It was raining cats and dogs, but I still drove to PJ to see Cleo.
Just before I left, the vet texted to say she detected a murmur in Cleo’s heart and did a pro-BNP blood test to check. Cleo has hypertrophic cardiomyopathy (HCM) which is the same as what Cow Mau has, only in a lesser degree and probably at an earlier stage.
Hypertrophic cardiomyopathy (HCM) is a disease in which the heart muscle becomes thickened (hypertrophied). The thickened heart muscle can make it harder for the heart to pump blood.
Cleo’s pro-BNP reading is 178.6 (Cow’s was more than 1400, any reading above 100 is considered abnormal). An echocardiogram was also done and Cleo’s ventricle wall measures at 7.1mm. Anything above 6mm is considered abnormal. Cow’s was 11.4mm. So Cleo’s heart issue is at an early stage.
After I arrived, we discussed this and I agree that Cleo should start on blood thinners to address this heart issue. We do not want a clump to form in the heart and if it gets stuck somewhere in the arteries, it would cause a stroke. Starting on blood thinners (Clopidogrel) would mean Cleo cannot be on the Kidney Support Gold supplement anymore. I agree too because averting a stroke should be prioritised. The Kidney Support Gold is only a supplement; it has rave reviews, but we don’t know if it works on Cleo’s CKD. Astro’s Oil already does not work and this package also has rave reviews.
The vet said she collected some urine from Cleo and a urinalysis was done as well, and it shows that Cleo still has proteinuria after being on Semintra for two weeks. So is Semintra working? Or should we give it more time?
Also the vet thinks that Cleo’s high blood pressure is not controlled despite upping the Amlodipine to 1/6th of a tablet. It used to be 1/8th. So she will discuss with the senior vet if the Amlodipine needs to be adjusted higher.
With regard to the possible tumours in the left kidneys, if we want to determine the malignancy (or not) of the tumours, an invasive procedure would have to be done where Cleo would have to be sedated to do a biopsy. It cannot be done without sedation. So, we decided not to do this. Cleo is already 16 years 8 months old. Going under sedation at this age is too risky. And even if we ascertain that there is lymphoma (cancer) in the kidneys, then what? The only allopathic treatment is chemotherapy and the side effects will weigh heavily and negatively on her wellbeing.
So, we will just manage whatever conditions Cleo has now and the most important for me (and the vet agrees) is to make her feel comfortable and it would be a bonus if she has an appetite too. Feeling comfortable is very important. And to achieve this, the vet had already started her on a low dose of transdermal Gabapentin since yesterday and the positive effects are kicking in now.
I can see a difference in her demeanour too. She seems calmer and she surprised me by eating on her own when I was there this evening. Not once, but THREE times!! See photos below!
Eating on her own!! This is actually this morning’s breakfast, but if she likes it “leftover”, that’s fine.
A second round of eating!!
A third round of eating!!!
I spent about an hour visiting Cleo. She seemed so much more alert and dare I say, happier too, compared to yesterday. The vet says it’s most likely the effect of the Gabapentin kicking in now, which is good.
Also, the vet purposely did not give Cleo Mirtazapine (appetite stimulant) and now, Cleo is eating by herself, on her own accord, which is a good sign!
For me, I just want Cleo to be comfortable and be able to eat. The vet said that Gabapentin is good for her because her kidney condition will cause back pain as well. She described the back pain as having something on the back. Poor Cleo. She won’t be able to tell us that, so yes, I totally agree with giving Cleo this low dose of Gabapentin for the long term.
I drove home in the very heavy rain with very, very heavy traffic. It took me one hour to get back from PJ to Subang Jaya, but it gave me time to think.
Our animals do not know what sickness they have. All they want is to feel better, more comfortable and to be nourished. In doing palliative care as I have done for so many of our pets now, that’s what I aim for. Thank goodness for modern medicine where we have all these medicines to help our animals now. They help give us some peace of mind and comfort too!
I will be visiting Cleo tomorrow. The vet might decide to do a blood test tomorrow for the kidney readings. If by chance it shows a good improvement, Cleo might be able to come home already!