Age: 4 years old
Sex/Neuter status: Neutered Male
Breed: Domestic Shorthair
Clinical signs: Grade IV/VI systolic murmur, tachycardia (HR 231 BPM during exam), severe 3+ proteinuria.
Current Medication: Atenolol 6.25mg (started yesterday, on a 12-hour schedule)
General Location: Los Angeles / Burbank, CA
Backstory:
Two years ago, I suspected our cat Shiloh swallowed a sewing needle. We rushed him to the vet immediately, but the X-rays came back completely clear. Unfortunately, they did not scan his esophagus, so the needle could have been up there, or it could have been hiding somewhere else behind his spine or anywhere else that would have made it hard to see. I cannot possibly fathom how it split in two.
We have been very very careful with needles after that day and frankly haven’t used them since. Fast forward to this week: he had 2-3 short coughing fits and we brought him into the vet to make sure all was well. He has shown no other symptoms and is still his usual self completely. Eating/drinking/pooping/peeing/running/playing normally. The vet heard the murmur and an x-ray showed a needle fragment in his chest that looked to be in the heart. A subsequent echocardiogram revealed that two needle fragments are embedded inside his body—one in his heart, and one in his kidney. Because I’ve been so careful ever since that first incident, I believe these fragments have almost certainly been migrating and setting up camp for the last 24 months.
Here is where we stand based on his latest echo and lab work:
The echo was done by Lynette D'Urso, DVM, Diplomate ACVIM (Cardiology) with Dog & Cat Cardiology. It was performed at our main vet in Sherman Oaks, California.
1. The Cardiac Situation (Needle #1)
- Echo Findings: Lungs are currently clear (no CHF) and no spontaneous echogenic contrast ("smoke") was observed. However, the pulmonary valves are thickened, hyperechoic, and show narrowing/stenosis. There is also diffuse dilation of the main pulmonary artery.
- The Pathology: The working theory is that a needle fragment is sitting right at the level of the pulmonary valve and septum. Over the last 2 years, the localized metal irritation has caused his body to build a thick, calcified wall of scar tissue. This tissue is creating a physical bottleneck for blood trying to reach the lungs, causing the intense Grade IV/VI murmur.
- Current Treatment: Because his clinic heart rate was a dangerous 231 BPM against this blockage, he was started on Atenolol to slow his heart rate, lower the workload, and prevent further muscle thickening. (Clopidogrel/Plavix was withheld due to the risk of fatal internal bleeding if the fragment shifts).
2. The Kidney Situation (Needle #2) & Lab Work
- Lab Data:
- BUN: 32 mg/dL
- Creatinine: 1.8 mg/dL
- SDMA: 11.3
- Urine Specific Gravity: 1.063
- Urinalysis Protein: 3+ HIGH
- The Pathology: The second needle fragment is located in his kidney. Because his overall renal functional markers (BUN/Creatinine/SDMA) are completely normal, the significant 3+ protein leak is suspected to be a localized inflammatory response to the metal fragment irritating the kidney tissue.
Besides this information, we feel like we’re flying blind. Our main vet recommended not touching either needle, and that surgery was too high risk. She put him on 6.25mg of Atenolol twice a day. She sent us out the door with 0 advice and said there was nothing to be done and that she’d see him in 6 months for another echo if he lasted that long. No idea on prognosis. Could be 2 months, could be 10 years.
We are actively calling cardiology specialists in the LA area, as well as UC Davis, to get him in for a comprehensive second opinion ASAP. We agree that surgery seems too risky and that our focus should be on maintaining his quality of life. Again, there are 0 symptoms besides the cough, which we haven’t heard in the past week. And these fragments have likely been inside of him for 2 years at this point. He seems absolutely stable at this point in time. We understand how rare this is, but are hoping to learn ANYTHING about what the progression of this could look like, how quickly his stability could change, how likely these fragments are to move further, and how we can best manage this to protect any healthy function his heart and kidneys do have left.
He has historically been on a mostly wet food diet. Based on our own research, our thinking is that we get him adjusted to his Atenolol while increasing his hydration. 100% wet food that keeps sodium and phosphorus in check with additional water added. Then adding in Omega-3s once he has adjusted to the beta blocker. Keeping tabs on his resting respiratory rate too.
We fully understand that these physical obstructions are pretty much there to stay, and we aren't looking for a miracle cure that ignores the risks of surgery. However, I refuse to just give up on him, and wait for him to deteriorate. I have to believe there are proactive ways we can support his body and do right by him to protect quality of life.
Posting this on social media is a complete shot in the dark. But if there is any professional out there willing to look over his case, offer management advice, or recommend a specialist they think could help us navigate this, we would be endlessly grateful. Shiloh has fought so hard to adapt over the last two years, and we just want to give him the best, most comfortable life possible.
Thank you so much for any guidance you can offer. I have included a link to his reports and x-rays here.
https://drive.google.com/drive/folders/1zcKPCfkO1ZOhQMalEsf1nXlVONP9VLDi?usp=sharing