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Two year old male - confusing/terrifying health issues, could use some insight.

maximusprime

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sorry, folks, this will be long, but i'm looking for some insight from people who might have on the ground experience with this. i could probably bottom line this, but i feel like the details could be relevant. the tl;dr is that they just found a grade 2 murmur in my boy, so obviously i fear hcm. the problem is, i also fear that there's something else going on, so i wanted to run his symptoms past everyone. particularly interested in feedback from those with hcm kitties, but if anything i write here inspires an unrelated flash of brilliance, please do share. (sorry, no idea why my font got weird here.)

in may 2014, max had a consolidated left lung. after several treatments failed over the course of three weeks, it was finally determined that he had mycoplasma felis, and a course of baytril corrected the problem and he's been fine ever since. (at the same time, he was diagnosed with herpes.) that's not necessarily relevant to the current situation, but will go toward explaining the series of recent events.

fast forward to august 17. he developed a sneeze with no other symptoms. activity seemed normal, no vomiting or fever or anything like that. normal activity, everything absolutely fine (seemingly) other than the sneeze. however, on the 20th, i took him in to be checked out just in case. figured it was a herpes flareup, but given his history and the likelihood of secondary infections taking hold, i wanted to have him checked out. his vet - not the one who normally sees him, but another doc in the clinic that day - confirmed my home-diagnosis and sent me home with ointment for his eye, which had mild conjunctivitis.

by the 23rd, he had developed some nasal congestion, but fluids were clear, and apart from the sneezing, he had no other symptoms. however, on the 24th, he coughed after eating an l-lysine treat. it was a strange, shallow little cough, almost like you do when you're clearing a stuck piece of popcorn from your throat, and since the treats were dry, i thought perhaps that was the issue. just a throat clearing.

however, later that evening, he vomited his dinner about 30 minutes after eating. i was immediately alarmed because he never vomits, but chose to simply keep watch. long story short, over the course of the next three days, i saw the cough several times, and he vomited once more. the cough always occurring after eating, and sometimes randomly, later on. so, on the 27th, i took him back to the vet - this time he saw the one we normally see, whom i've always trusted implicitly due to not only my history with her with our other pets, but also due to the fact that she saved his life fifteen months ago.

she was not alarmed at all (for various reasons not necessarily important) and sent us home without labs or anything, but she did mention he was down a few ounces from his visit seven days prior. from 8.9 to 8.3. she wasn't particularly concerned because his history has him normally at around 8, but she told me to watch his weight. i advised that his activity level and food intake had decreased slightly, but she chalked this up to him feeling basically under the weather, which made sense to me, though i just had this nagging little feeling...

the following morning, i was finally able to capture one of his coughing fits on video, and t his time, it didn't look like it had the prior few days - it looked like the deep cough from before. i immediately emailed the video to her, and she had me bring him back in for xrays. so i did.

his lung is not consolidated this time around, which is good, so she decided to treat this like asthma, as she HAD noted "bronchial activity" in the xray. this felt wrong to me, but i couldn't place it, and i'm not a doctor, so.

she prescribed baytril to ward off secondary infection, that terb-stuff that i'm too lazy to look up for his breathing, and - this is key - prednisolone. i shelled out a small fortune for the meds and went home with a very nagging, concerned feeling about the steroid. however, i administered the meds as directed friday night, saturday, and this morning.

however, here's the thing. max is normally extremely active and rambunctious, but for the last few days, has been very skittish, inactive, and jumpy. sometimes when i pick him up, he freaks out like i'm hurting him. he's extremely tentative even when crossing the room, like he has to think about it first, and then all the way across. his vocalizations have reduced to a minimum, and when he does talk to me, his voice is completely different. very weak and tinny. he sleeps a lot, isn't eating as much as usual (still interested, but doesn't pig out like he normally does - normally he chases me around all over the house all day asking for food. he eats about half what i put down, now, and doesn't show any interest in eating till the next time i put food down, and even then i have to beg. i've taken to just giving him fancy feast to entice him to eat as much as possible.

this morning i worked myself up into a near panic over all of this, in addition to a couple of brief coughing fits as he slept, and did some research and finally googled exactly the right terms that led me to what i've feared since i got him - hcm. i immediately checked for prednisolone in hcm patients and discovered it is absolutely verboten. between this and my sense from the beginning that my vet was missing something (and concerned about the fact that we hadn't done labs), i took him into the emergency clinic.

his vitals were good, everything checked out perfectly. i was horrified, however, to see him weigh in at 8.1. that's two ounces in three days, eight ounces in ten. then doc listened to the heart, and found a murmur that he put at grade 2. i immediately mentioned the steroid - "i have to take him off this" - and doc agreed, and assured me it was fine to stop him cold without tapering since he'd only received four doses.

based on everything i've read, this all looks like hcm to me, but i'm just stunned that he would go from absolutely fine 13 days ago to clearly sick at this point. i asked them to run labs just to be sure, and everything came back clean, other than low K. (3.4 - low range of normal starts at 3.5.)

so, that's the history. speculation, experiences, suggestions, commentary welcome. in the meantime, obviously i plan to take him to a cardiologist, but this just all looks SO strange to me that i'd love any and all feedback.

thank you for reading, and for any insight. i'm desperate and heartbroken. i cannot tell you how much i love this cat, and i probably don't need to. it's killing me, watching his movements now. also, his breathing appears to be slightly labored, but i honestly don't know if that's legitimate or if i'm just staring too hard at this point.
 

Catzzzmeow

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@maximusprime Sorry trying to read through your thread...did you have an echocardiogram done? That will be the only true way to diagnose HCM. Having a murmur is not a death wish. Our boy who is 13 has had a grade 2 murmur since being a kitten.

I totally understand being freaked, concerned and everything else that goes into being a cat parent. We are here for you. Positive vibes are sent.


Patti
 

maximusprime

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thank you so much. i'd be worried far less about hcm if it weren't for the diagnosis of the murmur coinciding with all these other symptoms. they have me terrified.

no echo yet - i'll be getting one as soon as possible, though. waiting for a recommendation from both my vet and amanda at hairless hearts.

Sorry trying to read through your thread...did you have an echocardiogram done? That will be the only true way to diagnose HCM. Having a murmur is not a death wish. Our boy who is 13 has had a grade 2 murmur since being a kitten.

I totally understand being freaked, concerned and everything else that goes into being a cat parent. We are here for you. Positive vibes are sent.


Patti
 

Catzzzmeow

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@maximusprime The echos can be quite pricey...see if there are any shows/clinics in your area to help keep cost in line. I have never been so lucky, but have heard others score with discounted prices. You might just as a back up line up a possible second opinion, but it sounds like your vet is attentive.

Murmurs can be just simply that... a murmur and I hope in your baby's case that is it. If your baby is diagnosed with HCM, there are several members who will be able to chime in and make suggestions and share how they have been able to stabilize things.

Just never lose sight your baby knows nothing but this moment...don't forget they just want love and they feel it now. If that is your forever goal then your baby is beyond lucky.


Patti
 

maximusprime

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your last comments brought tears to my eyes. i love this guy so much. i've never known anyone like him, human or feline. he's my guy.

i AM fortunate enough to have low cost clinics in my area, but they come through twice a year. $150. next isn't till october, though, and i can't wait six weeks.

this whole thing has already cost me about $700 for what has turned out to be nothing other than ruling out more obvious culprits, but i guess that's the way it goes. i certainly can't let this go. i just hope he doesn't worsen, at least before we figure out what is going on.

thank you so much, again, for taking the time to comment.

@maximusprime The echos can be quite pricey...see if there are any shows/clinics in your area to help keep cost in line. I have never been so lucky, but have heard others score with discounted prices. You might just as a back up line up a possible second opinion, but it sounds like your vet is attentive.

Murmurs can be just simply that... a murmur and I hope in your baby's case that is it. If your baby is diagnosed with HCM, there are several members who will be able to chime in and make suggestions and share how they have been able to stabilize things.

Just never lose sight your baby knows nothing but this moment...don't forget they just want love and they feel it now. If that is your forever goal then your baby is beyond lucky.


Patti
 

ZiggyStardust

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::HUGS:: I know that awful feeling of a murmur diagnosis and waiting for a scan. My Cornish Rex has HOCM (obstructed HCM). For lowering cost of a scan you can check if there's any vet schools in your area. Ash is scanned at NCSU vet school for $200 for the entire visit.
You are correct that prednisolone is not good for him if it is HCM, so it's good you stopped that until you can get a scan. Though the murmur still could be just stress. Did you notice if he was swallowing after the cough? Did it look like this?:

Dropbox - IMG_0258.mp4

If so, it could just be bronchitis. Ash had that. I was panicked by the cough, but the tale-tell swallowing at the end made the vet suspect bronchitis and a lung x-ray showed some cloudiness. My vet indicated that it is rare for a cat to present with coughing for a heart issue - that it is usually dogs that do - though not to say they absolutely can't, but it's unusual.

Praying for a positive outcome with the scan! Do keep us updated.
 

maximusprime

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it does look kind of like that, yes! he does swallow afterward. the cough doesn't sound exactly the same (it's more... simultaneously shallow but also sharper than that, which i don't think makes sense, but it's hard to describe), but the swallowing is extremely similar, and something i've told the vets about. and the coughs ARE short like that.

she didn't mention the xray being 'cloudy,' she just said 'bronchial activity', but maybe it's the same thing, i don't know. because the left lung was entirely consolidated a year ago, it's possible she was so focused on looking for that and not seeing it that she didn't feel inclined to go into further detail about what WAS there, which i can understand. i'm going to be speaking with her tomorrow i'm sure, since i blew her up with emails today, and since i'm pretty sure she won't like me going "over her head" re the pred. :) i'll ask her about it. she didn't mention bronchitis, but she did say she wants to treat as though it's asthma (hence the prednisolone).

i know you aren't a doctor, but would you say to not give pred even if it IS bronchitis, given the murmur? that's how it seems to me. either way i'm definitely not giving the second dose tonight, and have no intention of giving him any beyond that, but now i'm confused. the er doc did say to still give him terbutaline, so hopefully that will suffice...

that's a really good tip re the vet schools - i'll look into it. amanda at hairless hearts got back to me and already has him on the october list, with a referral to the attending in the meantime (it's weird that if i go in now, i'll pay full price, whereas if i could wait till october, the same doc would charge only $150), but i'm going to look to vet schools too, since the thing right now is the scan, and the cardiologist can come later.

to be honest, though i'm not hoping it's hcm, if it's not, then we still don't know what's causing these symptoms. 'treating for asthma' doesn't mean it IS asthma, after all. did your baby (or the one in the video, anyway), present with lowered activity/appetite, during the bronchitis?

(i feel like i'm all over the place here, but i'm so scatterbrained right now. i've had max since july 2013 and knowing how sphynxes are, i've viewed every day as a gift, knowing he could be snatched from me, but it's not like i'm actually ready for that to happen. it's strange, i feel like only other sphynx moms and dads get the bond. losing him would be having my heart torn out. i'd always be grateful for my time with him, i'm just not ready for it to end, and even if it's not anywhere near that, watching my feisty, bit-of-a-jerk baby go from jumping around and wreaking havoc to tentatively crossing the floor and being wary when anyone goes to touch him, it just breaks my heart.)

thank you so much for the comment, and the video. it's the first one i've seen that looked like what he's doing, and i've been looking for days. so even just seeing something that looked familiar helped.


::HUGS:: I know that awful feeling of a murmur diagnosis and waiting for a scan. My Cornish Rex has HOCM (obstructed HCM). For lowering cost of a scan you can check if there's any vet schools in your area. Ash is scanned at NCSU vet school for $200 for the entire visit.
You are correct that prednisolone is not good for him if it is HCM, so it's good you stopped that until you can get a scan. Though the murmur still could be just stress. Did you notice if he was swallowing after the cough? Did it look like this?:

Dropbox - IMG_0258.mp4

If so, it could just be bronchitis. Ash had that. I was panicked by the cough, but the tale-tell swallowing at the end made the vet suspect bronchitis and a lung x-ray showed some cloudiness. My vet indicated that it is rare for a cat to present with coughing for a heart issue - that it is usually dogs that do - though not to say they absolutely can't, but it's unusual.

Praying for a positive outcome with the scan! Do keep us updated.
 

ZiggyStardust

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it does look kind of like that, yes! he does swallow afterward. the cough doesn't sound exactly the same (it's more... simultaneously shallow but also sharper than that, which i don't think makes sense, but it's hard to describe), but the swallowing is extremely similar, and something i've told the vets about. and the coughs ARE short like that.

she didn't mention the xray being 'cloudy,' she just said 'bronchial activity', but maybe it's the same thing, i don't know. because the left lung was entirely consolidated a year ago, it's possible she was so focused on looking for that and not seeing it that she didn't feel inclined to go into further detail about what WAS there, which i can understand. i'm going to be speaking with her tomorrow i'm sure, since i blew her up with emails today, and since i'm pretty sure she won't like me going "over her head" re the pred. :) i'll ask her about it. she didn't mention bronchitis, but she did say she wants to treat as though it's asthma (hence the prednisolone).

i know you aren't a doctor, but would you say to not give pred even if it IS bronchitis, given the murmur? that's how it seems to me. either way i'm definitely not giving the second dose tonight, and have no intention of giving him any beyond that, but now i'm confused. the er doc did say to still give him terbutaline, so hopefully that will suffice...

that's a really good tip re the vet schools - i'll look into it. amanda at hairless hearts got back to me and already has him on the october list, with a referral to the attending in the meantime (it's weird that if i go in now, i'll pay full price, whereas if i could wait till october, the same doc would charge only $150), but i'm going to look to vet schools too, since the thing right now is the scan, and the cardiologist can come later.

to be honest, though i'm not hoping it's hcm, if it's not, then we still don't know what's causing these symptoms. 'treating for asthma' doesn't mean it IS asthma, after all. did your baby (or the one in the video, anyway), present with lowered activity/appetite, during the bronchitis?

(i feel like i'm all over the place here, but i'm so scatterbrained right now. i've had max since july 2013 and knowing how sphynxes are, i've viewed every day as a gift, knowing he could be snatched from me, but it's not like i'm actually ready for that to happen. it's strange, i feel like only other sphynx moms and dads get the bond. losing him would be having my heart torn out. i'd always be grateful for my time with him, i'm just not ready for it to end, and even if it's not anywhere near that, watching my feisty, bit-of-a-jerk baby go from jumping around and wreaking havoc to tentatively crossing the floor and being wary when anyone goes to touch him, it just breaks my heart.)

thank you so much for the comment, and the video. it's the first one i've seen that looked like what he's doing, and i've been looking for days. so even just seeing something that looked familiar helped.

Yes, Ash was feeling under the weather during his bronchitis. Ash did take pred for it, but we had a conference between his cardiologist and his vet regarding the dosage and the status of his HOCM. At that time, it was stable and at a mild level so they both felt a low dosage for a limited time would be okay. And he did do fine on it. However, now that his disease has progressed, I would not put him on it again. So if Max were mine, I would want to know IF he has HCM and if he does, what stage it's at before I'd use pred.

Believe me, I understand. Knowing Ash has HOCM and seeing him cough had me in a panic. And here, you don't know if Max has just a stress murmur or something more, so it has to be a worry. It was nearly a month before we could get Ash in for his first scan after the vet heard the murmur and he put it at a 4/5. I have my fingers crossed and am sending prayers it is just the stress of being ill with something like bronchitis that is causing the murmur and hope with some antibiotic treatment he'll be right as rain soon!
 

Xandria

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I am so sorry to hear of the news. You sound like a fabulous feline parent. Kudos to you. And it's also nice to see another one with a feline companion named Max!

I have nothing else to offer than what others already have. But I am sending you some healing vibes. Please take care of yourself as well as your companion in these times. Hugs.
 

Hairless Blessing

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Bless his heart and yours. I know it will cost more, first, I would
see about the Vet School and then, I don't think I would wait until, October.
It won't change the results, if it's hcm, but, you'll know and treatment
can start sooner. Will be praying for your baby and you.
Be sure to keep us updated.
 

maximusprime

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a few things have been uncovered in the past few days.

activity levels are the same (low - no jumping, absolutely NO running). still eating, but not nearly as interested. pretty much stays in the same place all day and night. (as an experienced pet owner, i know this isn't good. as a max-lover, i REALLY know this isn't good. he's not even chasing me down for the turtle's mealworms anymore, and is in fact refusing them. and the treats he loves, he sniffs at and walks away from.)

the cough is more infrequent, so there's that, but it offers no solace.

he has an appointment on friday, being moved up to thursday, for an echo.

in the meantime, they finally noticed that his heart is enlarged on the x-ray that was taken last friday - just got word of that today. this in combination with the murmur doesn't bode well.

also noticed increased pulse in his jugular. my son took horrifying video of this yesterday, and i saw it for myself tonight.

his distended belly could be because i'm intentionally overfeeding him, but it could also be fluid in abdomen. given his bony back and butt bones, this seems possible. (vet confirmed an hour ago that they don't know, because the x-ray didn't include abdomen.) at this point, i'm even concerned about DCM, which seems even *worse*, if such a thing is possible. i'm also concerned that he's already in early CHF, though the myriad vets i've been talking to aren't quite as.

just hoping he stays steady until i can get him in for the test.

in the meantime, and this is far too personal but it makes things even more difficult, my husband isn't exactly supportive. "you knew this was a risk."

so these are difficult days.

here's my beauty, taken yesterday.
 

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maximusprime

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Bless his heart and yours. I know it will cost more, first, I would
see about the Vet School and then, I don't think I would wait until, October.
It won't change the results, if it's hcm, but, you'll know and treatment
can start sooner. Will be praying for your baby and you.
Be sure to keep us updated.

i'm actually just taking him in to probably the most expensive cardiologist in the area. not on purpose, but she's renowned, and did his first scan. (well, i mean, it IS on purpose because she's renowned and he's seen her before, but not on purpose as far as the expense. :) ) though i'm probably pushing him up a day - he can't see her, but will see a resident onsite. i'd prefer she see him from the get, since she's the one i want under his care ongoing, but at this point i just need that scan. his vet offered to call in her traveling cardiologist as early as tomorrow, for less, but max won't be under his care and i'll have to pay for the one i want to examine him anyway. i just don't feel like i can shop around for this.

i'm just hoping max doesn't decline before thursday morning. this is so hard. thank you so much for your kind comments and thoughts, we could really use them and i truly appreciate it.
 
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ZiggyStardust

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So sorry there seem to be other symptoms. Good you're getting him in sooner rather than later. But don't give up hope yet! If there is something wrong with his heart they can get him started on medication. Remember, there's no expiration date stamped on the bottom of his paw! We're here for you! ::HUGS::
 

maximusprime

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Bless his heart and yours. I know it will cost more, first, I would
see about the Vet School and then, I don't think I would wait until, October.
It won't change the results, if it's hcm, but, you'll know and treatment
can start sooner. Will be praying for your baby and you.
Be sure to keep us updated.

definitely not waiting till october. i can barely wait till thursday (moved his appointment from friday, and would take him tomorrow if i could, but i also need to hang on to my job so i can pay for all this - ha).

thank you so much for your prayers and kind thoughts. it really does help.
 

maximusprime

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So sorry there seem to be other symptoms. Good you're getting him in sooner rather than later. But don't give up hope yet! If there is something wrong with his heart they can get him started on medication. Remember, there's no expiration date stamped on the bottom of his paw! We're here for you! ::HUGS::

this made me smile (a mean feat!) - the expiration date comment. you're right. in the meantime i'm just trying to love him as much as possible.

i just wish he was still sparkling. it's so hard to see him like this. he doesn't seem particularly uncomfortable - he's just not himself, and his spunky, obnoxious personality is part of what makes him, him. he is still giving me baths, though. i love his baths! he always thinks i'm so dirty, apparently. :)

i miss seeing him race to the door when i get home, though, and race me downstairs for breakfast. it's so hard to see your babies' subtle ways of showing that they just don't feel good. i don't think most people would even think he's sick, looking at him, but i know how he usually is, and i know. i just hope i didn't catch things too late.
 

maximusprime

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i'd always wanted a cat named max, but until max, it never fit. but he really is a max. he's the best guy i've ever known.

I am so sorry to hear of the news. You sound like a fabulous feline parent. Kudos to you. And it's also nice to see another one with a feline companion named Max!

I have nothing else to offer than what others already have. But I am sending you some healing vibes. Please take care of yourself as well as your companion in these times. Hugs.
 

Annika Laybourn

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Hoping that you will not get bad results thursday. Keeping all my fingers crossed for Max to get better. Must be so hard :( And sorry to hear about the lack of support from your husband, sometimes... men dont get attached like women do - I dont know, but if less attachment, then less worry and less support for your worry.
 

maximusprime

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hi, everyone. just wanted to offer an update and to thank everyone for their good thoughts.

wednesday night i started to see a bit of a change in max - a bit livelier, but not so much that i could hang my hat on. then last night, more so. refusing to go to bed, up all night prowling around, like he wanted to get into some kind of trouble but didn't know quite what. and this morning, he was up to his old tricks - racing around, attacking our big guy, running across the room to a blanket that had been on the floor for him, delighting when he slid with it into the wall. the usual. i was sort of baffled - 'you're supposed to be sick! your heart! relax, dude! - and wary about hoping that today's scan would turn out positively.

but in summary, it did. i'd already ensured they had his labs, the note of his murmur, his recent x-ray, and a video of his venuous jugular, and dr. zimmerman (if you're in so cal, i highly recommend) expressed concern based on what she'd already seen (she had apparently begun reviewing his case on wednesday), explaining to me what i already knew (insofar as what all this could mean, and what she'd be looking for). i asked her if DCM was a possibility (based on the jugular), and she told what i already knew - that it was rare - and that what she was hearing in his heart was on the right, not the left, and DCM could be ruled out. on that note, she took her time with the physical exam, finding the murmur and listening long enough to determine it as dynamic. i was honestly so overwhelmed that i can't recall exactly what she explained that meant - i recall only that she seemed pleasantly surprised; that it seemed like a positive sign.


she took him back for the ultrasound and the ekg, and returned with her student 20 minutes later to tell me: no HCM. no DCM. no RCM. no arrhythmia. she explained all the tests, the appropriate ranges and where within them he falls, and the bottom line is that his heart checks out. she said his lungs likewise sound clear. "i can't say what's causing his cough, and you might want to have one of our internal medicine doctors take a look at him, but i CAN tell you it's not his heart."


it was an expensive price to pay for the peace of mind, but well worth it, and max and i just woke up from a nap, and he's now at the patio doors yowling at me to let him out with me. :)

we still have to figure out what IS going on, but i don't need to tell you how relieved i am that year two, still HCM-free.

thanks again, everyone - your support over the past few days has really helped.
 

Hairless Blessing

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This is wonderful. So happy for him and you. Glad he is feeling better.

If the cough continues, I would see one of the specialist.
 

Catzzzmeow

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Big sigh of relief from me reading this update. So far it is great news.
 

kauna

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Happy to hear that he is HCM free!

I read the previous posts and was concerned for you and him. I know how you feel going though those "unknowns" and just worried about what the results could mean and not getting clear answers. It is completely nerve-wracking. kudos for following your instincts and not settling until you had answers.

Keep us updated! Give him lots of love!
 

ZiggyStardust

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AWESOME NEWS!! And glad to hear he seem to be feeling better as well! Is he still coughing? Has that lessened at all? In all this examining have they looked in his throat? Giz was kind of gagging one time & the vet thought it was upset tummy and gave him meds for that, but he kept doing it, so I had them sedate him (lightly) and look in his throat. He had a sore throat! Vet changed his meds and he got better.

::HUGS:: to you! I'm thrilled it's not HCM and hope you can get the coughing sorted out.
 
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