Hello,

I posted previously about Kuhio's heart murmur. I recently found out that in December it was a grade 1-2. When he was neutered in January, it was a 3-4. I won the photo contest (ya!!! thanks for voting!!!) and a friend gave me a few Hawaiian Miles points because I was just short of a free flight.

So on Saturday I went to Honolulu, rehomed Screech, not sure if I posted about him here but he was my foster kitten for about three weeks, and took Kuhio to the vet. I wanted to share the results with you all. It's pretty sad. Right now I am trying to figure out if Kalani should to go a home that sounds really great, but they don't want Kuhio because of his heart. I may be keeping Kuhio but I haven't decided yet. If I do, I may have to rehome a permanent resident. Here are the results:


General Information:
1. He is very petite. The vet says he is actually more like a female.
2. He has all his adult teeth so she said he's probably 7 months old.

Bill:
1. I was actually ready for a bill that hit 500. But it was only 270. My contest prize basically paid for it. THANK YOU SO MUCH for voting, the financial relief was much appreciated.

Most Surprising Information:
1. There is no fluid in his belly. He is just fat:) I said I only wanted an ultrasound on his heart but I didn't realize that she couldn't just move that instrument down real quick without charging me. So she told me she didn't think it was fluid but I was dubious and she said ok, I'm going to put the wand on his belly, but as if I am not. (No charge)
2. The vet told me I should keep him.

Indoor/Outdoor Issue:
1. Never, ever outside. She voiced many concerns including if he was injured or attacked, he could die in surgery because of the risk of anesthesia. (I turned down a family who was supposed to take Kuhio and Kalani home after the ultrasound on Satruday because they were going to let them inside. After I backed out they promised to keep them in but I couldn't be sure they would actually do that.)

Can he survive a trip to the mainland?
1. She never really answered, she just kind of talked in circles and I was thinking she was going to tell me no, that he needs to find a permanent local home, but instead she told me it would be best for him to stay with me. I think she was saying the risk is worth it. (I never said I was going to keep him, I told her he was a foster, she was the one that was encouraging me to do so.)

Murmur update:
1. Records from our December mange scare trip said the murmur was a 1-2. It is now a 3-4. She listened to his heart and said oh yes, it is very bad. She said she was very worried about Kuhio. She said it's always the sweet ones!

Ultrasound results:
1. She cannot diagnose, I would have to see a feline cardiologist for that. I told her I would not be taking that route because it is beyond my financial resources. She was very understanding.
2. She said his left atrium is twice the normal size.
3. She thinks it's an aortic <sp?> problem because that's where most of the trouble seemed to be. <Sorry I didn't write fast enough to get more that that)
4. She thinks he was born this way and the starvation didn't help.

Symptoms:
1. I never noticed but I guess his heart is constantly pounding.
2. Wheezing.
3. The gas is unrelated. (But boy is it bad!)

Treatment:
1. He will be on Atenolol, a beta blocker, for the rest of his life. 1/4 pill a day. She said it's a dollar a pill but I got a four month supply, 30 pills, for 12 dollars. Not sure what happened there. (They won't mail the pills so if I run out I have to get back to the office somehow.)
2. She said she has never seen side effects from the beta blocker.
3. Office policy states she can't give me a prescription for Internet use.
4. The prescription is good for one year, then I have to ultrasound again.
5. The beta blocker will slow down his heart and allow it to pump more. (If I am reading my messy notes properly)

Life Expectancy:
1. Kuhio could have a heart attack and die at any moment.
2. Many vets say one year.
3. She says up to two years because she has seen quite a few cats living longer than one year.
4. With medication, it would be pretty amazing if Kuhio lived more than three years.

Alisha

Alisha, I am so sorry about the diagnosis on Kuhio. I had really hoped it was something he would grow out of. I am glad he has you to care for him. How long will you be in Hawaii before you have to move? Your vet sounds pretty darn awesome. It seems she went above the call of duty in trying to help you out and get Kuhio the medication he needed. How did he handle the flight to the vet? I mean, will that give you an indication on how he would handle the flight if you take him when you move?

Oh, Alisha, I am so sorry. But, that does explain why Kuhio was smaller than his brother. I guess he got fat due to not being able to grow normally, but his instinct for eating a lot to aid growth still worked normally.

It sure is a sad thing. It is wonderful, though, that you found them both and took them into your loving care. I suppose you will be keeping him.

Too bad they can't mail you the meds. If you have a pharmacy on your island, maybe you can get a prescription to use locally.

Hugs to you and Kuhio.

Alisha, I'm so sorry that the news wasn't better.

Quote:

She said she was very worried about Kuhio. She said it's always the sweet ones!

No matter how long Kuhio has with you on this Earth, he'll be loved, well taken care of, and happy. I just wish the news was better.

{{{{Alisha & Kuhio}}}}}

Alisha,

I'm so sorry about Kulio. That is so sad. You're taking such good care of him, that he may even live longer than the expectation of 1-2 years. Love can heal too!

Maria

Oh Alisha! That is such sad news! But the new vet seems to be very good at covering all the bases.... good that your bill was less than expected too!

Poor Kulio! Did you post a picture of him? I missed it somewhere if you did... How is HE handling all this? Is he ok? I mean, from his standpoint. Is he acting and trying to play like a normal kitty?

Many prayers and hugs coming your way and Kulio's. I hope his quality of life will be top notch for however long you are blessed with him and that he will know no pain at all - ever.

Thanks everyone. I will try to answer everyone's questions.

Minzismom: He handled the flight well but going from Molokai to Oahu is only 20 minutes in the air and only at 10K feet. Luckily I found out for sure that cats can fly in cabin LEAVING honolulu. Most airlines require cargo so they go straight to quarantine. I am going to call her back and clarify but I am assuming there is a risk, but the vet thinks its worth it. I told her he was a foster, she was the one that encouraged me to keep him.

GG: You may be surprised to find out it is actually the bigger cat with the heart murmur. It is the all brown cat that is sick, not the white/brown on. Kalani was the smaller, weaker one but is now the healthier one. Kalani looks even more female than Kuhio though. So I know that's why you thought it was Kalani.

She won't write me a prescription to fill outside of the vet office. It's policy. But it's okay, I'll figure it out. She told me it would be a dollar a pill but it came out less than 50 cents a pill so I should have just gotton a years supply which is the max.

Yes I think I may be keeping him but I will keep him on petfinder, you never know. I have quite good luck with finding good homes. Screech is in an amazing home and they already love him to death. They sent pictures and he is already adjusted and sleeping in "daddys" arms. (Daddy happens to be a hottie too!) I may have to rehome a permament because five is my max. I really need to stick with that. But regardless, everyone will be well cared for.

Thanks rubygirl1968. I am happy that I was able to find him and give him a few good years.

Maria, thanks for the thoughts. It is sad but you are right, he may outlive all expectations. He actually seems completely healthy.

Anaimalangel1: Yes it is sad but the vet is awesome. She is young and she was so empathetic. When she checked his belly with the ultrasound for free, to give me peace of mind, I was so touched. I am going to mail her a thank you card. I am going to try to add a picture at the bottom of the theatre kittens back from November and a current one. Kuhio is the one on top, protecting his brother that was in much worse shape. Now the coin has flipped!

Kuhio is acting and playing like a normal kitten. When I played with him using a wand with a mouse at the bottom, he did have a hard time. He was just very slow in his reflexes. Other than that...and the fat belly....he is normal. Oh but he wheezes when he sleeps.

Thanks everyone.

Dear Alisha:

I’m so sorry to hear about Kuhio’s condition. Although I think you were expecting bad news, it is better to know what you are dealing with then to be fighting blind.

Floyd, my bridge kitty, had hypertrophic cardiomyopathy. From your description, it sounds like what Kuhio has. In my research, beta blockers were the drugs of choice. If there is any fluid buildup caused by the condition, diuretics are also prescribed. Seeing that you did not find any fluid buildup, well, to me that is a good sign.

I’m really not sure how to bring up the next topic. I’ll probably not do it right, but please know that I am doing so out of concern for Kuhio and for you.

Floyd passed away when a blood clot formed in his heart and broke away blocking his descending aorta where it branches off to the hind legs and tail. The condition is called a saddle thrombosis, and it is very serious. Only about 1/3 of cats that develop this condition survive without any problems. One third die outright. The remaining one third usually require amputations of the tail and/or limbs, as the tissues die off from a lack of blood flow. There are no good treatment options, as most medicines do not dissolve the clot. There are surgical options, but it is high risk (because of the underlying heart condition) and requires a specialist.

A saddle thrombosis is also very painful. Floyd was crying out in pain when it happened and he bit me at the vet office when I took him there.

Where am I going with this? I know that you do not have a vet on your island. If Kuhio develops a saddle thrombosis, he will be in a great deal of pain until you can get him to a vet. Most of the vets might not be able to do anything for him, other to give his some pain medication (Floyd was put on pain medication, sedatives, blood thinners, beta blockers and diuretics after he suffered the saddle thrombosis). At least, in his final hours, he was not in any pain, so the vets assured me.

Although I don’t want to burden you with any unnecessary fears, I am asking you to give some thoughts to a plan in the event Kuhio does develop a saddle thrombosis, or any other type of severe emergency. I pretty much fell apart when it happened to Floyd; if it were not for my EMS (Emergency Medical Services) training, I would have become paralyzed with shock and fear. As it was, the ten years of training kicked in and I was working on autopilot. My body was doing things and my conscience mind was a bystander, looking on.

Can you discuss with you vet the option of having a sedative and/or pain medication on hand to use if needed?

Again, I’m sorry to bring this up. I don’t want to burden you and I hope that it never comes to this. But, your situation is very different from what any of us might face.

Mark

Mark,
Thank you for sharing that with me. I really appreciate it. It sure is sad but actually I was not surprised by his vet results. In fact, I think it could have been worse. If Kuhio starts to suffer, I will be on the next plane possible to Oahu. He will not suffer long. The flight is short and check in is possible 30 minutes before the flight. I have thought about that, even though right now he seems happy and playful. The vet says at the moment he feels no pain. I hope these meds work. She said she could not diagnose him but I chose not to see a feline cardiologist.
The stomach has no fluids but he does wheeze, does that mean there are fluids in lungs? She did mention diuretics or a low sodium diet. Just the beta blocker.
I wish I could get a sedative or pain meds. But this vet office doesn't really work with off island patients and they are very strict.
Thanks again
Alisha

Alisha:

The wheezing in the lungs could have several different causes. One of the causes, common in heart patients, is a build up of fluid in the lungs. It may have something to do with blood pressure or poor circulation - my biology and / or health classes were a very long time ago and I don’t remember this being discussed in my EMS classes.

Here is a link to heart conditions in people:

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As I read through the link, it mentioned that left side heart failure result in fluid filled lungs, which cause wheezing. I think I remember that Kuhio suffers from an enlarged left side.

Mark