated.
The occult was probably the snap test done right there in the office. Our clinic now automatically includes it when sending superchems out to another lab. While in cats, it is still considered rare, one important thing to mention is that it is often misdiagnosed, simply because in years before, it was so commonly recognized in canines. Now that we know it's more difficult (to treat) in felines, vets are taking extra precautions.
If heartworm is eventually ruled out, please, talk to your vet about heartworm preventative, it only takes one female mosquito to infect, I'd hate for your kitties to become statistics (no matter how infrequent you let them outdoors). Ruling it out completely however, would probably require an antigen assay to an outside lab. If other differentials provide more insight to the heart problem or congestion, your vet can then talk to you in greater detail about heartworm preventative.
Cuddles' and Charlie's murmurs are both grade IV, not what I was hoping for, but so far (knock on wood), no apparent problems. They're both getting a recheck soon, with x-rays to monitor heart size. Charlie is a little congested at the moment, and sometimes it scares me, but I know that the potential is there and I just take one day at a time, knowing I will treat however necessary for the time. Cuddles has CRF and I would have thought she would have the bigger problems, but she's a trooper and hanging in there with no additional problems.
It is really best to focus on the moment, and try not to think too far into the future during the diagnostic stage. If you fret and worry, you're not helping yourself or them.....just take it one day at a time and you will be better prepared to handle what comes your way, if anything. I know it's hard not to worry, heh, but keeping a positive attitude helps a great deal.
Thanks for elaborating on the event at the clinic. We generally do not like to perform too many radiographs on a stressed kitty. As you witnessed, the films can turn out really bad and are a total waste. It could also be that next time, you might have a more experienced and adept tech to get the x-ray shot perfectly clear (sometimes, it's pure luck
). You really do need clear x-rays though at this point to proceed further. If you are truly in the position to get an ultrasound by a cardiologist, you will have more peace of mind, and of course, more expertise to guide you, but don't jump the gun just yet, wait for the remaining labs, r/o parasitic, etc and go from there.
I know it's scary, but you gotta hang in there. Smokey's a trooper, that's for sure.....keep us updated.
..........Traci
Re: Vet found a heart murmur in Smokey
Traci, Ashley, Jason...Thanks for the insight and support. I'm in denial right now so the my stress level is low and I'm just waiting. I have a medical background, so I am familiar with the terminology, although my cat motherly instincts take over and I too forget to ask questions. So, I'm a sponge for information but leave the diagnoses and treatment up to the experts. There are 3 vets at the clinic and they discuss and make decisions together. As I mentioned, outside vets are brought in too so that's good.
A few other things I forgot to mention. His lungs were not congested...As for the mosqouites, they are around, not too bad, but present. A few birds nearby have been found with West Nile..never a good thing.
I hope Charlie and Cuddles stay on the healthy side. We always want the best for our furbabies.
I'll post on Sunday night or Monday with an update. In the meantime, I'm hanging tight .
Thank you all again!!
A few other things I forgot to mention. His lungs were not congested...As for the mosqouites, they are around, not too bad, but present. A few birds nearby have been found with West Nile..never a good thing.
I hope Charlie and Cuddles stay on the healthy side. We always want the best for our furbabies.
I'll post on Sunday night or Monday with an update. In the meantime, I'm hanging tight .
Thank you all again!!
Lisa, Angel Smokey and little Caz
Re: Vet found a heart murmur in Smokey
Smokey came home from the vets today. I spoke with my vet at length on Friday and again today.
Heart murmur was a grade II/III and difficult to hear. ECG results showed no arrythmia or conduction problems however a there was a left sided shift ?? (I believe that it was she said) that could indicate cardiomypathy. No other problems were noted on the ECG. His X-ray was repeated, but still not the best positioning. Smokey was quite feisty I understand (maybe that a good sign).
Serum Chem tests and T4 tests was WNL; Heartworm was negative (results via antigen testing) Fecal specimen for roundworm was obtained today and I don't know the results. I am feeding him a prescription diet for control of the c/o crystals. The dry food has a higher sodium content than other rx diets so for now, I'll feed him more wet food and limit the dry (based on the advise of my vet and the company) and will re-evaluate after the ultrasound. I have this scheduled test for next Tuesday.
He is prescribed Aminophylline 25 mg twice a day for now. She doesn't want to start any other meds until after the ultrasound. I haven't heard him cough yet today, but I only came home awhile ago. While at the vet, they heard his cough once on Friday and it sounded dry rather than wet. Not to say, he didn't cough more and no one was around to hear because it was the weekend.
Needless to say, Caz and I are very happy to have him home and he is acting as if all goes fine. I'm keeping my fingers crossed and hoping for the best.
I think that's all for now. Thanks for the help and support.
Heart murmur was a grade II/III and difficult to hear. ECG results showed no arrythmia or conduction problems however a there was a left sided shift ?? (I believe that it was she said) that could indicate cardiomypathy. No other problems were noted on the ECG. His X-ray was repeated, but still not the best positioning. Smokey was quite feisty I understand (maybe that a good sign).
Serum Chem tests and T4 tests was WNL; Heartworm was negative (results via antigen testing) Fecal specimen for roundworm was obtained today and I don't know the results. I am feeding him a prescription diet for control of the c/o crystals. The dry food has a higher sodium content than other rx diets so for now, I'll feed him more wet food and limit the dry (based on the advise of my vet and the company) and will re-evaluate after the ultrasound. I have this scheduled test for next Tuesday.
He is prescribed Aminophylline 25 mg twice a day for now. She doesn't want to start any other meds until after the ultrasound. I haven't heard him cough yet today, but I only came home awhile ago. While at the vet, they heard his cough once on Friday and it sounded dry rather than wet. Not to say, he didn't cough more and no one was around to hear because it was the weekend.
Needless to say, Caz and I are very happy to have him home and he is acting as if all goes fine. I'm keeping my fingers crossed and hoping for the best.
I think that's all for now. Thanks for the help and support.
Lisa, Angel Smokey and little Caz
Re: Vet found a heart murmur in Smokey
glad to hear the good report, do let us know as things progress.LisaLisa wrote:Smokey came home from the vets today.
Needless to say, Caz and I are very happy to have him home and he is acting as if all goes fine. I'm keeping my fingers crossed and hoping for the best.
I think that's all for now. Thanks for the help and support.
Re: Vet found a heart murmur in Smokey
Hi Everyone,
I wanted to update you on Smokey. His ultrasound done today shows he has significant heart disease.
The vet cardiologist says he has genetic subaortic stenosis with fairly significant concentric hypertrophy. He will be started on Cardizem CD 30 mg a day. I will take him in for thryoid testing and EKGs every 3-4 months. This cardiac finding appears to be an incidental finding and he does not believe it is related to his coughing.
In that area, his cough has improved but still present. Pilling him has proved to be a challenge and I've found a number of pills in various places in my house. He will be evaluated in 7-10 days hoping his cardiac status improves so a transtracheal aspiration can be done to determine the cause of the cough (bacterial, viral, fungal, or asthma) so the proper treatment can be given.
This is not the news I was hoping for, but I do know that he is getting very good care. He is 7 years old, and hopefuly he will respond to treatment and he will still have a good 3-5 years left in his life. I know he's very happy here and is going anywhere yet.
but he's not too happy about being shaved for the bloodwork last week and now the ulrasound.. 
I wanted to update you on Smokey. His ultrasound done today shows he has significant heart disease.
The vet cardiologist says he has genetic subaortic stenosis with fairly significant concentric hypertrophy. He will be started on Cardizem CD 30 mg a day. I will take him in for thryoid testing and EKGs every 3-4 months. This cardiac finding appears to be an incidental finding and he does not believe it is related to his coughing.In that area, his cough has improved but still present. Pilling him has proved to be a challenge and I've found a number of pills in various places in my house. He will be evaluated in 7-10 days hoping his cardiac status improves so a transtracheal aspiration can be done to determine the cause of the cough (bacterial, viral, fungal, or asthma) so the proper treatment can be given.
This is not the news I was hoping for, but I do know that he is getting very good care. He is 7 years old, and hopefuly he will respond to treatment and he will still have a good 3-5 years left in his life. I know he's very happy here and is going anywhere yet.
but he's not too happy about being shaved for the bloodwork last week and now the ulrasound.. Lisa, Angel Smokey and little Caz