# Cat falling over?



## Spherogirl (Apr 21, 2013)

*New Hampshire Cat Owner*

Hi!

I have a 9 year old cat named Oogie. I acquired her from a rescue group in Massachusetts and she has been my companion ever since. It seems every time I go away for a few days something ends up being wrong with her lately. As of late we have had run-ins with pothos plants, random vomiting, and what now appears to be some pain in her mouth and associated licking (going to the vet tomorrow). This site has helped me on several occasions now....even notifying me of the recent recalls of Innova cat food. 

Hoping to get some more answers by making a post very soon...


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## Spherogirl (Apr 21, 2013)

My cat fell over tonight. This is the second time this has happened now. 

The history:

The first time she fell over like this it was the middle of the night. I awoke to what I can best describe as my cat flopping on the floor. It was as if she was trying to get up and walk away but she just couldn't walk straight. My fiance immediately got up out of bed and made the cat lay down. 

After a few minutes of keeping her calm in one position, he coaxed her to walk around the room. She was walking fine, breathing fine, and acting normal. He swears she was clawing the side of the mattress (which she does sometimes) and that she must have hurt her paw. Since she does the clawing right next to my head and I don't remember waking up to the clawing, I disagree.

She seemed fine, so we just left it as a weird thing and that was that.


Shortly after this happened, Innova had their recall. I was forced to change her diet and decided to try to go with something grain free. I went with Wellness. It took some time to get her to adjust. She wasn't eating as much at first and didn't exactly seem to love it. On the second week she seemed to catch on and was eating mostly normally again.

I went away for three days to Atlanta and came back with the surprise of the cat acting completely bizarre. My fiance took care of her while I was gone. She had stopped eating the food altogether. Since we still had Innova wet food (I feed her a mix of a wet and dry) I told her to only feed her that and see what happens. She ate it. However, she was acting very funny. She was just out of touch with reality and she kept licking her "lips" over and over again. He thought she may have hurt her jaw. She was also having trouble yawning and that's what made him think that.

We brought her to the vet on my return. She had a full check up, a full round of bloodwork and they tried to take her urine but couldn't (she didn't have any in her bladder)? They gave me this tiny container of black absorbent material that I was supposed to collect her urine in. That didn't work and I've kind of let it go. She started eating and acting normally again after we gave her pain medication that the vet provided to us. Her bloodwork came back perfect. 

Fast forward to tonight - I'm sitting on the couch watching tv and the cat does the falling over thing again. This time she did claw the couch but I don't know if she did it before she started falling over or after she started falling over. I couldn't see her until she started moving forward in front of me, leaning to her left as if her left side couldn't hold her up.

We calmed her down again, coaxed her around with treats, and now she's laying down as if nothing ever happened.


Before I go back to the vet to spend another $300 on whatever tests and meds I have to pay for (which I will do because I love her)....I was hoping someone here might have some idea of what's going on here.

Sorry for the very long post. Any thoughts? Is this something I should be super concerned about?


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## wallycat (Nov 10, 2012)

My baby-girl cat had a dizzy-falling spell that freaked me out. We took her to the vet and they could find nothing...they suspected something with her ears. We treated for ear mites. No way to know if that was the issue or if there was something transient going on or what, but within 48 hours, she was back to normal. At the time, she was between 1-2 years old. She is now 8 and has not had this happen again.
Best to you and your kitty!

Epilepsy might be a possible but not sure how they can determine it or treat it.
Please post back to update us.


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## doodlebug (May 13, 2006)

Yes this is something to be concerned about....vet visit is definitely needed. Vestibular disease may be a possibility:

http://www.winnfelinehealth.org/Health/Feline_Vestibular_Disease_Thayer.pdf


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## Spherogirl (Apr 21, 2013)

Just for clarification - She is 9 years old. She has never done anything like this before. She has never had any illnesses that I have been aware of. She is an indoor cat. These two events occurred nearly two months apart. They each happened one time and she recovered as soon as we made her lay down.

Vestibular disease sounds interesting, but I don't think what they describe there is exactly what happened. Her head certainly wasn't tilted to the side nor were her eyes wildly moving. Those seem to be pretty standard characteristics of that disease. 

Here's to hoping it's just an ear infection....


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## marie73 (Jul 12, 2006)

I merged your old intro thread with this one, maybe the extra information is relevant. I hope you get some answers soon.


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## Cat Lover Lennie (Jan 7, 2013)

I would bet my litterbox that she is having seizures. Everything you described, right down to the lip licking can be attributed to seizure activity. My Katy-Did had grand mal seizures that I blamed on some boosters she had gotten shortly before. I have a very close relationship with my vet....and he did not think that was the cause. The really tough thing is that, unless she does it in the office witnessed by the vet...you probably won't get a definitive diagnosis. I asked the vet what could be causing the seizures (they were AWFUL to watch)....but she would get up when it was over and go on about life. My vet said that I would probably never know why and, unless they got really frequent, we should do nothing. He said it is a temporary short circuit in the brain and when it's over, it's over. Katy had one about every 3 weeks for 4-5 months and they were gone for good. She was about 3 then and she is 7 now.
My advice would be to have her checked out but, before you have CAT scans, MRI's or whatever, I would do nothing but keep a log of what happened, when it happened, what the symptoms are. If she just has this occasionally and is okay the rest of the time......none of those expensive tests are going to make a difference anyway. Now if the episodes happen daily or several times a week, there is medication that can be given.
Hope this helps. Believe me, I was panicked at the start. You might want to check out the Cornell Veterinary Feline Health Center online. Best site I've ever found.
Consultant=..


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## Spherogirl (Apr 21, 2013)

Thanks Marie73.


Catloverlennie - The lip licking was a completely separate event somewhere in the middle of this myriad of issues I've been having with her. It stopped after I came home and she was given pain medication.

Wouldn't a seizure involve a much more violent reaction? I haven't seen a seizure in cats...but I have seen them in humans. If they are similar at all, I'm not so sure that's what happened here either. The vestibular disease sounds closer to what it looked like.

I watched some youtube videos last night and at least the falling part looks similar. Like I said before...she didn't appear to have the wild eye movement or the head tilt....she also didn't wobble or walk stiff legged afterward.


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## Marcia (Dec 26, 2010)

Neuropathy from diabetes did a similar thing to Billy. His back legs would just go out all of a sudden. We ended up giving him insulin shots twice a day for the remaining 3 years of his life. He was 9 when diagnosed.

This is a puzzler for sure. I hope you find an answer soon.


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## Mitts & Tess (Sep 4, 2004)

Did this happen after the Innova was eaten by the cat or was this happening before?


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## laurief (Jun 22, 2008)

Sounds like seizures to me, too.


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## Spherogirl (Apr 21, 2013)

Marcia - At our last visit to the vet a few weeks ago she was cleared for diabetes. Her blood work came back perfect.

Mitts - The first time she fell was prior to the change in diet, but it was while she ate some of the recalled food. She had gone through most of the bag before I found out about it. The whole reason I found out about the recall is because she was having some stomach upset...mostly vomiting. Which cleared up with a bland diet in about a day or so. The second time she fell was last night. She is back on innova after the recall. She wouldn't eat the wellness anymore.




I really don't think this is a seizure. Her eyes don't roll back, there's nothing going on with her tongue when the fall happens, it's not violent, she doesn't shake. 

Logging the events is a great idea. Ill do that. I'm hoping that if this happens again I'm better prepared to actually observe closely what's happening. I've learned a lot from everybody's comments.


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## Justteri1000 (May 27, 2013)

Some seizures can result in nothing more than zoning out for a little while. When your cat has one of these episodes, take a close look at her eyes. Are the pupils moving left and right even though her head is not? This is a pretty good sign of seizure activity in the brain.


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## Cat Lover Lennie (Jan 7, 2013)

The seizure thing just struck home for me because of Katy having them out of the blue. Seizures come in all shapes and severities ..... from just staring into space for a little while, to momentary weakness, to full blown siezures (by the way, Katy must have had some kind of aura because she would run to the farthest bedroom in the house before it started....which would make sense because they instinctively know they are vunerable).
Please let us know if you get a diagnosis, because we are all learning from each others experiences.


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## Spherogirl (Apr 21, 2013)

Just thought I'd post an update.

So it doesn't end. Prior to our vet visit I applied some Advantage II and the kitty had a bad reaction. Normally I use Frontline (because I take her outside with me when I garden...she loves it) but I thought I'd go the cheaper route. Big mistake. She ripped open her back/neck.

So as of the day we went to the vet she had two episodes over a span of two months and a gaping wound on her back. 

The vet said she couldn't really make a determination on the spot. Oogie's ears were perfect. Oogie felt ok (no lumps, bumps, or noticeable physical issues). No fever. The vet said it sounded like it could be consistent with seizure activity but that it was way too early to talk about medication and definitely not a time to have an MRI. 

Oogie's blood work is perfect, so that rules out any causes related to liver/kidneys/internal stuff. If she is truly having seizures, the other options are tumor (cancer or non-cancer) or she could have suffered head trauma. The vet told me to observe and record what I can in terms of frequency and what happens while an episode is occurring. If the episodes start happening more frequently (multiple in a month) then we might have to talk about medication and really trying to get a handle on what's going on.

That night Oogie had another episode. It was really fast so I couldn't get it on video. I also didn't really get to see much more than I already had. 

She hasn't had an episode since. 

One thing we did notice is that the cat is acting normal again. We didn't realize it while all of this was going on. We thought she WAS acting normal before but we realize now that she wasn't. I don't know if that makes sense or not. It was such a subtle change in her personality that we just didn't see it at the time. 

We took her camping with us over 4th of July weekend. LOL She took it much better than I had anticipated. I just didn't want to leave her alone or with anyone else if she had another episode. I wanted to make sure I could observe it myself. She spent four days in my parents' 27 foot camper and received more attention in those four days than she's ever gotten in that time span. (SPOILED kitty) People can't help but love her. She's a total sweetheart of a kitty. 

I can't get her to stop scratching her back. It starts to heal and she rips it open again. Her nails are trimmed. I keep cleaning out the wound and putting liquid bandage on it. My latest plan is to buy a small doggie tshirt. I'm going to clean the wound again, put some Neosporin on it with some gauze, then put the shirt on her.

Thanks again to everyone who provided comment. I'll update this again if she has another episode. I'm sort of hoping this was a weird/freak thing going on.


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## wallycat (Nov 10, 2012)

They have nail coverings for cats that have not been declawed. That may be a temporary solution as well.
Thank you for the update. I hope continued improvement.


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## krazykiwi (Oct 21, 2012)

There's a really wide range of seizure presentations, and some of them are really subtle. One kind that I have experience is drop seizures, and they sound actually rather like what is happening with your cat. In people at least, these are a pronounced muscular stiffness, followed by a complete relaxation, which causes a characteristic drop of the head, hence the name "drop seizure". If you're unlucky the drop isn't just the head dropping, but you can fall all the way over. Sometimes it's followed by a sort of semi paralysis, where some/all of the muscles just seem frozen (but no longer tensed) and don't work right. Like Katy the cat mentioned above, I get an aura beforehand (buzzing in my ears, a weird metallic taste in my mouth) and that can be almost more disturbing than the actual episode. But I know to just sit down, so I don't risk falling over, and it'll pass.

Another pretty common kind of seizure that people are often more inclined to put down to rudeness than to epilepsy, is when the sufferer zones out momentarily, or for up to a couple of minutes, often without being aware of it. Compared to the grand mal seizure that first pops to mind when you think "epilepsy", the other kinds really don't impact quality of life too much. 

I can tell you from experience, drop seizures are much much more disconcerting to everyone around than the one experiencing it - and not saying this is what your cat is having, but if it's some kind of seizure disorder, as long as she's not hurting herself during the episodes, it's very likely bothering you a lot more than it is her. 

Sorry, got nothing to offer in the itching, but it sounds like she's doing better in general anyway


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## Spherogirl (Apr 21, 2013)

*Update 3/4/14*

So not long after I made my last post we were able to clear up the wound on her back. Liquid bandage did the trick. She didn't like it upon application, but she kept away from the wound after that.

We happily proceeded to go months without observing another "seizure" until last month. She had 3 in a span of about 3 weeks, the last one being on the night of 2/22. These presented in a much different way than before. She will be laying down, her front right paw will paddle a bit (it sort of looks like she's petting something), and she's clearly out of it. Her pupils are fully dilated and her head moves from side to side slowly, as if she is looking around the room. Total duration is less than 30 seconds. 

We took her in to the vet this past Saturday. Her previous Dr. is no longer with the practice so she is seeing someone new. This vet has a much different (more aggressive?) approach. 

The exam, itself, did not result in anything out of the ordinary aside from what I would call a significant weight loss. Since her last vet appointment last year she lost just under 3 lbs - taking her from an overweight 18lbs to about 15 lbs. We were actively trying to get her to lose weight so I don't know how much significance this has. I can say that I've had a lot of trouble getting her to lose weight for years now. Part of what she was getting tested for last year were possible thyroid issues which came back clean.

What the vet suggested was that she may have a stressed heart and that this is actually a relatively common problem in Maine Coons. The vet took more blood and performed a urinalysis. I got the results yesterday. The results show an elevated level of the protein she was testing for in the blood. They also show a small amount of blood, crystals, albumen, and calcium in urine. She hasn't yet said what any of this means beyond thinking that my cat has HCM (Hypertrophic Cardiomyopathy). 

I put my Internet Veterinarian hat on and I did a bunch of reading up on this condition and feel like Oogie's symptoms don't really match up. What I DO think matches up is hypertension caused by renal failure, which truly scares me. Everything I've read makes this sound like a doomsday diagnosis. There doesn't seem to be any real way to treat the renal failure, however; medication can be used to control the hypertension so that more damage isn't done to her organs. I don't know what to expect. 

The vet is trying to push me to put Oogie through a heart ultrasound, a stomach ultrasound, an ekg, and more bloodwork. At no point in time has she suggested simply taking the cat's blood pressure. This annoys me.

When I get the labs in hand I'll post the specific results. But does anyone have any thoughts on this? Feeling a little helpless right now and not sure what I should do. These ultrasounds and additional blood work cost a lot of money and I'm not really a proponent of torturing an animal who doesn't understand what's going on. Medication I will do. Reasonable things I will do. But if these ultrasounds and additional blood work are just for the sake of telling me what we either already know or what can be determined by less intensive means, then I'd prefer not to do them.

Note - Aside from these weird episodes, the weight loss and the lab results she is her normal happy self. She loves to eat, is consistently drinking (but not overdrinking in my opinion), she is going to the bathroom normally, and doesn't seem depressed or lethargic.


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## Spherogirl (Apr 21, 2013)

Oh I forgot to add - the reason the vet wanted to check for proteins in blood and thought the heart might be an issue is due to an observed heart murmur. She says it's rated on a scale of 1-6 and that Oogie's came in at about a 2.


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## laurief (Jun 22, 2008)

Since HCM is a common cardiac affliction of Maine Coons, I think that a cardiac ultrasound is a VERY good idea, and the sooner the better. HOWEVER, it should be performed by a veterinary cardiologist or radiologist with specific training and substantial experience in performing and interpreting feline cardiac ultrasounds. I would never trust a general practice vet to perform or interpret this test as accurately as a specialist, and you need accurate results.

Getting his blood pressure checked would be great, too, but there are a couple of potential problems with that. First, many private practice vets don't have the equipment necessary to take feline blood pressure. I have to drive 100 miles to access a vet with the equipment. Second, cats tend to stress out at the vet clinic, and that will spike the blood pressure, giving a temporary high result. Vets try to adjust for this by taking the cat's blood pressure 3-5 times in a row, then averaging the results, but this only helps if the cat eventually calms down. Getting an accurate feline blood pressure in a vet's office is iffy at best and useless at worst.

I know you said that your cat's thyroid hormone levels were tested last year, but in light of his recent substantial weight loss and heart murmur (both of which are common symptoms of hyperthyroidism), it'd be worth running another Total T4 now to see if his thyroid function has remained stable. 

A cardiac ultrasound is not invasive, and a blood test is just a needle stick. The diagnostic information you gain from them may make the difference between having your boy for a day and having him for years.

Laurie


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## Spherogirl (Apr 21, 2013)

Thanks Laurie. Oogie is a female  She did have her T4 looked at again as part of this blood work and it appears fine. I wasn't concerned about the ultrasound being invasive, but intense. 

I wouldn't even know how to go about finding a specialist nor do I know if I could even afford one. The place she goes is a veterinary hospital as well as a regular office, does that help?


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## laurief (Jun 22, 2008)

Spherogirl said:


> I wouldn't even know how to go about finding a specialist nor do I know if I could even afford one. The place she goes is a veterinary hospital as well as a regular office, does that help?


A Google search will make quick work of finding your closest veterinary cardiologists. Just Google "veterinary cardiologist", along with your state name. Any vet hospital at a university vet school would have a full range of veterinary specialists on staff, and you should be able to find private practice veterinary cardiologists, as well.

As far as expense is concerned, you may very well find that a specialist will be comparably priced, or perhaps even cheaper, than your local vet. In any event, all it takes are a few cheap phone calls to locate the specialists and ask for pricing for a cardiac ultrasound and evaluation. 

Laurie


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## Spherogirl (Apr 21, 2013)

Laurief - Thanks again for the response. I spoke to the head vet at the practice tonight. He said he personally would be performing the cardiac ultrasound and that he would be sending the results out to a specialist to be interpreted. Do you still think I should find a specialist?

I know for certain that the veterinary school at Tufts University has specialists, but they require a referral from your vet.


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## laurief (Jun 22, 2008)

Well, if it was me, and I had access to Tufts, that's where I'd go for the cardiac ultrasound. At the very least, it's worth a phone call to see how much the procedure would cost at Tufts compared to cost at your local practice. If Tuft's price was even remotely doable, I'd opt for a referral there from your local vet. Even with your local vet sending the results out for interpretation, the interpretation is still dependent on the quality of the ultrasound itself.

Laurie


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## Spherogirl (Apr 21, 2013)

I called a cat only vet in my area to confirm a few things for me in terms of cost for the ultrasound and some of the other findings. Everything seems to match up, though they provided me with a much greater sense of urgency in getting this cardiac ultrasound done. Because of this, I'm not going to mess around with waiting for more evaluation appointments before getting Oogie in for the ultrasound.

For the sake of expediency, I have decided to schedule the ultrasound with her existing vet. If something bad comes up in the ultrasound, then I will fork over the extra cash to get a second opinion either at Tufts or with the cat only vet who has a cardiologist come in to perform the ultrasound. They are also going to perform an ECG at the same time. I have opted out, for now, of performing the abdominal ultrasound. The heart thing seems much more critical to me right now.

I received her blood and urinalysis results via fax today. Here's what they show:

*Senior Screen CHEM 25 (3/2/2014)* --- (I'm only showing abnormal results)
Test  Result  Reference Range
Albumen 4.0 2.6-3.9
Calcium 11.9 8.6-10.6

*Senior Screen T4 (3/2/2014)*
Test Result Reference Range
T4 2.8 NORMAL! 0.8-4.7

*Senior Screen: CBC Comprehensive (3/2/2014)* - All NORMAL!

*Senior Screen: Urinalysis (3/2/2014)* ---- (I'm only showing abnormal results)
Collection Method - Cystocentesis
Test Result Reference Range
Blood Can't make the # out on fax but it says HIGH
RBC 6-10 0-5 HIGH

*Cardiopet ProBNP (3/2/2014)*
Test Result Reference Range
proBNP - feline 922 0-100 HIGH

Last year's blood work was performed on 5/18/2013. There was no proBNP test and no urinalysis. They couldn't get any urine from her on that day and she failed to produce in the tiny cup size amount of pellets in her litter box. All of her blood work was normal. I can say she was on the higher side of the normal range for albumen (3.7) and her T4 this time is a little higher than last time (1.7).


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## Spherogirl (Apr 21, 2013)

Sorry for the weird posting. For some reason the spaces were cut out. I tried to edit it fast enough..but didn't make the 5 minute mark. If you can't make out the results let me know and I'll clarify.


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## laurief (Jun 22, 2008)

In a senior cat, T4 is generally considered within normal limits when it is in the lower half of the reference range (T4 level typically lowers with age). When it is in the upper half of the reference range, as your cat's is now, it is advisable to perform additional bloodwork - either a Free T4 by Equilibrium Dialysis and/or a T3 Suppression Test - to clarify the condition of the thyroid. A jump from a T4 of 1.7 to 2.8 in less than 10 mos is significant, esp. in light of your cat's other symptoms.

The blood and high RBC in the urinalysis may be the result of the cystocentesis, which sometimes nicks a vein and causes blood to leak into the urine during collection.

I don't know what proBNP stands for. I'll have to do some research on that.

Laurie


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## Spherogirl (Apr 21, 2013)

The Cardiopet proBNP test is to detect the enzyme that indicates heart issues. I've read a little bit about it but don't full understand how reliable the results are.

Basically, her proBNP is off the charts bad. <100 is normal, 100-240 is concerning, >240 means something bad is happening. The vet told me on the phone, however; that he has had cats (very similar to Oogie) get an abnormally high proBNP test and have a heart that is in fine condition.

With regards to the calcium, I have read that high albumen can trigger high calcium and that high albumen could mean she was a little dehydrated at the time of the test. I've been adding water to her food since the vet appointment just to see if she's not getting enough water. I've watched her drink several times for long intervals, though, and she is peeing normally. I never thought I'd spend my days counting and recounting pee clumps in the litter box.

Good to know about the change in T4. The vet hadn't yet recommended performing additional thyroid blood work.....but had mentioned the possibility of very very early stage hyperthyroidism, at one point, as a possible cause of the heart stress.

The thing still bothering me is her weight loss. I did change her food and I was actively trying to get her to lose weight... I want to feel happy because I did something good for her that I was trying to do for a long time.....but now I just feel guilty and concerned about it and wish she was still overweight. That's a very weird feeling.


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## laurief (Jun 22, 2008)

Spherogirl said:


> The Cardiopet proBNP test is to detect the enzyme that indicates heart issues. I've read a little bit about it but don't full understand how reliable the results are.


I've been doing a bit of reading on it, too. Here are a couple of the better links I've found:

http://c.ymcdn.com/sites/www.michvma.org/resource/resmgr/sas_2013-2014_proceedings/cardiac_bnp.pdf
New studies show uses for NT-proBNP - DVM

If you read through those links, you'll see that there are a number of variables that can affect the test results, including some concurrent diseases (hyperthyroidism, hypertension, renal insufficiency, and others), how the blood sample is shipped to the lab, and others. After reading those and other links, it seems to me that the greatest value of that test is in identifying the possibility of cardiac disease to the extent of convincing pet owners to have more definitive testing performed.



> With regards to the calcium, I have read that high albumen can trigger high calcium and that high albumen could mean she was a little dehydrated at the time of the test. I've been adding water to her food since the vet appointment just to see if she's not getting enough water. I've watched her drink several times for long intervals, though, and she is peeing normally.


In my experience, cats don't drink a lot unless they ARE dehydrated. If your cat's sodium and/or total protein are at or near the high end of their reference ranges, they, too, may be indicative of dehydration. What was the result and reference range of your cat's creatinine?



> Good to know about the change in T4. The vet hadn't yet recommended performing additional thyroid blood work.....but had mentioned the possibility of very very early stage hyperthyroidism, at one point, as a possible cause of the heart stress.


I urge you strongly to insist on additional thyroid testing ... FT4ED and/or T3 Suppression. Hyperthyroidism could account for the heart murmur, rapid weight loss, and/or elevated proBNP. You need to get her thyroid status clarified.

Laurie


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## Spherogirl (Apr 21, 2013)

laurief said:


> In my experience, cats don't drink a lot unless they ARE dehydrated. If your cat's sodium and/or total protein are at or near the high end of their reference ranges, they, too, may be indicative of dehydration. What was the result and reference range of your cat's creatinine?


Sodium - 154 - Range - 147-157
Total Protein - 8.2 - Range - 6.3-8.8



laurief said:


> I urge you strongly to insist on additional thyroid testing ... FT4ED and/or T3 Suppression. Hyperthyroidism could account for the heart murmur, rapid weight loss, and/or elevated proBNP. You need to get her thyroid status clarified.


Based on what you've said, I agree completely. I'm going to suggest the FT4ED to the vet. Sounds like the T3 Suppression test might be difficult for me due to my work schedule. I don't know if I'd be able to get the pills in her 3 times a day to meet the requirements of the test.

Is this something he should have suggested right away? By the sound of it ...it seems like this should be something completely obvious. The heart condition could easily be caused by the hyperthyroidism. To what purpose is it to perform the ultrasound if we can resolve this with a blood test? If she does have HCM caused by hyperthyroidism, do you treat the heart condition first or the hyperthyroidism first?


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## Spherogirl (Apr 21, 2013)

Forgot the creatinine...

Creatinine Kinase - 140 - Range - 64-440
Creatinine - 1.7 - Range - 0.9-2.5


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## laurief (Jun 22, 2008)

Spherogirl said:


> Sodium - 154 - Range - 147-157
> Total Protein - 8.2 - Range - 6.3-8.8


Yeah, with those two and albumin at the upper end of the reference ranges, dehydration seems apparent. Dehydration is another potential symptom of hyperthyroidism.



> Based on what you've said, I agree completely. I'm going to suggest the FT4ED to the vet. ... Is this something he should have suggested right away?


It sounds like your vet is focused on the heart issue, which is pretty darned important. HyperT and HCM often occur together, and we mustn't forget about the genetic susceptibility of Maine Coons to HCM. But I see no reason why diagnostics for both can't be performed simultaneously.



> To what purpose is it to perform the ultrasound if we can resolve this with a blood test?


Even if she is hyperT, I don't know that managing that would resolve any existing HCM, esp. if the HCM is genetically based.



> If she does have HCM caused by hyperthyroidism, do you treat the heart condition first or the hyperthyroidism first?


If she has both, I assume the vets would treat both simulatneously. I also expect her progress with the meds would have to be closely monitored and adjusted, as necessary, until her condition is as stable as possible. That said, I've never had a cat with both hyperT and HCM (that I know of, anyway), so I'm making my assumptions based solely on what seems most logical to me.

Laurie


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## laurief (Jun 22, 2008)

This Google search should keep you busy for a good long while:

https://www.google.com/search?q=fel...j7&sourceid=chrome&espv=210&es_sm=93&ie=UTF-8


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## Spherogirl (Apr 21, 2013)

I've sworn off reading anything else between now and Oogie's ultrasound because I'm driving myself absolutely insane. I did speak to the vet again last night. I will say, given my lack of confidence in them, they have been very nice about talking with me whenver I call with very specific questions. 

I asked the vet if she thought it was appropriate to add the Free T4 test given a bunch of the symptoms line up with hyperthyroidism. She agreed that it is appropriate and will add it to the list of things being done on Monday, however; she truly does not believe that the heart condition is secondary to the hyperthyroidism. She is also not convinced that Oogie has hyperthyroidism, however; if Oogie does have it, it's more important than ever that we catch it early given her potential heart condition.

On top of that, when I asked about the possible prognosis for a cat with a heart condition like she assumes is there... well let's just say she didn't sound very convincing in the thought that my cat could be treated or live very long. I know they have to caveat what they say because the backlash of a loving pet owner who received the impression their cat would be just fine and wasn't can be severe......but ugh. I'm just not feeling so happy today. I hate wishing my life away but I really truly wish Monday were here and over by now.


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## laurief (Jun 22, 2008)

Spherogirl said:


> She is also not convinced that Oogie has hyperthyroidism, however; if Oogie does have it, it's more important than ever that we catch it early given her potential heart condition.


Exactly! She may not be hyperT, but you need to know for sure one way or the other. If she is hyperT, you could seek out a cardiologist who should be able to differentiate between primary and secondary HCM and give you a more specialized and experienced prognosis and treatment options ... assuming the cardiac ultrasound and ekg come back consistent with HCM.



> On top of that, when I asked about the possible prognosis for a cat with a heart condition like she assumes is there... well let's just say she didn't sound very convincing in the thought that my cat could be treated or live very long.


But she's not a cardiologist, right? When dealing with a cardiac issue, a cardiologist is the one you want providing the diagnosis, prognosis, and management protocol ... not a general practitioner. That's why there are medical and veterinary specialists.



> I'm just not feeling so happy today. I hate wishing my life away but I really truly wish Monday were here and over by now.


I don't blame you. The "limbo" stage is the worst. It's better to have answers so that you know what you're dealing with.

Wishing you the best on Monday.

Laurie


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## Spherogirl (Apr 21, 2013)

So we got through the ultrasound, ECG, and FreeT4 test.

FreeT4 results came back normal. I don't have them in my hand but anticipate asking for them to be faxed to me. 

When I spoke to the Vet yesterday after the ultrasound, he told me that there appears to be some thickening of the heart walls and therefore some heart disease is present. He didn't think, from his review of the ultrasound, that there was any heart failure. He said it was likely that Oogie was going to have to be on medicine for the heart disease but that I should wait for the cardiologist's results (obviously).

Today, I received a call from the other Vet in the office. She informed me that the cardiologist agreed with the Vet's assessment of the situation. The cardiologist said that the heart disease could be caused by hypertension or it could be hcm. There wasn't a distinction either way. The cardiologist agreed with the medication. 

Unfortunately, I was walking outside when I received the call so I wasn't able to ask too many questions. Apparently, I'm going to receive a prescription for a beta blocker. It has to be administered orally. She was wishy washy about whether or not I could crush it up and add it to her food. I highly doubt this cat will be easy to pill....I've never done it before...and I'm terrified I might make her choke on it. I don't know the dosage yet either.

I will call to ask more questions later....


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## Spherogirl (Apr 21, 2013)

And now tonight, Oogie vomited like I've never seen before. The entirety of her stomach contents came up...and I didn't think her little stomach could hold that much. This is now making me nervous.


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## laurief (Jun 22, 2008)

I'm sorry that Oogie is feeling so "oogie". If the vomiting had occurred yesterday, I'd think that it was either a reaction to the stress of the day and/or any anesthesia she may have received for the procedures. But since it's occurring today, my best guess is maybe constipation? When was the last time she pooped, and what did the poop look like?

Laurie


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## Spherogirl (Apr 21, 2013)

It appears she pooped today. It looks normal, I think. Though I'll be honest in that I didn't check the litter box yesterday. Usually, when she first gets back from the vet she doesn't want to move a whole lot. She also doesn't usually go to the litter box. Last vet appointment it took her two days to recover from the experience. I'm hoping I have a happy normal cat back tomorrow. I've just never seen her vomit like that before.

She's had an upset tummy in the past and didn't vomit anything like that. I solved it with chicken and rice for a couple of days. I'm going to see how she fares over the next hour or two...then I may see if she wants some kibble with water. It's a trick I use to get more water in her. I don't want her to be dehydrated.


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## spirite (Jul 31, 2012)

I'm sorry to hear she isn't feeling well.

Maybe a compounding pharmacy that could the meds into a different form? If it's a liquid, maybe you can get away with mixing it into wet food. If it's a pill, then you might try Pill Pockets. Or putting it in a blob of cheese, if she eats cheese. 

I hope she's okay, and that the vomiting was just a one-time thing from stress (just went through a bad experience with a vomiting cat).


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## Spherogirl (Apr 21, 2013)

And the saga continues....

After my last updates, the vet prescribed atenolol. Oogie has been on atenolol ever since, though not at the full dosage the vet had described until recently. The way things were going I didn't have very much confidence in my vet's ability to diagnose the problem so I was erring on the side of caution to see if the medication would actually have any effect on the cat first.

In the past couple of weeks Oogie has developed a much more rapid breathing pattern. I took her back into the vet to find out what has been going on. He listened to her lungs and they sounded fine. Her breath rate was sitting at around 60 breaths per minute...though much of that could have been nerves from being at the vet's office. He suggested an xray.

After reviewing the xrays with me, he concluded that Oogie likely has feline asthma. I think he put it on the print out as "bronchiectasis." There was no visible fluid in her lungs so he didn't think it was related to the hcm. He suggested that we start her on some albuterol. In the meantime, he would send the xrays off to a radiologist for confirmation. He did note that her heart murmur was still present and we adjusted her atenolol dosage.

Before investing in the aerokat, I wanted to make sure that the albuterol actually had an effect. I was able to fashion a "chamber" out of a small soda bottle with an inhaler. It didn't appear to help. Her breath rate at home has been sitting between 40-45 bpm with or without administering the albuterol.

The vet called me a few days later and said the radiologist noted a thin white line around the lungs on the xray. The radiologist said that this could either be a small amount of fluid in the lungs or it could be a small layer of fat around the lungs. He wasn't sure either way. As a result, the vet suggested we try a round of lasix (furosemide) to see if it had an effect on her breathing. Ten days later on lasix and her breathing is the same. 

Last night was a particularly bad night because she had a seizure, then she had a wheezing/coughing fit (looks like she's going to cough up a hairball but doesn't), and she was just generally not her normal self.

I called the vet today to let him know there is no change with the breathing on lasix. Now he is suggesting that I take her in for another cardiac ultrasound to see if she is in heart failure. It could still be bronchitis he says...but we have to rule out heart failure.


I'm at a complete loss. She is still eating, drinking, and going to the bathroom normally. She is generally her happy self with the exception of last night.

I don't have the money to pay for a second ultrasound and I'm not sure, at this point, if this actually does me any good. Shouldn't he be able to diagnose the bronchitis without an ultrasound if it is bronchitis? If anyone is experienced enough to review the xrays, I have them and can put them up on photobucket. 

What should I do? I just don't know what to do now.


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## Marcia (Dec 26, 2010)

I wish I could give you some concrete answer but I can't. If you are confident the vet is trying their best to come up with an answer, then I'd say just love on her as best you can and try to make her life as comfortable and happy as possible. Should the vet have been able to correctly diagnose? I dunno. It seems to be bronchitis would not cause "seizures" so I'm thinking there is much more we don't know yet. Cyber hugs to you and pets to your Oogie. I hope you both get over this hurdle soon.


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## howsefrau32 (Mar 6, 2013)

I don't have any advice to offer, just sorry that you are going through this. You have done so much to try to help her. I agree with Marcia, I would just try to keep her comfortable and if she gets to that point where she seems to be in pain, you will have some tough decisions. Was the seizure the first one she has had? If that continues to happen, you may definitely need to think about what to do next. 

It is clear you love her, and it is so heartbreaking when our cats get sick, especially since we don't know what is causing it. I jsut went through $1,000 in a week with one of my cats who would not eat and was throwing up, and we still do not have any concrete answers. I know how frustrating it is. Hang in there, and just love her and keep her as comfortable as you can.


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## Spherogirl (Apr 21, 2013)

howsefrau32 said:


> I don't have any advice to offer, just sorry that you are going through this. You have done so much to try to help her. I agree with Marcia, I would just try to keep her comfortable and if she gets to that point where she seems to be in pain, you will have some tough decisions. Was the seizure the first one she has had? If that continues to happen, you may definitely need to think about what to do next.


Definitely not her first. If you go back in the thread you'll see that the start of this mess was her having seizures in the first place.

They don't happen frequently. I have observed, on average, one per month...maybe less...over the past year or so... Has it been two years now? I forget. So you can assume they happen a little bit more than that since I work full time.


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## Spherogirl (Apr 21, 2013)

Marcia said:


> I wish I could give you some concrete answer but I can't. If you are confident the vet is trying their best to come up with an answer, then I'd say just love on her as best you can and try to make her life as comfortable and happy as possible. Should the vet have been able to correctly diagnose? I dunno. It seems to be bronchitis would not cause "seizures" so I'm thinking there is much more we don't know yet. Cyber hugs to you and pets to your Oogie. I hope you both get over this hurdle soon.


That's the problem. I'm not confident my vet has any clue what is going on here besides the obvious. Yes, she has a heart murmur. It appears from the last ultrasound that she has a slightly enlarged heart.

The seizures are likely caused by elevated blood pressure/heart murmur/supposedly diagnosed hypertrophic cardio myopathy. That's why she is on atenolol. That's why she was prescribed the furosemide. 

If it is bronchitis she has right now...that would be separate to all of the other issues we have been treating for a while now. 

Has anyone else had their cat diagnosed with bronchitis and/or feline asthma? How were they diagnosed? Is there anything I should be asking my vet to do aside from this ultrasound? Did anyone else's cat with hypertrophic cardio myopathy develop a rapid breathing pattern or a cough?


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## Mochas Mommy (Dec 9, 2013)

Mocha had HCM....she had both rapid breathing and a cough.


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## Spherogirl (Apr 21, 2013)

Mochas Mommy said:


> Mocha had HCM....she had both rapid breathing and a cough.


Thanks for sharing! Do you know if she was in heart failure at the point in time when the rapid breathing and coughing began? Were you able to get it under control and stabilized?

Just trying to figure out whether I should be in quality of life mode.... Or continuing to try to treat her. I just want her to be happy and comfortable. I don't want to put her through unnecessary treatment. Vet visits stress her out and she ends up being a zombie for a few days. I don't want to lose my kitty for a few days if they are some of the last ones I have.


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## 10cats2dogs (Jun 16, 2013)

Spherogirl,
Any updates on your girl?
Keeping All Paws Crossed for both of you!


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## Spherogirl (Apr 21, 2013)

Sorry it has been so long since I last updated. It's been a tough road trying to accept the reality of this situation.

We haven't been able to get Oogie out of Congestive Heart Failure, even with aggressive doses of medication. Since I last posted, Oogie has been put on and/or ramped up various meds. Her latest medication list is as follows:

Vetmedin
Furosemide
Atenolol
Spironolactone

Last month we had a bit of a scary day. I brought her into the vet because she was having trouble passing stool and was in serious distress. I came out of the visit with poor Oogie having both an enema and thoracocentesis. Come to find out she had about 280 ml of fluid around her heart. I was told the heart was swimming in fluid. 

The vet suggested we start her on Vetmedin. He said it's fairly controversial, but is in common use in Europe for felines with Congestive Heart Failure. Since she started Vetmedin she hasn't presented with a single seizure. I know this doesn't make any sense at all, but there's the one good thing in all of this.

Exactly one month after her thoracocentesis (last night) we had to go in for another round. There was no distress but her breathing was faster and more labored than usual.

The prognosis isn't good. Vet says that we won't get her out of Congestive Heart Failure at this point. She is basically living on borrowed time. If we can afford to keep doing thoracocentesis, we can keep her alive. However, the condition will continue to degrade and there will be a point where quality of life comes into question.

That being said, she is perfectly her normal self most days. She eats like a little piggy, goes to the bathroom normally, and is just as affectionate and happy as ever. And she is a wonderful pill-taker. I just now know that when she gets a little bit slower and lazy, it's time for her chest to be tapped.

I'm so incredibly torn at this point. I know that I can't afford to have this procedure performed indefinitely, but I can't justify putting down a cat that is her normal happy self after such a simple procedure.

Has anyone else gone through this that can comment on how they handled it? I'm really struggling here......


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## NebraskaCat (Jan 15, 2013)

I'm so sorry. You know the facts and the cat better than anyone. It will be your call to make. These kind of decisions are very personal, and heartbreaking, but always remember, the decision is never "wrong".

One thing I've learned is that it is not always a good rule to believe "the cat will tell you when it's time". Sometimes, whether for self preservation or to attempt to make their people happy, a cat will endure difficult physical hardships. They are so skilled at hiding pain.

I'm glad she's herself for you to enjoy each moment with. Cherish all the time you get together.


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## dt8thd (Jan 7, 2013)

I understand how you're feeling, and I'm sorry for what you're going through; it's really tough! *hugs* I remember when one of our previous cats began having falls, and how awful it was knowing that it was only a matter of time before we would lose him. We don't know for sure what he died of, although it was very likely a cancer of some sort; we weren't willing to put him through unnecessary procedures to officially diagnose something that, at 21 years old, the treatment for which would have just been too taxing, traumatic, and painful for what little extra time it could potentially have bought him--if it even _was_ treatable.  It was still really hard to watch him get sicker and sicker though, and we did eventually have to make the decision to have him put down. I was maybe 15 at the time, but, had it been up to me, the decision would probably have been made sooner--I still regret that he suffered as long as he did. We all thought that he would pass at home--vet trips were always really upsetting for Spunky, and my parents didn't want him to pass at the vet's, but it was too long to wait; there was no quality of life there. Less than a year later, they were much quicker to make the decision when Fraidy, also 21, got sick; which I'm sure was because of our experience with Spunky.

Galileo is my current eldest, and he's slowed down a lot in recent years. He's always had health problems, but they're beginning to catch up with him now that he's an old man (our best guess is 15-ish; he was adopted as an adult). His breathing is an issue sometimes, as a result of being hit by a car before we adopted him--his internal injuries were repaired via surgery, but his lungs and diaphragm are still affected to some extent; he's also got arthritis. As a result, he's more sedentary than he used to be, and he has difficulty jumping and climbing the stairs sometimes. Despite his physical issues though, he's still cuddly, and playful, and inquisitive, so we just keep an eye on him, make sure he gets his daily meds, and check in with the vet on a regular basis. Galileo is still enjoying his life, and any pain seems to be pretty well managed via the medications. I know that someday we are going to have to say goodbye, but, as long as the good outweighs the bad, we'll love and cherish him and do whatever's necessary to keep him around for as long as possible, provided that doing so is in Galileo's best interests.


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## cat owner again (Dec 14, 2012)

It's tough to watch decline but you have really gone out of your way for Oogie. All I can say is for me personally, I only have regretted waiting too long, not the other. To me the decision can be based on how Oogie is doing and how you are doing.


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## Spherogirl (Apr 21, 2013)

I'm sad to say this is my final update. 

Oogie made the decision for us yesterday morning. I woke up because I heard her go down the stairs. I found her at the bottom, splayed out, vomiting, and clearly in a lot of pain. She had a saddle thrombus.

I rushed her to the vet and there really weren't any other options. Her heart function has been gradually getting worse and there was no guarantee that removing the clot would result in her regaining movement of her hind legs. I was forced to put her down. It was a terribly horrifying experience and not one I'm willing to repeat.

I'm heartbroken. Really and truly heartbroken. I lost my best friend.

If anyone ever has any questions about Hypertrophic Cardiomyopathy, Congestive Heart Failure and Saddle Thrombus... feel free to message me. I'm more than willing to share my experiences if it will help someone else to make the decisions that are right for them. 

Thanks to all those who did their best to help me on here. I truly appreciate it.


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## Mochas Mommy (Dec 9, 2013)

I am so sorry for your heartwrenching loss! HCM and Saddle Thrombosis are bad words in my house too....it is what we lost my beloved Mocha to a year ago. I wouldn't wish that on any cat....so I am sorry your Oogie went through it.

I know your heart is broken right now.....she knew she was loved and you fought hard for her. While you feel heartbroken, know that the depth of that feeling is a testament to all you and she shared. Her spirit will forever be with you...open your heart and you will feel her presence with you again.


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## spirite (Jul 31, 2012)

Oh no.  I'm so, so sorry about Oogie. You did everything you could for her, but there are illnesses that you just can't cure. Having lost one of my girls recently, I know how heartbroken you are, though I didn't have to experience the awful pain of having to put her to sleep. My thoughts are with you.


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