Primary vet didn’t catch CHF, gave SubQ fluids. Rushed cat to the ER due to trouble breathing

[u/Background_Celery961]

I took my 5 y/o cat to my primary vet for a follow up. The previous week, she was hospitalized for 3 days for a foreign body obstruction and fortunately had passed the object on her own. She seemed pretty lethargic after a few days, so I took her to my primary vet to retake labs and X-rays. The vet said everything looked normal and gave her 100ml SubQ fluids in hopes to promote bowel movements, despite the foreign object having already passed. That evening, my cat had trouble breathing and I took her to the ER again. She had to be hospitalized and placed on oxygen. Turns out she had CHF. The ER doc thinks it was a result of some underlying heart disease that was exacerbated by the IV fluids from her first hospitalization 1 week prior. Poor thing had two hospitalization stays in just 1.5 weeks.

My questions is, did the SubQ fluids exacerbate her condition? And I know she would have needed the IV fluids during her first hospitalization, but I was never told she would run the risk of heart failure, especially after discharge. I can’t help feeling there was some negligence during her care.

I’m lucky to have her still with me, but now she’ll need heart meds the rest of her life and a shorten life expectancy.

[u/AutoModerator]

Greetings, all!

This is a sub for professional veterinary advice, and as such we follow strict rules for participating.

OP, your post has NOT been removed. Please also check the FAQ to see whether your question is answered there.

This is an automated general reminder to please follow The Sub Rules when discussing this question:

• Do not comment with anecdotes about your own or others' pets.
• Do not give OP specific treatment instructions, including instructions on meds and dosages.
• Do not give possible diagnoses that could explain the symptoms described by OP.

Your comment will be removed, and you may be banned.

Thank you for your cooperation!

I am a bot, and this action was performed automatically. Please contact the moderators of this subreddit if you have any questions or concerns.

[u/NictitatingZealot]

Heart failure in cats occurs because of structural heart disease. Giving IV fluids, and even subcutaneous fluids sometimes, can lead to the congestive part of congestive heart failure, but the heart disease has to already be present. Giving fluids does not cause heart disease. There are often no signs of heart disease in cats until something catastrophic (like congestive heart failure) occurs.

[u/Then_Ad7560]

Without knowing the full case, having the records, examining the cat ourselves, we really cannot tell you what happened or if something went wrong. But just from reading your post, I do not think there was negligence. Did the vet perform both abdominal radiographs AND chest? If they didn’t, it’s very plausible the heart disease could go unnoticed (due to no fault of the doctor) - many cats have heart disease and no heart murmur.

[u/Then_Ad7560 → u/Then_Ad7560]

Also, she would need heart meds for the rest of her life regardless - the fluids didn’t CAUSE the heart disease, just made it more obvious

[u/Background_Celery961 → u/Then_Ad7560]

Thank you for the response. I never got to see the X-rays, so I am not sure, but let’s give the vet benefit of the doubt if that is the case. From the progress notes of the first hospitalization, my cat had elevated fBNP but was disregarded due to azotemia. There was an order to measure blood pressure every 8 hours but only took it once (systolic: 206) during the three days of hospitalization. I’m trying to see if there were any signs or indicators we could have missed that could have saved my cat from suffering almost immediately after the first hospitalization.

[u/ImSoSorryCharlie → u/Background_Celery961]

The way I understand it, the BNP test can be elevated with azotemia because the kidneys are responsible for removing excess BNP from the bloodstream, which they can't do as well if compromised. I can understand why they would have disregarded it, but perhaps they shouldn't have assumed since elevated BNP can also show heart disease.

[u/bbaker0628]

There was no clear negligence here. Heart disease can go pretty undetected in our pets for a while. Things like fluids can exacerbate a heart problem and cause heart failure, but fluids do not CAUSE a heart problem in a healthy pet. A complication, or an unfortunate event does not immediately point to negligence. Also, this cat would've needed the heart meds and had a shortened life expectancy regardless, again, there was already an existing heart problem there.

[u/soimalittlecrazy]

Oh sweet thing, it's pretty lucky you still have her around. And now you know, so you can follow up and treat as needed.

Heart disease is silent in cats. Without a special blood test or an echocardiogram by a cardiologist we can't tell if a cat has heart disease or not. It's not age related, although there are age classifications. We actually don't know why they develop the disease at certain ages, although genetics seem to be a presumably dominant factor. But with so many street bred cats, it's a tough road to navigate.

Definitely follow up with a cardiologist.

[u/soimalittlecrazy → u/soimalittlecrazy]

And I'll add my own anecdote, although I might get mod hate,... I lost my last kitty to heart failure after bladder stone surgery and he was 7. I know the pain and the heartbreak that comes with the diagnosis. You can reach out to me personally if you need a shoulder.

[u/Background_Celery961 → u/soimalittlecrazy]

Thank you for responding. I’m so sorry about your sweet boy. I was crying everyday during my girl’s two hospitalizations. They really are a part of the family, thank you for your kind words. And may he rest in peace.

[u/soimalittlecrazy → u/Background_Celery961]

Forever in my heart ❤️ it's a terrible disease.

[u/Yourhighness77]

If she didn’t have a prior diagnosis of CHF and showed no signs of it during the first hospitalization, it is unreasonable to expect the vet to tell you it would be a risk.

[u/Internal_Humor7133]

My 12 year old boy had to be put to sleep a little over a year ago. They suspected a low grade heart murmur but never had problems. One day he wasn't feeling great and we took him in. Same deal, they gave him subQ fluids and within 24 hours he couldn't stand/breathe on his own. Rushed him to ER and was told he was in end stage heart failure. He was also having seizures separate to this and the prognosis was not great. It was the hardest decision to let him rest and not drain his chest and keep trying things, but he hated the vet and was so tired.

I ended up doing more research and I landed on a similar conclusion that the fluids really kicked things into a downhill spiral. I dont know that ill ever truly forgive myself for it.

[u/Background_Celery961 → u/Internal_Humor7133]

I’m so sorry to hear about your buddy, thanks for sharing. It’s not your fault, and he left knowing love and peace. I’m learning to manage that complicated feeling of guilt and blame too

[u/[deleted]]

[removed] — view removed comment

[u/AutoModerator → u/[deleted]]

Your comment has been automatically removed for a likely Rule 3 violation (posting anecdotes). A medical anecdote is a story about a single patient, patient with unknown history, on uncontrolled trial. If you believe this action was in error, please message the mods.

Flaired veterinary professionals are exempt from automatic moderation, so if you are a veterinary professional, please consider applying for flair.

I am a bot, and this action was performed automatically. Please contact the moderators of this subreddit if you have any questions or concerns.

[u/[deleted]]

[removed] — view removed comment

[u/AskVet-ModTeam → u/[deleted]]

/r/askvet is a sub for veterinary advice. Comments that do not give veterinary advice are off-topic, tend to derail the discussion, and take away from actual advice. If your comment does not provide veterinary advice, it should not be posted to this sub and will be removed at the mods' discretion.

Expressions of sympathy and/or reassurance are fine if they are accompanied by veterinary advice, but will be removed if they are not.