10 yo cat fluid on lungs, chf, high protein

I have a 10 neutered male cat. He and his litter were abandoned as very young kittens - ferel mother may have been killed.

Of the four kittens: one was blind and tiny and has a heart murmur but is otherwise healthy; one died of FIP, one is OK but not the most robust of cats and this one had a diaphragmatic hernia when he was about 8 weeks old and had successful surgery.

He has always been the most healthy of them all. He has tended to be overweight, though.

He has health problems now. At first, we wondered if he had diabetes and ensured that he only had the canned food, and then we investigated his dental. He started losing weight and his hair got rough. He did have a dental issues, though his blood work came back very good.

At his first exam in preparation for his dental work, his expert vet detected a class 2 heart murmur. He got an antibiotic shot and pain shot. The clinic did further investigation the following morning found fluid on the lungs as well as the tooth problem. The breathing rate then increased to 60.

He was then put on Lasix and Benazapril. A week later one lobe on his lung had collapsed. The breathing rate went down to 30 or 31.

He was given another antibiotic shot.

He was then put on Lasix and Pimobenden .

He was taken in yesterday with plural effusion and the vet took it off with a needle. The fluid has a protein of 7.7 which is high and further lab work is pending.

Spironolactone has been added to his drugs.

During this his ears have been cold. But, over the weekend they got hot. Then his breathing got worse and we took him in.

I will have to look at the records to get drug names as I was out of town for most of the vet visits. The pain killer was a four-day pain killer.

He certainly feels better with the fluid having been removed. His appetite is and has remained good. His breathing seems to be about 30 to 32 today. He is more active. But most of this relates to the temporary measure of removal of the fluid.

He has seemed to get worse when he has the antibiotic shots, but that could be coincidence. At least he was worse when he had the antibiotic shot without the paid killer, and when he had the antibiotic shot with the pain killer, after the pain killer wore off. The antibiotic was Covenia.

Yesterday, the cat expert vet was saying is not responding to treatment and was thinking that he won’t make it through this.

We would like to change that outcome. I know these vets are really good and caring. However, I can’t help but think that there is something still being missed. He didn’t have these breathing issues until after the pain shot and the antibiotic shot. The heart meds don’t seem to be working well on him.

I gave his family history to indicate that he is not a genetically strong cat. His sibling had pancreatitis about a year ago and recovered, but that was all quite vague. One other household cat had an episode with something called “pancreatitis” too, and it was also vague but resolved. Those cats saw a different less-competent vet and received only antibiotic shots. The situation did resolve well though. I’d say they both resolved a little slower than I would have expected.

ETA He has developed arythmia and that was causing him a lot of problems when he was at the vets yesterday. The slowness of his pulse contraindicates certain medications. I don’t know if the arythmia was abated by the removal of the fluid.

We had one that had an enlarged heart and ended up with fluid on the lungs. It came on very suddenly with his breathing. We had to let him go It was going to be a constant pulling fluid to keep him comfortable just temporarily. I have no idea what triggered it nor did the vet He was a wonderful cat too. So ours with fluid on the lungs had a heart condition which was deteriorating. Hoping for the best for you.

OK, in looking at this Covenia drug, it certainly seems to have some side effects. Inflammation can result in the plural effusion with the higher protein count from our limited research.

Thank you. I’m sorry for the loss of your kitty. It seems from your experience that its coming on so rapidly may not be unusual.

Cats are great at masking illness or disease processes. A lot of the time they seem fine, and then just drop dead from heart issues. I’m sorry you’re going through this; has he been seen by a board certified cardiologist?

I’m sorry to hear about your cat. It sounds like if you want to move forward seeing a cardiologist and internist may be a better option than a cat specialist at this point. Jingles for some answers and a positive outcome.

If the protein level is that high in the fluid, it is likely chylous or neoplastic… an echocardiogram would be the best tool to diagnose heart disease vs. other problems, but cancer is high on the list with a protein level that high. A thoracic ultrasound would also be helpful.

Has anyone ever looked at the fluid to see what kind of cells are present? That will tell you a LOT.

Pleural effusion is rarely associated with a “good” outcome in cats. Best case scenario, you have an infection (pyothorax) or chylothorax which can be fixed with surgery. Usually though, it’s cancer or heart failure. I’m betting the injections of pain medication or antibiotic were just coincidental; usually they feel “fine” until the fluid accumulates to the point where they can’t tolerate it.

Other things you’ve not mentioned is his bloodwork; all that lasix is hard on cat’s kidneys. That, combined with the arrhythmia, make me very worried too that your cat has something bad.

I hope your vet can sort things out. So sorry you and your kitty are going through this.

Sending Jingles & AO for your beloved cat ~

((Hugs)) laced with strength for you ~

Wrap him up in “home love” ~

Cherish each day you two have together ~

So sorry for you and kitty. No words, just hugs. He is young.

CindyCRNA and Zu Zu, thank you. I agree that it is much too young for a cat to face such serious diseases. I’ve had cats live into the mid 20’s. We have another who has now outlived her life expectancy by almost eight months so we are trying to make them very happy. Tough days. Hopefully, we will find a solution for this boy.

Horsenut_8700 He was only seen by a cardiologist when he was a baby and facing his first surgery. I was not impressed. The local vet school is CSU and it is my opinion that they don’t train vets well relating to cats. My vets are from a different vet school, and that is one of my criteria.

Thanks Squish the Bunny. I will stay with these vets for now. They are better than any except my retired vet. We have discussed cardiologists, but haven’t gone there yet. As I said to horsenut-8700, I’ll have to find one who was trained out of state.

[QUOTE=Pancakes;8659233]
If the protein level is that high in the fluid, it is likely chylous or neoplastic… an echocardiogram would be the best tool to diagnose heart disease vs. other problems, but cancer is high on the list with a protein level that high. A thoracic ultrasound would also be helpful.

Has anyone ever looked at the fluid to see what kind of cells are present? That will tell you a LOT.

Pleural effusion is rarely associated with a “good” outcome in cats. Best case scenario, you have an infection (pyothorax) or chylothorax which can be fixed with surgery. Usually though, it’s cancer or heart failure. I’m betting the injections of pain medication or antibiotic were just coincidental; usually they feel “fine” until the fluid accumulates to the point where they can’t tolerate it.

Other things you’ve not mentioned is his bloodwork; all that lasix is hard on cat’s kidneys. That, combined with the arrhythmia, make me very worried too that your cat has something bad.

I hope your vet can sort things out. So sorry you and your kitty are going through this.[/QUOTE]

Thank you. There seem to be a lot of things that can cause the high protein. But, chf doesn’t come with elevated protein levels, does it? The sample will be back from the lab in a couple of days - thinking Monday since tomorrow is Friday. So, that is in process.

His bloodwork was excellent, but hasn’t been taken since he started the Lasix.

For the moment, he is doing well, having had the fluid removed yesterday.

CHF does not come with protein levels that high, no. So the heart medications are not the answer to this and the causes of an effusion with protein levels that high are short. Chylous effusion is pretty easy to identify, so is infection/pyothorax. Those are diagnoses you can make just looking at the fluid. Chronic inflammation is trickier but the cytology should tell you that. So I guess you’ll just have to wait for the lab. I am used to looking at my own samples and getting results back in no more than 1-2 days tops.

Glad he’s feeling better for the time being, please keep us updated.

Yeah, they did some tests in house, but sent the sample out for the complete testing. They had said 3 to 4 days.

Is there any way to tell when a cat’s fluid level is increasing? In humans, there are a lot of checks on fluid levels that can be found long before breathing is impacted. Are there any with cats?

There are definitely some internists who have a strong interest in cats over dogs. We have one (out of 4) here who primarily work with cats. She is excellent. My own kitten at 12 weeks had chylous effusion in both the thorax and abdomen. Every other vet said FIP and to put him down. He is now 15 and never had a recurrence. It may be worth the drive to find an internist who has an interest in cats and that have acess to diagnostic tools such as a CT as these are usually quite sensitive with thoracic cases. Good luck!

Ultrasound of the thorax should also give you a rough idea on fluid amount. I’m sure you’re aware of what to look got at home, but any increase in beating rate or effort at all, could indicate a rapid increase in fluid. Slow build up often doesn’t create much of a difference until it reaches a threshold level.

Also.edited to ad that the fluid sample should really be under 24 hours unless you are in a really remote area. Out stat samples are read within 6 and regular samples have a 24 hour turn around time. I suppose however it is area dependent.

Sorry to ask if this has already been stated (may have missed it in the history) but was his abdominal ultrasound clear?

Is the plural effusion on both sides or just one? I had a cat with neoplasia that developed effusion only on one side.

I’d be looking for a internal medicine veterinarian and a cardiologist for your cat. I’d also not judge an entire veterinary school’s graduates off ones you’ve met in the past.

[QUOTE=SquishTheBunny;8660964]
Ultrasound of the thorax should also give you a rough idea on fluid amount. I’m sure you’re aware of what to look got at home, but any increase in beating rate or effort at all, could indicate a rapid increase in fluid. Slow build up often doesn’t create much of a difference until it reaches a threshold level.

Also.edited to ad that the fluid sample should really be under 24 hours unless you are in a really remote area. Out stat samples are read within 6 and regular samples have a 24 hour turn around time. I suppose however it is area dependent.[/QUOTE]

His breathing is the best that it has been since this started - which was after the Covenia. (ETA It is better than it was after he got home from having the fluid removed.) It’s interesting that the sample should be back so soon. This clinic is pretty far from CSU, and I assume they are using a pathologist there. It is probably the response time from them. Hopefully, it will be back tomorrow, but perhaps it will be Monday.

He has had ultrasounds and x-rays. The last time, of course, he showed enough that the fluid was removed. That was done while he was being ultrasounded to ensure that the needle didn’t do damage.