Wednesday, October 19, 2005

Visible Improvement

About 6 weeks ago I saw a 16 year old cat who had suddenly lost one of her upper fangs. That's what the owners brought her in for, anyway. She did have terrible periodontal disease. But straight away I could see something else in this cat wasn't right. She had sunken-in eyes, hollow cheeks, and a skinny, unthrifty body. Cats are covered in fur, and some of these signs are subtle, so I am a little surprised when I can see so clearly that is obviously wrong from across the exam room. In an old cat, this usually means either kidney disease, hyperthyroidism, or diabetes.

As I laid my hands on the cat, she felt thin and had a heart pounding through her thorax. I listened to the LOUD murmur and had a feeling of dread. This owner brought his cat in for a dental evaluation, but I feared she would not be a good anesthetic patient.

I explained the dental problems, then addressed my other concerns - obvious weight loss and heart murmur. I also feared she had hypertension (high blood pressure) because of her bounding pulse. Before this patient could get her tooth fixed, she'd need a full work-up. The owner readily agreed to $100 worth of labwork, and scheduled a $200 echocardiogram.

The labwork revealed hyperthyroidism but no other problems. This is a chronic condition but can be relatively easily remedied with oral medication, which I immediately prescribed. The ultrasound revealed only mild changes to the heart. High thyroid levels tend to hypertrophy (enlarge) the heart muscle and elevate the heart rate. The echo let me know in this case, despite the loud murmur, her heart function was pretty good.

This week she came back for her first check up after being on tapazole (hyperthyroidism) treatment for a month. She's gained a pound. Her blood pressure is normal. Sometimes treating for hyperthyroidism unmasks kidney disease because the high thyroid level actually increases blood flow to the kidneys, but her kidney function is still excellent (yea!). Her murmur is still loud but at least it doesn't worry me now. Stroking her back, she feels "fuller," not as bony and skimpy. And, her attitude is improved. We noticed it working with her at the clinic, but the owner really noticed how much less grumpy she is at home.

I thought I wouldn't get the chance to work on her teeth at all, but I'm pleased to report she has a dental appointment with me next week. (might temporarily return her grumpiness, though!)

5 comments:

EdamameMommy said...

Yeah, I like your descriptive, non-medical but informative adjectives "skimpy" and "nonthrifty"

Here Jenn, this link's for you...http://www.theregister.co.uk/2005/10/07/ig_nobel_prizes/ Reminds me of your days in Harker Heights

Anonymous said...

YEA! I'm so glad the cat is doing better. Believe me, I know what its like to know a SKINNY,old kitty. My grandmother's cat had thyroid problems in his last years....Oh yes, I vividly remember giving Romeo liquid medicine through a syringe. Poor fella hated it.

That cat lived " the perfect cat life" but finally passed on this year.

So, I'm glad to hear of a successful story...and that this patient is GAINING weight!!!!!

Love-Bevie-

Emily said...

It must feel so good to help a patient like that. I'm glad things are progressing well for the cat!

Dad said...

Tud said this morning (He's in Hong Kong) that the cat was lucky to see a good Vet.......
Now you have readers in China! Wow.

Sinda said...

Jennifer - I read this post last week, and it made me think about our cat (1 of 2, mother of the second, who is about 15-16 years old). Sally moved outdoors when Hannah was 18 months old and began to chase her on a regular basis. At our last house, she lived under the deck, and ventured out at night to come in the cat door and eat and maybe snuggle up with George, the lab and her bosom bud.

When we moved, we had to set out a HavAHart - no way would she come willingly.

Now, she lives in the woods, and the minute we let the dog out in the morning, runs up for her cuddle time. We keep food out during the day, although we have to lock it up from the racoons at night.

She's pretty skinny, as you described, but she's so OLD...anyway, that's what made me think of her. Jesse had mentioned that morning that he hadn't seen her in a few days, so I was pretty worried.

Friday afternoon he called and said, "I found Sally." That sounded like her death knell to me, but luckily, was not. Sally had somehow entered a storage closet in our carport and had been locked in. We don't even know when we had the door opened...and why we didn't hear her, since it is on the other side of our living room wall. Regardless, he did hear her on Friday, and let her out. We gave her a can of tuna and some fresh water, she reunited with George, and has seemed fine ever since.

Thanks for sharing your vet stories, I really enjoy them!