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Jaundice in HCM cat taking clopidogrel

Discussion in 'Cat Health and Nutrition' started by Elaineb73, Mar 1, 2021.


  1. Elaineb73

    Elaineb73 PetForums Newbie

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    My cat, Archie, was diagnosed with HCM at the beginning of February after having three fainting episodes and two bouts of panting. It was really scary. He is a rescue cat about five years old and we have only had him since last July. He is really affectionate and will lie in your arms. The specialist vet put him on Sotalol, half a tablet twice a day, and Clopidogrel, one tablet once a day. Last week I took him to the vet as he had only passed small round amounts of motions for two or three days. The vet said he was constipated and gave him an enema. He passed small amounts of poo in the vet then when he came home did a bit more in the garden which looked a funny colour sort of yellowy green. I got the vet to give him his clopidogrel while he was there as he is very difficult to pill. The next day he had to go back and I again got the vet to give him his clopidogrel but the vet phoned me before he gave him anything else to say he looked jaundiced and wanted to do a blood test. The blood test showed very very high bilirubin so an appointment was arranged with the specialist for tomorrow 2 March. Archie had to go back to the vets on Friday where he had an injection of cerenia, an injection of convenia, 4 ml of lactulose and his clopidogrel tablet. He really wasn’t well on Friday night into Saturday and on Friday he had several bouts of diahorrea. I have managed to get some food into him but not cat food. He is eating very little amounts of tinned salmon, roast beef slices and roast turkey. I did an internet search of jaundice and clopidogrel and found that in humans it can cause jaundice in 1-3 percent of cases. I then found a small study where a cat had suffered liver problems after taking it. The heart specialist had never heard of problems with the drug in cats but advised me to stop administering it for now so he is just on sotalol and a half tablet of cerenia. Has anyone else had a cat who has had side effects when taking clopidogrel? Many thanks for reading.
     
  2. Mrs Funkin

    Mrs Funkin Human mother to Oscar

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    How worrying for you @Elaine b37 :( Our boy has clopidogrel each day (along with fortekor and amlodipine for focal HCM and raised BP) but he also has a liver condition (Lymphocytic cholangitis) so has medications for that too. He doesn't exhibit any jaundice though. Oscar has been on 18.75mg OD of clopidogrel since September 2019. It took several weeks to get both diagnoses and was a very stressful time. He now has five medications each morning.

    Could it be that actually Archie has a liver condition going on as a separate issue? Is he having a liver scan/biopsy tomorrow? Paws crossed all goes well. Do let us know how you get on with him. Be strong Archie, I know it's tough having all these tests but the humans need to help you.
     
  3. Elaineb73

    Elaineb73 PetForums Newbie

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    I will let you know how we get on. Dread the thought of giving him any more meds. He hates us giving him any tablets. He hasn’t eaten so well today although he did have some of his munchies this morning. Yes I think they may do a scan tomorrow have to starve him overnight.
     
  4. Mrs Funkin

    Mrs Funkin Human mother to Oscar

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    I dreaded it too, Elaine. We started with two (steroid and Urso, for the liver condition) then added another three a few weeks later. It's definitely a two person job for us - and a couple of days last week he was REALLY feisty about having them. You do get more used to doing it - and I do talk to him about what they are for and why they are important. Good luck, Archie.
     
  5. Elaineb73

    Elaineb73 PetForums Newbie

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    Hello Mrs Funkin and Oscar. Which condition was discovered first the heart condition or the liver? There was no sign of liver problems prior to receiving the drugs for the heart. I don’t envy you doing five in the morning. We used greenies at first and that worked well for about a fortnight then he got wise to it. Then tried sausage that worked for three days. It is definitely a two person job and I think I can safely say that Archie is left pawed.
     
  6. Mrs Funkin

    Mrs Funkin Human mother to Oscar

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    For us it was the liver issue - we adopted him aged 11 and knew nothing of his medical background. The anorexia started and as a result he had a dental extraction (it was very sore) and after the GA just never started to eat. It took a long time to get to the bottom of everything, a lot of worry, crying, begging him to eat, talking to him and asking him to let me know if he was done being in the world. It makes me so sad when I read our Oscar thread about that time in our lives. He lost 670g in weight in 16 days, which was terrifying. His bloods were showing some renal damage which a couple of the vets kept referring to but our vet always felt that they were a red herring and it wasn't CKD (it wasn't) as he didn't clinically present as though he had CKD. The lymphocytic cholangitis was diagnosed by scan and a biopsy - which involved sedation which was worrying given his previous reaction to anaesthetic. He had a heart murmur and was cardiac scanned at the same time, which was okay. Six weeks later he had another cardiac scan, as he still wasn't right and his vet said if she hadn't done both scans, she wouldn't have believed it was the same cat as the deterioration was so great in six weeks. That was when the focal HCM was diagnosed.

    However, he is still with us - and is pretty chirpy most of the time. He is super fussy with food though! We absolutely cannot put medication in any food/treats/pill putty etc., as it sparks a huge reaction and refusal to eat, so we just pill him. Our vet and I have an understanding that if she thinks we are going too far, she will tell us. She saw him a couple of weeks ago and is very happy with how he is doing. I hope this gives you some hope for your boy. I hope you can find an alternative to clopidogrel if they do think he has had a reaction to it.

    Good luck Archie.
     
  7. Elaineb73

    Elaineb73 PetForums Newbie

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    That sounds so familiar. The crying, sitting with him trying to get him to eat. At the moment he has about six bowls of different foods but if he eats even one I feel relieved. Glad your boy is doing ok at the moment. I think the trouble is when they are rescue cats you don’t really know the background. Archie was found living under a conifer. I read somewhere today that HCM could be related to a lack of taurine which strays might be more susceptible to because no reliable food supplies.
     
  8. Mrs Funkin

    Mrs Funkin Human mother to Oscar

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    I think our "personal worst" for a day was 16 different pouches being opened. Personal worst for eating was 10g in a day. That's interesting about the taurine. Oscar wasn't a stray but he wasn't particularly well looked after.

    Hope you aren't too cross about not having breakfast in the morning, Archie.
     
  9. QOTN

    QOTN PetForums VIP

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    Unless it is a recent discovery, the heart condition sometimes caused by lack of taurine is DCM or Dilated Cardiomyopathy. That is where the heart is enlarged. HCM or Hypertrophic Cardiomyopathy is a condition where the heart wall is thickened. I have a boy with asymptomatic HCM and he is on Fortekor and a quarter of a junior aspirin three times a week. The aspirin is to prevent a thrombo-embolism.

    When clopidogrel was introduced, I asked my vet if my Biscuit should be given it and he said the aspirin was better for asymptomatic cats but I do wonder if it might be a possibility if your vet decides your boy is reacting badly to the clopidogrel. I have had a quick google and it seems the plavix is generally well tolerated in cats so I hope the specialist can sort the problem.
     
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  10. Elaineb73

    Elaineb73 PetForums Newbie

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    He has been to the specialist this morning. As his bilirubin has declined from 119 last Thursday to 28 today the vet said we could just keep an eye on him rather than go for the scan at the moment. He has also eaten some cat food today. The vet said though that Archie’s liver is enlarged. He has sent one of the blood tests away to an external lab as he wants to see the results of this. At the moment he says not to give the clopidogrel. Archie was much brighter this morning the vet also said Archie’s heart rhythm seemed much better.
     
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  11. Mrs Funkin

    Mrs Funkin Human mother to Oscar

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    Oh that's good, lots of positives in there @Elaine b37 :) Well done Archie. I hope all remains stable.
     
  12. Elaineb73

    Elaineb73 PetForums Newbie

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    The specialist phoned today. His external blood results show increased liver enzymes and the bilirubin higher than the results at the vets. He has to have another external blood test next week. The specialist thinks it may have been some sort of acute shock to the liver. He still isn’t eating much wet cat food but is eating dried cat food. I am wondering if his mouth is sore for chewing.
     
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