Following are selected posts to the Holisticat (TM) Mailing List on the subject of the heart. There's a lot of information here, and the posts are arranged in ascending chronological order. If there is a particular word you're looking for, it's probably best to utilize the "Find in Page" function in your edit menu!

Happy hunting :)

(Also see Cardiomyopathy archive & FAQ)

<30 Oct 1998 From: Vick Re CPK levels...>

hey all-

<<Can someone please tell me about a high CPK reading.  My "little boy's" CPK level was 4683 out of a range of 56-529.  I know  that CPK can come from the heart, muscles, and brain & lungs.>>

<<Yes, they all appear to be within the normal range.  CPK is something put out by the 1)heart, 2)brain & lungs, and 3) muscles.  Can't recall the exact word c---phosphokinase, or something of that sort.>

okay, here's what i found on hillary's site (she has her vet school notes online and they're searchable!!):

CPK in regard to myofibril breakdown in MI: (myocardial infarction?)

but the enzymes that are liberated that are most often used as diagnostic tools are the serum GOT (a transaminase) and creatine phosphokinase CPK and also dehydrogenases. when you see elevations of these enzymes in the serum, that would suggest myocardial damage. that doesn't really mean the animal has to have myocardial damage. it could have skeletal muscle damage, or liver damage. so you can't go by this alone. but if you do an EKG if there is muscle damage you will see EKG changes like deviation of ST segment. when you have EKG changes along with the enzyme changes you can confirm the MI.

from what i can understand, you should probably have an EKG done on your kitty.

here's another snippet:

when people have heart  attacks, the first thing MDs due is draw blood and check CPK. when heart muscle is damaged, it leaks, and CPK will increase.  bloodwork would show rise in these enzymes...occurs in seconds.....these changes are early indicators of disease.here's the search page in her notes:
http://www.hillary.net/school/#search

if you need help w/ terminology, let me know. i have most of the lingo down from my vet assisting and pre-vet course work days.
Vick, Skippy, Sam, Max and Jezebel

Hi -

<<Yes, they all appear to be within the normal range.  CPK is something put out  by the 1)heart, 2)brain & lungs, and 3) muscles.  Can't recall the exact word - c---phosphokinase, or something of that s>>

I am talking human biochemsitry here but I a guess a lot of it   applies to all mammalian species! CPK or CK is creatine phosphokinase,  an enzyme found in muscle tissue.  AS Vick mentioned,  it is elevated in myocardial infarction, being the first "cardiac" enzyme to rise after the MI.  AST and LDH (lactate dehydrogenase) are the other 2 enzymes usually measured to
check for MI.

However,  even higher CK levels are seen in muscle disorders such as muscular dystrophy.  In MD the levels are raised many times above normal (in the 1000s).  In Duchenne muscular dystrophy, for example,  CK levels can also be used to determine if a person is a carrier -  the levels in these people are way above normal but not nearly as high as in the disease itself.

I don't know a lot about muscle disorders in cats,  but the very high level you found may well indicate something like MD.  First thing to do would be to check the level on a  fresh blood sample just in case there's been a lab. error or something wrong with the sample. Hope you hear what the problem is.

Naomi

Hi all

CARDIOMYOPATHY
Cardiomyopathy refers to impaired function of the heart muscle. There is more than one cause in cats, and not all causes are known.

Dilated cardiomyopathy occurs when the heart muscle loses its tone and becomes flaccid. The heart chambers overfill, the walls of the ventricles become thinner and the chambers enlarge. One cause of dilated cardiomyopathy is taurine deficiency. Another cause is myocarditis, which is inflammation of the heart muscle. (Virus diseases and autoimmune diseases  have been implicated in the cause of myocarditis in humans.)

Dilated cardiomyopathy is often a rapid onset disease that progresses over two or three days as the heart begins to fail. The most frequent sign is labored breathing at rest.

The treatment of dilated CM is directed at correcting taurine deficiency when present, and controlling fluid retention. A restricted mineral and sodium diet is recommended.

Hypertrophic cardiomyopathy tends to affect cats one to five years of age. In this condition the walls of the ventricles become thick. However, because the muscle fibers are replaced by scar tissue, the thicker heart wall does not translate into increased pumping power. Loss of pep and appetite and reduced exercise tolerance are signs.

Hypertrophic CM requires the use of drugs that relax the heart and increase its efficiency. Most of the drugs used in treating heart disease in people are used for similar purposes in small animals. The choice depends on the stage of illness and presence or absence of complicating factors such as arrhythmia.  These measures often yield results in a longer, more comfortable and active life for your cat.

Accurate diagnosis is necessary to establish which form of the disease is present to provide the proper therapy. Chest X-ray, electrocardiogram, ultrasound of the heart and thyroid function tests are utilized.

Coolness of the feet and ears and a below normal body temperature are signs of poor circulation. Heart murmurs are common.
Loss of appetite, rapid weight loss, weakness, fainting attacks and crying out spells often accompany the above signs of illness.

I haven't found a lot of stuff on the Net connected with CoQ10 and cats, but  http://www.homevet.com (Dr. Jeff Feinman) mentions it. He may be willing to direct your vet to his info if you wish.

Also:

http://www.oocities.org/Heartland/Plains/1151/hlthlnks.htm is a page devoted to Cat Health-Related Links, including cardiomyopathy links.

http://www.ovcnet.uoguelph.ca/ClinStudies/Courses/Public/Cardiology/Concepts/conceptsindex.htm is an excellent university site with tons of stuff on cardiomyopathy. Somewhere in there I saw CoQ10 but I can't remember where...

http://www.ovcnet.uoguelph.ca/ClinStudies/Courses/Public/Cardiology/Concepts/Concepts86-105.htm#94. is the specific feline CM page in that site.

www.vetinfo.com may be of help www.vetheart.com - also may find something, or perhaps your vet can pry alternative med info out of them.

It's true that the human studies seem to have dealt more with CoQ10 and dilated CM but if it was my cat I'd try it with hypertrophic CM also. 10mg daily seems to be a minimum dose, with 30mg having been recommended by a feline cardiologist as a therapeutic dose, and the owners on the Holisticat list with CM cats are using that dosage.

--Jean, Saski Basket & Amber Sweet T'ing

Leah writes:
<<the dosage (even more surprised look on my face - it's really too bad Giddy doesn't like this vet much). I guess the enzymes that pertain to heart activity have been somewhat elevated all along, but now the CPK is higher than it should be.  For those of you who have CRF kitties with heart disease, when you've had blood panels done, what is the CPK level?  >>

Just a FYI,  CPK (creatine phosphokinase) is not JUST a "cardiac" enzyme.  It is also an indicator of muscle damage elsewhere in the body (e.g it is elevated way above normal in muscular dystrophies - in humans that is).  A slight elevation may not even be significant,  allowing for random errors in analysis,  drawing of the blood sample etc.  After an MI, the CPK is usually the first enzyme to go up,  but it only stays elevated for a few days.  I wasn't aware that it was elevated in chronic cardiac problems.

I am using human references because that;s my experience (was a clinical biochemist previously)

First thing to do when any test comes back abnormal is to check the analysis again on the same blood sample,  then take a fresh blood sample and repeat everything!  This doesn't seem to happen too often in veterinary pathology!!

Naomi

Naomi,

Just a question.  We had a blood test on our cat about 3-4 months after a muscle injury.  It may not be related, but everything was normal except the CPK - it was about 4300, where the highest normal was 500 +/-.  Our allo vet suggested all the heart tests, but wasn't too concerned or worried.  We have not done this as yet, and I'm more inclined to suspect muscle problems, as  he tends to be just a wee bit weak in the muscle dept.  What's your thought on this?

Judi & the MacFolds

Naomi

Judi, you asked about one of the blood values (CPK) that apparently relates to the heart - Giddy's was 356, which is way off the charts and out of normal range (normal according to this chart is 25-185)  When I first had his blood panel done in June of '98, it was 326.  What was your fold's? Giddy's other values are far from normal though too:

BUN - 55; only slightly up from 53
CREAT - up to 2.8 from 1.6 on his previous test

Liver values quite high
    SGOT 445 (could this be right?) - up from 85 (yowza!)
    SGPT 295  - up from 121
LDH had lowered considerably from 575 down to 216.  Other than the above values, nothing else was much out of whack. The hematology aspect (rbcs, platelets, lymphs, etc) were all within normal ranges.

Although I need to determine what to do about those liver values, could those of you who have been using supplements for the heart, please e-mail me privately and give me the amounts of taurine, hawthorn, CoEQ10, etc. that you are using, pretty pllleasee?  This may be part of the reason for his coughing/gagging/catching of breath episodes. I have had so much trouble with my e-mail program swallowing posts I've tried to save lately, I haven't been saving much.  I'll just write it down when I get it and keep it in Giddy's medical folder at home.

TIA,
Leah

Hi all

My last post about bladder problems hasn't shown up yet, as far as I can tell, but here's another post on heart problems. Heidi, this may all be a bit overwhelming at first, but I hope some of it can do some good. If your vet only suggested taurine and nothing more drastic, it is my hope that the murmur isn't too severe. This first part is from CJ Puotinen's "The Encyclopedia of Natural Pet Care".

begin quote

Nutritional Therapy: to prevent and help treat heart disease, feed your pet a well-balanced, raw diet. Supplement the diet with high quality vitamins A, E, and C, coQ10, essential fatty acids and trace minerals...

Cider vinegar provides essential potassium; make a cider vinegar tincture of garlic or add cider vinegar by itself to food and water. Magnesium is essential to heart health but consult with your holistic veterinarian before adding magnesium supplements in large quantities. Raw bones provide magnesium, calcium, potassium and other minerals in the form most easily assimilated by dogs and cats in their proper balance; make raw bones your first choice in mineral supplements for heart health.

Selenium, zinc and chromium are also essential for the heart. Feed foods that are rich in these minerals, such as Brazil nuts (selenium), lamb, turkey and beef (zinc) and brewer's yeast or nutritional yeast (chromium) or give appropriate supplements. [My note: many animals are allergic to yeast; it may be wise to supplement cautiously with this one.]

Without the amino acid taurine, cats develop heart disease. This is not a risk factor for any cat on a raw-meat diet.

Herbal therapy: Garlic, which is both a food and a medicinal herb, is one of the best herbs for the heart. By far the most frequently prescribed herb for heart disease is hawthorn berry; it repairs and strengthens heart muscle and can be used daily for months or years with no adverse side effects. [My note: once again, I'd advise caution in using *anything* for months or years.] ... The Chinese herb fo ti protects and dilates blood vessels, increases blood flow to the heart and acts as an adaptogen to correct imbalances.

Cayenne pepper is another heart healer. Add small amounts of cayenne to your pet's dinner or give cayenne in capsules with plenty of food and water. Start with standard-strength cayenne, usually 45,000 heat units... Gradually increase the amount of cayenne in food or capsules or increase the heat units (100,000 or more)... Cayenne is appropriate for prolonged daily use.

The herbs gotu kola, ginkgo and ginger all help improve circulation. Bilberry strengthens capillaries. Add their teas, tinctures, powders or capsules to your pet's food on a rotating basis along with fresh minced dandelion greens, watercress and other herbs.

Homeopathy: For mild cases of heart weakness, the tissue salt Calcarea fluorica 6X can be given daily. If the problem is related to nervousness or excitement, use Kali phosphoricum 6X. [My note: perhaps someone better versed in homeopathy and tissue salts can confirm the daily use of salts???]     Crataegus oxyacantha remedies at low potencies such as 1X or 3X are
widely used for animals with weak, dilated hearts, breathing difficulty, fluid retention, and, in most cases, nervousness or irritability.
end quote

Pitcairn's suggestions include a B complex vitamin, especially with niacin and pyridoxine. He says major components should be 10-50 mg each. He also recommends a trace mineral supplement containing chromium and selenium, and chelated zinc. I can post his and Macleod's homeopathic suggestions if anyone's interested.

Diane Stein's suggestions are very long; I'll post these tomorrow.

Take care all
Kathy and the cats

Hi all

This is again very long. I want to include the Stein stuff because she says some interesting things about each *side* of the heart. I'll break this into two or three posts; this is Stein's "The Natural Remedy Book for Dogs and Cats", followed by Pitcairn, Macleod and maybe Allport.

begin quote

When failure occurs in the left side of the heart, pulmonary pressure builds, resulting in lung congestion and pulmonary edema (fluid buildup in the lung sacs). The animal coughs after exercise, may bring up a bubbly red fluid, is out of breath, and her tongue and gums may look bluish. The pulse is rapid, weak and irregular, with heart murmurs. When the dis-ease is advanced there may be anxiety or fainting spells. Coughing at night and after exercise or excitement are early symptoms. When the  failure is on the right side, pressure backs up in the veins, resulting in congestive heart failure. The animal is lethargic, with shortness of breath, heart murmurs, rapid pulse and lack of appetite. In later stages there is weight loss, spleen and liver enlargement, kidney failure and fluid in the abdomen.

In cardiomyopathy in cats the heart wall either thickens and stiffens, or thins and balloons out. There is low blood pressure, resulting in not enough blood to nourish the organs. Organ failure occurs, and blood clots may cause strokes.... [some stuff about dogs and heartworm snipped]

Naturopathy: Apple cider vinegar in the water bowl or on food is a potassium supplement for pets on diuretics; it may make a veterinary potassium medication unnecessary. Raw honey and / or bee products strengthen the heart, and are tonics and nutrients. Garlic lowers high blood pressure and cholesterol levels. Kelp lowers blood pressure and eases angina pain. For cats with cardiomyopathy's low blood pressure, substitute trace mineral powder for the kelp in [Frazier's] Vita-mineral mix. Richard Pitcairn suggests substituting dolomite powder for bone meal in the Dog/Cat powders. Be careful of lead contamination in dolomite if you choose to do this; a trace mineral powder is preferred. Give digestive enzymes daily with meals.

Vitamins and Minerals: Pets on veterinary heart medications need increased amounts of all vitamins and minerals. Diuretics in particular wash nutrients from the body. Use vitamin C in the salt-free ascorbic acid form, going to bowel tolerance. [My note: perhaps calcium ascorbate would be easier on the stomach than ascorbic acid?] Vitamin E is primary in all forms of heart dis-ease and hypertension. Give 100 IU daily for cats. Give 10,000-25,000IU of vitamin A daily [??] with 400-800 IU of vitamin D once a week. Both vitamins A and E come in emulsified dry forms that are easier to assimilate and make overdoses impossible. [My note: never say never. Use caution.] Pat Lazarus suggests adding vitamin E only after the pet's heart is stabilized. She also suggests magnesium to regularize the heart rate and potassium (as cider vinegar). Other minerals include 5-10 mg of zinc daily (important), and chromium and selenium in the trace mineral powder. Give a daily complete B complex in higher amounts than usual (20-50 mg), with additional B6 and B3 (niacinamide form only). CoQ10 helps bring oxygen into the cells and tissues. Essential fatty acids, such as evening primrose oil [my personal feeling would be to use salmon body oil instead for cats], may
prove helpful.

Herbs: Hawthorn berry is the most frequently recommended herbal for the heart; it is a tonic, strengthener and heart muscle repairer, and may be used daily long-term...Do not skip doses. Hawthorn may also be given as a tea/infusion, or made into an elixir. The major heart drug digitalis was synthesized from the foxglove plant, and a similar herbal -- considered safer -- is lily of the valley flowers. Use either of these only under expert supervision, or the homeopathic remedies.

Juliette de Bairacli Levy recommends rosemary tea with honey as her central herbal for heart dis-ease and heart weakness. Give one level tsp of pure raw honey to every tbsp on rosemary infusion. In addition, use dandelion and / or watercress in one meal per day as a diuretic and for mineral contents. Heartsease (wild pansy) is another heart tonic herb. Parsley or dill seed tea also makes excellent herbal diuretics and can take the place of medical drugs. Uva ursi (bearberry), juniper and buchu are other herbal diuretics. [My note: I recall that juniper is not supposed to be given to cats, and that bearberry is contraindicated for cats with kidney disease. I hope I'm remembering that correctly, someone set me straight if I'm wrong!] Alfalfa increases the action of other herbs taken along with it; it also regulates blood pressure and reduces cholesterol. Scullcap is a safe calmative, as is peppermint tea. A combination of scullcap, cayenne and goldenseal is a heart strengthener (but tastes awful -- put it into
capsules).

Homeopathy:

• Crataegus, homeopathically prepared hawthorn, is the remedy for the animal with extreme breathlessness on exertion, when she has irregular, weak or intermittent pulse, when symptoms worsen as the environment worsens, when she has high blood pressure and is nervous and irritable.
• Convallaria majalis (lily of the valley) increases heart action and regulates heart rate; it is recommended when there is difficulty breathing, dropsy, angina, palpitations from the least exertion, and lung congestion.
• Digitalis (foxglove) is used after faintness or prostration following exertion; the pulse or heartbeat is abnormally slow; the animal may collapse; she may have a blue tongue; and there may be liver involvement.
• Apis is indicated when there is edema (water retention, dropsy).
• Strophanthus hispidus is for heart weakness due to valve problems (murmurs); there is a weak, irregular pulse and difficult breathing. The pet may be obese and have skin problems.
• Carbo veg aids breathing.
• Spongia is for dry, gasping heart coughs.
• Aconite is a first-aid measure.
• Give Cactus Grandiflorus for emergencies and for general heart dis-ease symptoms; the animal may respond to cactus where other remedies fail. Crataegus and Cactus are the two primary remedies for pets or people with heart dis-ease.

Hi all

Pitcairn's homeopathy suggestions

begin quote

• Tissue salt Calcarea fluorica 6X: helps to restore strength to the heart muscle, especially when it is dilated and the action is weak.
• Tissue salt Kali phos 6X: Suited for the problem that seems more functional (rather than the result of tissue changes or pathology). That is, such things as nervousness and physical or emotional excitement seem to lead to symptoms.
• Homeopathic Crataegus 3X: Indicated for the animal with a dilated heart, weak heart muscle, difficult breathing, fluid retention and (often) a nervous or irritable temperament.
• Strophanthus hispidus 3X: For the weak heart with valvular problems. The pulse is weak, frequent and irregular, and breathing is difficult. There may also be fluid retention, loss of appetite and vomiting. Obesity and chronic itching of the skin also point to this medicine.
• Digitalis 6X: Give one tablet of the 6X potency after an attack in which the animal collapses or even faints after exertion, with the tongue turning blue. Often the pulse or heart rate is abnormally slow. There may be heart dilation and fluid retention. Liver disturbances may be evidenced by a white, pasty stool. If you give a tablet after each attack, the attacks will become less frequent (if treatment is helping).
• Spongia tosta 6X: For the animal whose crises are characterized by a rapid pulse, difficult breathing and fearfulness. It may have difficulty lying down and may breathe easier sitting up. A dry, persistent cough is an indication for this medicine.

He says these remedies are to be given once a day for four weeks.

Macleod's homeopathic suggestions (From "Cats: Homeopathic Remedies")

• Lycopus: An exaggerated, quick, irregular pulse. Prominent breathlessness. 3X, one dose twice daily for 30 days.
• Adonis: One of the best remedies for valvular disease. Urine output is decreased and the urine contains albumen and casts. The heart action is exaggerated. 1-2X, one dose 3 times daily for 21 days.
• Convallaria: The pulse is full and intermittent and the animal is disinclined to move. 2X, one dose three times a day for 21 days.
• Lilium tig: Small, rapid, weak pulse. Even slight movement exacerbates the condition. Sometimes the remedy acts better in the female. 3C, one dose twice daily for 30 days.

On Wed, 9 Jun 1999 LNHAR@ wrote:
<<something first.They gave him an IV with fluids and he seemed to do better.  He also has spells where he coughs and his little tougne hangs  out.  After  living here for about 8 months he had a terrible attack and I took him to the  vet where they kept him for a week and he pulled though again after alot of  tests and a lot of expense they said they think he may have kidney trouble.>>

Nancy, has your vet checked Simon's heart and lungs for congestion?  What you are describing is what cats do when they need oxygen.  That's why it's seen in cats during an asthma attack and also when they are suffering from Congestive Heart Failure (CHF).  IV fluids and the ones u do at home (subqs) deposit fluid not just to the kidneys but all over the body including the heart.  So pls make w/ your vet if it's safe for your kitty.

having said that, I'd urge u to also consider giving your cat Dandelion Leaf tea as a diuretic.  If Simon has pulmonary edema (fluid in the lungs), it may need to be aspirated by the vet.  The last thing he'd need then is more fluids forced into his body.

<<ever ready bunnie he keeps on going.  He drinks a tremendous  amount of water  and pees large amounts. I fear his days are numbered. I dont know if I should  take him in for another IV or have him put down his will to live is something  to behold . I would not like him to suffer.>>

Sounds like he has CRF alright.  But there is lots of hope for cats w/ CRF.  We have many on the list who are doing very well indeed - Leah'cat Giddy and Betty's Aldonza come to mind right away.  It's so neat that he has a strong will to live.  Unless he seems in pain or discomfort, I purrsonally would find it hard to see putting him down.  But pls don't assume IV fluids are your only option b/c they are not.  If anything, they are contrindicated w/ CHF and hypertrophic cardiomyopathy (HCM) Feel free to write to me if I can help.  There is a CRF FAQ on the list's website you might want to read. http://www.holisticat.com/crf.html
[snip]

Sandy, owned and operated by the mountain kitties who all love Burmese cats