A couple of days ago, I mentioned that I might have some good news to share this weekend. I say "might" because honestly I don't know what to believe at this point, and I'm hesitant to get my hopes up too much.
Jeff took Charlotte to the vet on Thursday for her regularly scheduled, twice yearly check-up to make sure that the condition of her heart and lungs isn't deteriorating. The office has a brand new department of Internal Medicine, and they wanted us to take Charlotte to see them, instead of to the Critical Care specialists like we have been doing. I'm sure that most of you that read my blog regularly have read (many times) that Charlotte, a little over three years ago, was diagnosed with congestive heart failure. We've been treating her with lasix, benazipril, and a low-dose aspirin compounded formula ever since that diagnosis. We've always known that this was not a forever-solution. That eventually the lasix would stop working and we would have some painful decisions to make.
So every time we take her in for this check-up, it's anxiety inducing. I always wonder if this would be the vet visit that confirmed my worst fears.
The new vet had reviewed Charlotte's considerable file. She checked her lungs, listened to her heart, and said that everything sounded great. Then, she went on to tell Jeff that she had serious doubts about the original diagnosis of congestive heart failure.
We'd been fully aware of the fact that we were extremely lucky that Charlotte was still alive after three years. The original prognosis was six months. Maybe a year if we were lucky. (And yes, we often muttered, good-naturedly, that maybe Charlotte was simply too mean to die.) But we hadn't examined the issue any further. Looking gift horses in the mouth and all of that. THIS vet said that not only is such a survival period with no signs of deterioration extraordinarily lucky, it was also, in the medical literature, unprecedented.
So, here's the timeline of events as I remember them.
September, 2008 - we adopt Charlotte. We notice that she has several coughing spells, maybe one or two big ones, a day. We chalk it up to hairballs and buy some PetroMalt for her. The symptoms continue, and we start to get concerned.
October, 2008 - Charlotte collapses in the hallway, gasping for air, at 11 PM on a Friday night. We rush her to the emergency vet a couple of towns over. They rush her to the back room without us even fully checking in, and wind up putting her on oxygen to save her life. They run some tests, take some pictures, and tell us that first of all, she has a nasty case of pneumonia, and has a lot of crud in her lungs. And that her heart doesn't look right. They suspect congestive heart failure, and the diagnosis is considered confirmed when Lasix helps her start breathing again. She is hospitalized for three days, during which time they perform a procedure called a "lung wash" which is exactly what it sounds like. She is also put on antibiotics for the pneumonia, and they work out what the proper twice-daily dosage of lasix should be.
*Humorous note: they didn't want to let her come home because she was not eating. Jeff asked what brand of food they were serving, and it was not the one that she was used to. They humored him by letting him bring some of her own food in. Which she promptly scarfed down. Stubborn lady.
November-December 2008 - One of the most expensive time periods of our lives. We take her in for several different tests, and even drive her to the next state over to see the only small animal cardiologist around. The cardiologist confirms congestive heart failure. She also tells us that there is scar tissue around Charlotte's heart, which indicates to her that Charlotte has had a couple of heart-attacks already.
One thing that every doctor said after looking at her... that she is not "playing by the text book." Her heart shows some of the signs of congestive heart failure, but not all. That where the heart walls for a normal cat with this condition would be thinning, hers are thickening. But no one questions it too much, since she's never had the symptoms again. We've always attributed that to the lasix.
And so this is why I'm so astounded at this new theory (and it IS still a theory) and really don't know what to make of it. The only way to test it is to take her completely off of the medication and wait a few days to see if she starts to have difficulty breathing. Of course if she started to have any difficulty at all, we'd put her back on the medication immediately. The vet recommended that we do this at a time where someone can be home with her for those several days. And that if she does have congestive heart failure, we should see signs of deterioration after a couple of days of no medicine.
Here is what we have decided, with the vet's help: the medications are not hurting her. We're leaving her on them for a couple of months. Then, on a weekend of our choosing, Jeff will try to get permission to work from home either on a Friday or a Monday. We'll take her off of the meds and watch her closely. After the weekend, whether or not we had to put her back on the medication, she needs to go back in to the vet for a check. Hence, the real reason we're waiting a couple of months... these specialist visits are not inexpensive!
Jeff did ask this vet about the entire collapsing and unable to breathe thing. The theory is, that is was mostly to do with the pneumonia, but that she might also have a touch of asthma. The reason that we haven't seen asthma symptoms since... lasix would treat asthma symptoms just as effectively as it treats congestive heart failure.
So everyone send some good thoughts our way. I would obviously love for this diagnosis to be the correct one. It's still not perfect, her heart probably is still not perfect, but it's a hell of a lot better than the original diagnosis, which was a long, slow death sentence. I am having some difficulty wrapping my mind around it though. And I can't get the image of me lying in the hallway, curled up around a gasping Charlotte, willing her to live long enough for us to get her to a vet, out of my mind.
Of course, Charlotte is as unconcerned about all of this as she ever is. Give her a patch of sunlight or a box to sit in, and she's as happy as can be.