[faranya]

My five-year-old neutered male cat was diagnosed with early cardiomyopathy in mid-May, after four years of normal routine checkups (the last one in October). His heart x-ray revealed a heart of normal size, so the diagnosis was made on the basis of an elevated heart rate (200). He also had cold feet, perhaps from blood clots. He didn't suffer from major symptoms, however; I recognized that he seemed to be somewhat less than his usual happy self and acted accordingly, but a casual observer would not have said, "This is a sick kitty."

He was immediately put on 30 mg diltiazem per day in tablet form, which was increased to 45 mg. As well, he was given a course of lasix, together with baby aspirin in very low dose. Ultimately this was discontinued. He was also prescribed Clavamox, which was renewed when the first course ran out.

Follow-up blood work revealed what appeared to be kidney impairment, so the vets assumed that there had been some renal problems owing to clots. We began subcutaneous saline injections (30cc twice daily) which I did at home, plus a potassium supplement. The saline was later cut back to once every other day, about ten days ago.

But little Gollum's appetite has plummeted since he took his first diltiazem. He's gone from almost 14 pounds to just over 10. He's always loved to eat but now he just licks at it, making a game attempt to please me. He is clearly anorexic and seems nauseated off and on. Follow-up blood work last Friday showed kidney function is now normal in all respects (!) but hepatic function has been disrupted - and that was normal earlier. I don't have the readings, however. My vets then put Gollum on a week's worth of liquid pediapred (3 ml a day), as the liver area felt tender to the touch. He also got another round of Clavomox which ends tomorrow. The prednisone finishes Saturday. He's also on 30cc of the subcutaneous saline, three times a day, and potassium capsules (234 mg). six per day. His diltiazem is now administered inside his ears, since he's being asked to swallow so many other things. The poor little fellow is enduring something like fifteen different doses and injections each day!

Needless to say, he looks and acts really depressed about life. He's gone from a happy-go-lucky adventurer on our 4 1/2 rural acres to a dull, miserable huddler in a corner. He still wants to go outdoors and is walked regularly so he can pee in the grass. He has no bowel movements to speak of (although he did have one in his carrier coming home on Friday), as he's ingesting only pureed foods turned into soup (liver, low-sodium salmon or tuna, pricy little tins of wet cat food). I added a bit of olive oil to this evening's puree in the hope of incorporating extra calories and some good fatty acids.

So my question is this: is it possible the diltiazem is causing this appetite loss? My vets are terrific folks so I hate to press the point. But when I asked them, they told me the drug hadn't caused this kind of problem for other patients. Yet I've done research which indicates it's a culprit in anorexia, vomiting and even hepatic complications.

If anyone can offer some added insight here, I'd be most grateful. We have another appointment with the vets who, needless to say, know us rather well by now. But I was wondering how to tactfully revisit this issue. I've come across the drug atenolol in my reading and am wondering whether it might be a viable alternative. The Incredible Shrinking Kitty sure does need that!

Thanks to anyone who can make any suggestions. I'm financially strapped now, as I'm a retiree on a fixed income, and emotionally I don't have much to work with. I can't afford to keep pursuing treatment options that might make the situation even worse for my cat. Nobody wins in that case. Yet I also want to do right by him. He's a sweetie who deserves it.