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low blood pressure

Published on: May 16, 2022 • By: karak · In Forum: Cats
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karak
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May 16, 2022 at 03:57am
Hello, can a cat live with a blood pressure of 60? My cat was on a norepinephrine CRI for low blood pressure and every time they weaned or tried to wean, her bp would drop. The lowest i know it went was 50 before she was started on the CRI, but when i personally saw it drop after a wean a couple days later it went to 60. she had heart failure with fluid in chest and abdomen, liver nodules and elevated alt, possible UTI or some sort of infection. her kidney values were up and down but i believe she was severely dehydrated from the heart meds and not being able to get iv fluids. she was hospitalized for 4 days with small improvement one day but then went downhill that night and next day. she was given a  poor prognosis all week and both vets on the last day said they didn't think she would recover and she could not maintain blood pressure without the norepenephrine which she could not stay on. she was not eating and could not walk. i thought she was dying, and that she would die a slow painful death if i took her home, and when i said i wanted to take her home first, the vet said she did not think she would make it home. but it took a few hours for her bp to drop before so im not sure why she said that. basically i thought she was dying and the vet implied she was dying by saying she wouldn't make it home and she looked so miserable just laying there, i felt i had no choice but to help her pass on. After trying to understand what happened, i feel like it wasn't the right decision, like i didn't give her enough time to recover if she was septic but no one really told me it could have been cardiogenic shock and they did not seem to think she was septic either towards the end of the week. i think for either of these issues it would have taken her longer than 4 days to improve especially since she was 19, but none of the vets said she might have to be hospitalized for longer to recover. i just feel like it was the wrong decision and rushed, could she have lived with a blood pressure of 60 for some time? they dont release from hospital unless blood pressure is at least 90, but i was also told low perfusion doesn't start until below 60 so what about between 60-90?
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Liz Buchanan BVSc MRCVS
Keymaster
May 16, 2022 at 10:37am
Hello - and I'm sorry to hear that you lost your cat.  Nineteen is a great age, but that's no comfort at a time like this, when you just want them back. Sixty is extremely low for blood pressure and as a vet, this case has my mind whirring- I wonder whether 60 was the blood pressure throughout her whole body, or just her front legs, for example.  I wonder whether there was a problem with the automatic systems within her body that would normally maintain the blood pressure?  Was fluid escaping somewhere rather than contributing to the blood pressure?  Was the heart simply unable to beat hard enough, or had the resistance in the blood vessels simply given way?  Was the blood pressure homeostatic system simply failing?  Could this have been cancer?  It sounds as though your vets had an initial hypothesis and then changed their minds, perhaps after seeing her response to treatment or scanning the heart or speaking to a specialist.  This is fairly normal when investigating a case - you find an idea that seems to explain the situation, then another symptom or perspective pops up that doesn't fit and it gets you thinking again. Whatever the answers to these questions, it sounds unlikely that a problem of a nature that would resolve spontaneously on its own. It might have been possible to refer the case to a medical expert (ie expert in medical presentations), but of course this isn't right for every cat; money aside, it can involve travel and a lot of examination and fussing in a cat that might not have very much natural lifespan left, even if the problem could be completely resolved.   Referral is not appropriate in every case. Furthermore I can tell you, with some borrowed experience from a friend of mine, that low blood pressure feels very unpleasant and the body can feel weak.  Rather than looking at the numbers (60, 100 etc), I think that it is important to assess the patient; are they experiencing a valuable quality of life? It sounds as though your car wasn't;. It sounds as though drips could only increase the blood pressure, but the pressure couldn't be maintained. I don't know your cat or this case, but euthanasia may well have been the hardest, most compassionate choice.    More to follow
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Liz Buchanan BVSc MRCVS
Keymaster
May 16, 2022 at 10:39am
There is a fantastic site called the Ralph site, named after the founder, Shailen Jasseni's own cat.   This site is dedicated to helping owners to grieve  following the death of a pet and has some services that you might find very useful.  We would advise running a search for their website.
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Liz Buchanan BVSc MRCVS
Keymaster
May 16, 2022 at 10:42am
Finally, sending a huge hug and wishing you the best of luck in answering any questions that you have left.  Remember that vets are used to the fact that people grieve and may be very happy to answer questions about a cats, particular case.
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