Thursday, November 29, 2007

Ventricular Septal Defect

We had put Pepper's neutering off because of his pneumonia battle, that was inexplicably combined with a persistant problem with loose stools. The need to make a choice to have Pepper neutered became crucial, so the procedure was scheduled to happen after an ultrasound scheduled for this morning, to check a suspected heart murmur. This murmur has now, with the ultrasound, been officially diagnosed as ventricular septal defect. This disease has been progressing quite quickly in the short time we have known Pepper, based upon signs of quick exhaustion, for example, and when the decision was made to go ahead for his neutering, the vet discovered that if it hadn't been done today, Pepper would not have been likely to survive having this procedure done. This was a big day in his little life, and I am very glad it is over as he recovers peacefully between 'Uncle' Hamlet, and 'Uncle' Thumper. The old boys are happy to oblige.

As Pepper's disease progresses, we are adding notes to the bottom of this blog.

Thursday, October 4, 2007

The New Boy in Town - Lifetime #4

The new boy in town looks so angelic, doesn't he? Don't let him fool you! This guy thinks he can fly, and runs around the walls, not the floor. You can be sure to find odds and ends dropped from one shelf or other when you get up in the morning with him in the house.

Within the first twelve hours of coming into our home, with only a couple of hours freedom to explore, Pepper, here, found my black shoes that had been lost for over a year, (already replaced with new ones), killed the fur trim on my favorite winter coat, swung from just about every ivy plant in the place, (we have more than twelve linear feet of wrought iron planter, full of pots), and discovered every good hiding spot where we can't retrieve him.

Photo above:
Pepper can't decide whether to sleep on top of his fur igloo, or inside it. His dilemma has been created by watching the 'older' boys in their beds. They don't have covers on theirs, so he has to sleep on, rather than in his bed.

However, he clearly understands what to do with a tackle bag in photo at right.

Pepper is watching the squirrels on the lawn below, after scaring off the finches on the feeder outside his window.

Above, Pepper punching Thumper in the nose to wake him up for playtime.

From that point on, the activity is mutual, and goes on until they either stop it, after a good ten minutes or so, by themselves, or we give Pepper a time out in his cage because he is still recovering from his pneumonia.

Right, Pepper can be seen having his time out after a satisfying round with his new 'uncle' Thumper.

In the past week we have noticed a marked decrease in Pepper's energy levels, and for a period of time he started developing explosive diarrhea. With the addition of Lasix, and return of Pro Pectalin, the diarrhea has backed off again, to the point that feces are now showing some formation. Pepper has a need to rest in a more vertical pose than the other boys, and we are making the assumption that this is caused by discomfort in his chest when lying flat, although we have no proof of this. In the past month, (at seven months, now), he has only gained about an ounce of weight with the diarrhea interfering. He does, however, have a ravenous appetite, so we hope to see a change.


Pepper starting up his water game. He became self conscious after I took this photo but it is common for him to work himself into quite a state splashing water all over the kitchen floor. Needless to say, we have had to develop a few strategies to protect the hardwood floors in other areas where water is supplied. It is safe to say that our kitchen floor is clean enough to eat off.

We are wondering if Pepper's need to splash the water he wants to drink is anything to do with the position of the pupils in his eyes as they seem to be slightly higher than those of our cats who have no problem drinking from the buckets. Pepper does this paddling no matter where the water is when he needs to drink.

We added Lasix, (aka Furosemide), and Pro Pectalin to Pepper's daily Fortekor and he seems to have settled down to formed feces, although they are still soft, and quite smelly because the food is not totally digested before passing through his body. He is back to having periods where he can compete with Legolas for highest climber on Legolas's door, (not an easy feat), and then alternatively needs more time to rest these days. Just today he had me quite worried as he rested very quietly for three hours, and I felt the need to hand feed and water him without asking him to get up. Then DH came home, and it was like a switch was flipped, up to and including another run up the wire door with least he is having fun while he survives this.
After a couple of weeks of using the Pro Pectalin, Pepper's "smelly" feces seem to have settled down to a more normal odor, and he has put on 5 ounces. Pro Pectalin is a godsend, and the greatest part is that Pepper will eat chunks of it like treats. He is back to being very active, looking for those 'oxygen deprived' highs again.

Yesterday I was phoning around for a company that would supply oxygen tanks for pets. There is quite a difference in prices depending upon the dealer, rather than the service. We almost lost Pepper a couple of Sundays ago. He howled with pain, (I thought), and stretched to get away from it, but became totally limp after that. I took him inside and lay him on something soft while I went to get the other cats off the deck, expecting him to be dead when I came back in, but like other cats in our past, he has just used up one of his lifetimes and moved on. I have since had consistent feedback from a number of professionals telling me that it wouldn't be pain with oxygen deprivation, but being helpless is not my way if I can fix something, so oxygen tank it is. You can get small ones the size of pop bottles for those who are imagining the big cylinders one sees in medical facilities.

There was another incident last week, but Pepper wasn't as stressed, and made it through quite well, so I am looking forward to having a solution.


We are wondering if Pepper's need to splash the water he wants to drink is anything to do with the position of the pupils in his eyes as they seem to be slightly higher than those of our cats who have no problem drinking from the buckets. Pepper does this paddling no matter where the water is when he needs to drink.


It is fairly common to see questions on the heart list regarding this pose, (left), resting vertically as a more comfortable position for cats with heart conditions. Pepper doesn't have the classic fluids on the chest that are blamed for the need to do this, and he can be very active, (not in any pain), before and after settling into this pose, so I am not so sure that the also common explanation of "sitting up because the fluids are causing pain", is a correct assumption.


This photo isn't that clear as I had to capture with a faulty lens and time was of the essence. Pepper eventually had to go and find his own chair as Hamlet was very persistent about staying put in his little 'tent'.


Hiding from Mom! This morning we took the bedding and folded it for storage and you should have seen the look of disgust from our fine fellow when his 'roof' was removed.

This month Pepper is one year old. Today he weights 8 pounds, 9 ounces, which is quite reasonable as some of his stomach capacity is taken up with his daily allotment of two tablets of Pro Pectalin used to prevent runny diarrhea because of fluid spillage into his GIT. He eats this voluntarily, thank goodness. We break each half tablet up into four sections to create roughly bite sized pieces. I am attempting to use freeze dried salmon or quail hearts as treats after each dose of Pro Pectalin, in the hopes that he will keep connecting it with a more pleasant experience.

This morning after the tail chase and 100 yard dash times two, Pepper was not only gasping for air for an extended period of time, but was also giving the first signs of a gurgling sound we have been dreading. He is at the present time still on lasix and fortekor. A major oxygen fix was needed and didn't provide as much relief as it has done in the past.

Two days ago, Pepper had some very sudden, serious symptom changes that caused me to phone the vet just in case we had a lung infection, or something that needed a vet visit, for this little fellow who gets so stressed out with travel to the vet office. He had marked congestion sounds when breathing, much like you would hear with a bad case of pneumonia, or heavy asthma, and was providing way too many large lumps of urine in the litter box. The next day he was right back to his relatively 'normal' self.

As Pepper has stayed at the point of only becoming winded when exerting himself, (which he loves to do), and his urination went back to small infrequent peeing since Saturday, we are breathing a sigh of relief as he is already at his maximum dosage of lasix, (furosimide). I expect we may have more and more of these periods develop over time as he is, after all, deteriorating as his body makes demands on his heart. We have been told that there is a Dr Unger at the vet hospital in Saskatchewan who might be able to insert a wire mesh to correct this problem, but the hole is so big, and Pepper gets so stressed with travel, that just the attempt to fix his heart would most likely kill him, and we do love him lots. Pepper is one year old this month and we are hopeful that he will at least fulfill his prognosis of a year and a half of just being a happy cat before leaving us.
Pepper has been with us for a year, now, and his prognosis has him in our lives for another two months. So far he is not progressing to further stages other than being more tired, and we have been thrilled to discover that FortiFlora has corrected his chronic diarrhea better than any other remedy. We wish we had known about this product back when we first adopted Pepper as it would have given him a better chance of absorbing nutrients during the critical growth period in his life. However, it is a blessing to have it available now.
This evening Pepper let out a loud moan that was very clearly an expression of pain. Then this happened a second time. When I found him he was lying out on the kitchen floor and we think he exerted himself too much running up the stairs as he likes to do. We believe he has had a painful angina attack.
After consulting with Pepper's veterinarian, I gave him a half tablet of baby aspirin in a gelatine capsule as he was still restricting his activity level immensely and has been hiding in the box at the top of the cat tree to avoid interaction with "uncle" Thumper. "Uncle" Thumper has, in his turn, not initiated aggressive behavior with Pepper. He has always been fairly sensitive toward Pepper's needs, which has been great considering he is just a cat.
About an hour after receiving the aspirin, which was given to reduce inflammation and pain from the bruising inside his heart, Pepper threw up liquid, and continued to have little bouts of this for another hour or so. Hopefully some of the aspirin stayed down to give him some relief. We think it did as he was more himself later in the day, but still restricting his level of activity.
This morning Pepper got up and had his usual chosen snack of Royal Canin Diabetic DS 44, and then promptly threw it up all around where I was trying to get lunches made for distribution. Grrr! Later he voluntarily ate his capsules of FortiFlora, (it is great to have a cat who pills himself), with no problem, and then chose to climb back into the box on the cat tree. This has recently become his favorite retreat. While I didn't push him to the 'family' breakfast, I did leave out freeze dried fish treats which were gone later when I checked. His paws are now warm from being in the enclosed environment, even though he has had little activity this morning.
As DH has been through heart troubles, he is thinking that as Pepper always has much more problem breathing when he has been at rest for a long period, that the nausea today was caused by a lack of oxygen to the brain. I sincerely hope that is what happened as I would like to have some resource available to use when Pepper expresses serious pain. The veterinarian has suggested trying some food first next time we need to give him aspirin, so as to 'fool' the stomach. I am not looking forward to experimenting on him like this as the wretching of nausea must be hard on his little heart, too.
At the moment he is feeling warm and cosy and purring contentedly, hopefully forgetting the pain his body inficts upon him with the angina attacks.
We have stopped the aspirin as Pepper seems to have a major issue with it. He seems to continue to do just as well without it, and if he does develop another angina attack I will be posting to indicate whether this was a wise choice or not.
Pepper seemed to be doing very well with feces stability so we slowly backed off with the FortiFlora, and he continues to do just fine without it. It is wonderful to see the fluid spillage back off as it is not showing up elsewhere instead. We are beginning to feel we will have this little fellow around for quite some time to come if he doesn't overdo the canonball runs around the house the minute human legs and feet are out of the way.