The March Patient of the Month is Chai (who has the honor of being our first Cat featured)! He’s had quite a journey since we saw him at the end of February, with a few overnight visits and many checkups. He’s quickly become a regular at EVS and a patient we love seeing every time.
At the end of February, Chai presented to our ER to assess labored breathing. A murmur was heard upon physical exam and X-Rays were consistent with Congestive Heart Failure, so diuretic therapy was started overnight. In the morning, an echocardiogram confirmed the diagnosis of Congestive Heart Failure and Hypertrophic Cardiomyopathy (HCM), the most commonly diagnosed disease in cats. HCM is characterized by abnormal thickening of the left ventricle (pumping chamber). When the left ventricle becomes severely thickened, it cannot fill properly. This results in increased pressure in the left ventricle, and enlargement of the left atrium (collecting chamber). After being weaned off of oxygen, Chai was able to be discharged that afternoon.
A few days later, Chai returned due to increased respiratory effort. X-Rays revealed Congestive Heart Failure. It was concerning that it recurred so quickly, but we were being conservative with the diuretic given Chai’s reduced kidney function. We were able to increase the diuretic dosage and he responded well to oxygen therapy and overnight monitoring.
Chai was doing well at home for 24 hours, but then his respiratory effort increased again. He came in for a recheck and his X-Rays were consistent with moderate congestive heart failure. Dr. Lake-Bakaar was concerned that he was not responding well to oral diuretics, even though he was responding well to IV diuretics. After looking at his blood work, the cardiologist was also concerned that he was not absorbing the diuretic or had developed a resistance to this particular diuretic, so she decided to switch him to a different diuretic that is more easily absorbed by the body. He responded well to the new diuretic and we have been monitoring his kidney levels and adjusting the medication accordingly for the past month. His recheck went well last week and he’s doing well at home!
To learn more about Chai’s life outside of the hospital, we interviewed Chai’s owner, Melissa:
In 2008, the summer before my senior year of college, I got my wisdom teeth out and had some painful complications. My mom felt that a kitten was a better cure than prescription pain medication, and surprised me by driving us to meet a family whose cat had a litter of multicolored teeny fluff balls. Chai was an immediate standout from his siblings, with his unusual creamy orange coloring and huge Hemmingway paws he would never quite grow into. He was also the only one of the brood that seemed equally content to play as he was to be held and cuddled. We left with him that night, and I remember he stayed on my shoulder the whole car ride, not squirming or scared.
I can’t recommend investing in a kitten to deal with the temporary discomfort of dry sockets, but I also can’t imagine my formative adult years without Chai.
Chai has always been fearless and up for the next adventure. He’s moved with us to 10 apartments in 4 different states, including the 26 hour car ride from New York to Colorado. He seems to really enjoy car rides (although he’s a bigger fan of napping than watching the scenery). Chai happily explores new spaces, too eager to find the next great perch than be fearful of new surroundings.
A few years ago, I was working long hours and worried that Chai was understimulated and a bit depressed alone at home, so I got him a playmate, Shanti. Shanti certainly brought stimulation into Chai’s life! He quite literally bounces off walls, and Chai is more keen on judging his antics than joining in. While they aren’t the best of friends, they share a love of blanket forts and will concede to share one (as long as they are separated by a hefty cushion).
In Chai’s younger years, he absolutely loved jumping for toys. We put his toys on the top of door frames for him to leap up and catch, which he did easily with no starting crouch. He tirelessly played fetch with hair ties and did a better job bringing them back than most dogs I know. Chai also lived for the times a moth would get inside that he could stalk and catch with his big mitts.
Chai’s favorite golden year activity is taking a nap tour of each available blanket, although he’ll deign to sleep on the floor if there’s a sunny spot. He also loves when any humans come visit, as he seems to identify with them more than his own species. It wouldn’t surprise me if Chai throws house parties when we’re out of town, to get his fix of fellow human interaction.
Although he was a very picky eater most of his life, eating is definitely one of Chai’s favorite hobbies now. The only thing he likes more than eating food is eating treats. He is extremely skilled at convincing you he is famished. Will comes up with a lot of songs about both cats, and one of Chai’s is about his treat persuasion: “He’s a good boy, knows that he is, uses his charms to get those Greenies of his!”
Chai pretty quickly became a regular at Evolution, so not much time has passed since his last visit! He’s doing pretty well! He seems comfortable and pretty much back to his normal self.
The first week of this process honestly felt like a nightmare that wouldn’t stop. Chai is very stoic, so the idea of him suffering silently was crushing. After several attempts to medicate him at home weren’t working, I had very little hope that this last treatment would work.
It’s taken a lot of medication tweaks to get him feeling as well as possible, and we sometimes still wake up in the middle of the night with the urge to check Chai’s sleeping respiratory rate for the 20th time that day. But I’m immeasurably grateful for the extra time we have with our boy. I genuinely doubt he’d be on my lap snoozing right now if we called up a different emergency vet the night we noticed his labored breathing. After being almost resigned to putting him down, we see whatever time we have left with him as a bonus.– Melissa, Chai’s Owner