Thursday, May 8, 2014

An Unexpected Anniversary (In the Category of Want What You Have.)

A year ago today, May 8, 2013, my Smitty kitty was diagnosed with an enlarged heart, a terminal, incurable condition that affects many mammals, including cats, dogs and humans. His breathing rate was 78 breaths per minute (14-18 is normal for a cat), and the echo cardiogram showed that only half of his heart pumped blood at all. The condition results in congestive heart failure when left untreated. The inability of his heart to pump correctly allows the fluid to build up around the heart and lungs; in essence, Smitty would drown in his own fluids;

It's more common in older animals but can occur at any age. Smitty had just turned two. With support from the excellent team of cardiologists at Virginia-Maryland Regional College of Veterinary Medicine at Virginia Tech, in Blacksburg, Virginia, my husband and I agreed to put Smitty through the standard regimen of diuretics (furosemide) and blood pressure medicine (enalapril) that wold improve his quality of life, even if nothing could be done to restore the quantity. Medicines change the end game for this condition: kidney failure due to overuse caused by the diuretics was now also a possibility, but if you read up on the two, kidney failure is a much more peaceful way to go than congestive heart failure.

Smitty responded well to the drugs, and his breathing came down to 22bpm, but he needed a dosage increase of the diuretic about every two weeks to maintain that rate. By August 2013, we had maxed out the dosage of furosemide that Smitty could safely handle, and we did not think he had much longer. 

Then a Twitter pal whose cat Tweets with our cats (yes, they Tweet...touchscreens have made thumbs unnecessary), told us about a second diuretic called torsemide. It metabolizes differently from furosemide, and while it had not been tried in cats, researchers had seen good results with humans and dogs. The pal emailed us a scientific paper she had found about the dosaging, and we forwarded it to Smitty's cardiologist, Dr. W. She agreed to try the new drug, and found a compounding pharmacy in Arizona who formulated the drug into a suspension in liquid so we could administer very small amounts. The pharmacy put it in fish flavored liquid. Smitty thinks it is a treat. He tells us when it's time for his meds, because he loves the taste.

We're nine months in using the torsemide. We have never yet had to increase the dosage, and Smitty is breathing a normal 16 breaths per minute. He runs again. He chases butterflies. Sometimes he catches a vole. (He likes to eat them whole.) It's quite disgusting, and we try to rescue what we can, but... Smitty doesn't know he is sick, you see. He's just Smitty, doing Smitty things, and being his adorable Smitty self. I do not know how many more days this kitty has left to play and purr. I try not to think about that. I have today with Smitty, an anniversary I never expected I would get to celebrate. If I am lucky enough to have tomorrow, I will cherish that too.
Smitty this morning, wishing I would let him back outside. A lack of thumbs doesn't hamper his Tweeting, but he still can't open the door for himself. Something to be thankful for.