Old Man Rook

2016-09-01

A month ago, Rook was scheduled for a dental cleaning.

During his dental pre-work, my vet noticed a low-grade heart murmur that he’d never noticed before. He called me while I was at work, asking me if I’d been notified of it before. I hadn’t.

He explained that it could be nothing, but it could also be indicative of some undiagnosed  problem with Rook’s heart. Heart problems can be an issue when going under anesthesia, hence the vet’s concern. 

Moreover, although Rook is a medium hair mutt, there is a chance he’s a Maine Coon mix. Maine Coons have a genetic disposition to hypertrophic cardiomyopathy.

The vet suggested a blood test, which checks for a protein secreted by the heart when the heart is experiencing damage. The test came back positive. We cancelled his dental procedure and made an appointment with the veterinary cardiologist.

At the cardiologist, there was an exam room and a separate room for the ultrasound. In the exam room, they used a machine to listen to his heartbeat through his tail. It’s weird how that works. The cardiologist could hear a grade two murmur. Besides that though, we hadn’t seen Rook display any other signs of heart issues. Maybe he’d wheeze every now and then, but with Scrabble having asthma, that wasn’t considered abnormal to us. Down the hall, he was placed on a table for an ultrasound.

 

As you can imagine, he was not thrilled, but still behaved like a good boy. The table had a hole where the doctor could run the ultrasound wand over his belly, which was covered in jelly. A tech helped hold him in place and roll him over when the doctor checked his other side. 

Sonogram

Let’s be honest, I don’t know what the above photo is supposed to mean, BUT the results of the ultrasound diagnosed Rook with unclassified cardiomyopathy. While some classes of cardiomyopathy involve the thickening of the heart lining, and others the thinning of the heart lining, Rook has “mild concentric hypertrophy of the interventricular septum and thinning of left ventricular free wall,” so both. He didn’t fit in a perfect category of heart disease,  thus unclassified. Oh Rook, even in health you have to be an odd one.

This was the description given in his medical notes:

This changes to the left ventricular heart muscle decreases how well the heart can relax, which will over time lead to enlargement of the left atrium and left auricle. With chronic elevations in left atrial pressure the pressure in the pulmonary veins increases causing fluid to leak from the vessels into the lung tissue. This is called congestive heart failure.

As of right now, it isn’t severe enough to warrant any medications. Cardiomyopathy is irreversible though, so he has a follow up in six months to determine the rate of the thickening/thinning, and whether or not he’d need maintenance medication six months from now, or years from now.
There are symptoms to look out for to make sure a cat with heart disease isn’t going into failure: vomiting, trouble breathing, lethargy. Our cardiologist instructed us to watch for these signs. Of course that means that now anytime I hear someone hork up a hairball, I freak out that it’s Rook throwing up. 

As for dental work, the doctor says he is safe for anesthesia, but it’s the post anesthesia that can be more risky, as the heart may or may not recover from anesthesia. However, his teeth are really bad. He has teeth dissolving at the gums, so a dental is necessary; it will just be the last dental he ever has. The cardiologist we go to has a protocol for anesthesia that they distribute to the vets in the area for when they perform surgery on cats with heart conditions, which they would use for Rook.

Patches had been my senior cat for awhile, so it’s hard to realize that my other cats are getting up there too: Scrabble and Rook are both 9.

What this experience has confirmed for me, though, is the importance of preventative health care. We diagnosed Patches with kidney disease three years before she died from it; some cats don’t live past a few months after diagnosis, and I think for us she lived longer because regular blood tests were taken and it was caught early.

Likewise, we wouldn’t have known about Rook’s heart disease without a routine exam and suggested dental cleaning.  His heart disease is very early, and the vet says he could still live 5 more years. This gives us a chance to treat him with medications that will make him more comfortable. 

Somewhat related, it also made me grateful for the pet insurance, for as much as I gripe about different policy offerings. My vet warned me that a cardiologist visit would run  $600-700. Not exactly fun considering a dental is already  $500-1000. I would have taken him anyway regardless, because my cats are  my children, but it’s always a relief for the financial aspect of the experience to not be prohibitive to his wellness.

It would’ve been heart breaking if we didn’t know about his cardiomyopathy until he was vomiting and struggling to breathe on the floor, having heart failure. Rook is our village idiot and our favorite cat to pick on, but I still want him healthy.

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