From:
Pam Sessoms
Date: 2003-09-20 20:22:30 UTC
Subject: managing cardiomyopathy and chronic kidney failure
To: ferrethealth@smartgroups.com
Message-ID: <Pine.A41.4.44+UNC.0309201610380.40262-100000@login4.isis.unc.edu>
Hey all,
I'd love any advise from anyone who has dealt with chronic renal failure
and cardiomyopathy simultaneously. My old guy Pumpkin has had chronic
kidney failure for a year or two but has done great. His only treatment
has been receiving large volumes of oral liquids (very watery soup) -
about 200 ml's of soup a day. His creatinine ranges between 1.2 and 1.4
and his BUN had been in normal range.
A couple of weeks ago, he began wheezing and became lethargic and was
swiftly diagnosed with dilated cardiomyopathy and left-sided heart failure
causing fluid to go into his lungs. With the dehydration caused by the
lasix, his BUN was elevated for the first time at 65; creatinine was still
around 1.4.
So far for his heart, he's on Lotensin (benazepril - mostly processed by
the liver rather than the kidneys like many other ACE inhibitors) and I'm
maintaining him on the injectable lasix rather than the oral. He gets 1 -
1.5 mg of injectable lasix twice a day while he eats soup; I dilute it
with some Ringers solution and he never flinches. He gets supplements of
CoQ10, taurine, L-carnitine, and hawthorn. We're also using nitroglycerin
paste. I've used it on previous cardiomyopathy ferrets, but only during
acute wheezing attacks.
The tricky part now is the amount of fluids he'd been getting for his
kidneys. At this point, he's getting a total of 180 ml's of soup daily,
broken into 3 feedings. However, I'm expecting that as his heart worsens,
he won't tolerate that much without having trouble breathing. Also, I
know he's on a fairly low dose of lasix now and there is a lot of room to
go up, but there is concern for his kidneys with increasing lasix. He's
improved since the cardio was diagnosed and plays actively a few times a
day (running, wrestling, chasing, dancing etc, normal ferret play).
Has anyone else been down this road, and can you let me in on any tricks
you found? Or, how did you best balance CRF and cardiomyopathy?
Thanks for any advice!
-Pam S.