TANYA'S

COMPREHENSIVE GUIDE TO

FELINE CHRONIC KIDNEY DISEASE

 

 

HEART PROBLEMS

 

ON THIS PAGE:


Heart Problems and CKD


Symptoms


Diagnosis


Heart Murmurs


Arterial Thromboembolism (Blood Clot to the Legs)


Congestive Heart Failure (CHF)


Hypertrophic Cardiomyopathy (HCM)


Commonly Used Medications


Links


 

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Home > Related Diseases > Heart Problems

 


Overview


  • Since the kidneys and heart are closely related, heart problems are relatively common in CKD cats.

  • This page covers the four main heart problems you may be faced with: heart murmurs, hypertrophic cardiomyopathy (HCM), arterial thromboembolism (saddle thrombus) and congestive heart failure (CHF).

  • Although it is a delicate balance, because the treatment for the heart condition may put additional strain on the kidneys and vice versa, it is often worth trying treatment.

  • Treating the heart must always take precedence.


Heart Problems and CKD                                                                                 Back to Page Index


 

If a cat has both a heart condition and CKD, the heart problem must always take precedence. Although the treatment for the heart condition may put additional strain on the kidneys and vice versa, making it difficult to manage both conditions, it is usually worth trying a try, because some cats do well.

 

How cats cope with heart disease varies from cat to cat, depending upon how advanced the disease is and how well the cat responds to treatment, but in most cases I would say it is worth trying treatment. Anything that may be contributing to the heart problems, such as anaemia, hyperthyroidism and hypertension, should be treated - in some cases, this may actually be all that is necessary. Try to keep stress to a minimum. 

 

Washington State University College of Veterinary Medicine has some suggestions on how to care for a heart patient at home.

Managing concurrent kidney and heart disease (2009) is an article by Jessica Tremayne in the October 2009 issue of Veterinary Practice News, which includes some information on diets for patients with both kidney and heart disease.

Feeding the aging heart (2010) Freeman LM & Rush JE Presentation to the 2010 Nestle Purina Companion Animal Nutrition Summit gives some advice on food choices for cats with heart disease.

 


Symptoms                                                                                                           Back to Page Index


 

Unfortunately many cats are asymptomatic or show very few symptoms, which is why it can be hard to diagnose heart disease. One of our cats, Harpsie, was suspected of having heart disease because of a high heart rate on two vet visits (which might just as easily have been caused by stress or "white coat syndrome") and weight loss. Other possible symptoms can be similar to those of CKD, including lack of appetite, lethargy and vomiting. You may also see faster breathing (the normal respiratory rate of a cat is around 20-30 respirations a minute).

 

In most cases, if you suspect heart problems, you can wait a day or two to see the vet. However, if you see the symptoms described under arterial thromboembolism or congestive heart failure, you should take your cat to the vet as soon as possible.

 


Diagnosis                                                                                                              Back to Page Index


 

Your vet may initially use a stethoscope to check your catís heart, and may follow this with a chest x-ray, especially if congestive heart failure is suspected. X-rays are the only way to diagnose pleural effusion, pulmonary oedema or ascites, all commonly seen in congestive heart failure.

 

The only way to obtain a definitive diagnosis of HCM is by way of echocardiogram (ultrasound), ideally with Doppler colour flow imaging. If heart problems are suspected, ideally you want to see a veterinary cardiologist to obtain an accurate diagnosis and a personalised treatment plan. Cavalier Health has details of veterinary cardiologists in the USA, Canada and the UK. If you cannot visit a veterinary cardiologist, it is sometimes possible for your own vet to perform the ultrasound and send the images through to a veterinary cardiologist for interpretation.

 

Idexx Laboratories offers a new blood test which checks levels of a peptide called NTproBNP, which it states "can be clinically useful as an initial screening test for cats with suspected cardiac disease." However, Diagnosing feline heart disease (2010) Gordon SG NAVC Clinician's Brief mentions (see the box on page 2) that NTproBNP is cleared by the kidneys, so damaged kidneys could make NTproBNP levels look higher than they actually are. In addition, Circulating natriuretic peptide concentrations in hyperthyroid cats (2012) Menaut P, Connolly DJ, Volk A, Pace C, Luis Fuentes V, Elliott J & Syme H Journal of Small Animal Practice 53(12) pp673-8 found that NT-proBNP levels are elevated in cats with hyperthyroidism. It concluded that "Thyroid status should be taken into account when interpreting NT-proBNP concentrations in cats."

 

One study, NT-proBNP measurement fails to reliably identify subclinical hypertrophic cardiomyopathy in Maine Coon cats (2011) Singh MK, Cocchiaro MF, Kittleson MD Journal of Feline Medicine & Surgery 12 p942, found that "56% of cats with severe disease in this study would have been considered normal based on a NT-proBNP concentration; the sensitivity for diagnosing severe disease was only 44% (at a cutoff of ≤100 pmol/l). For any other condition less than severe HCM, the measurement of NT-proBNP concentration was found to be insensitive. Cats with equivocal and moderate disease were not identified by this assay."

 

Therefore, whilst this test may be a useful starting point, I would not rely on it alone.

 

Laboratory tests for the diagnosis of heart disease and failure in dogs and cats (2007) is a presentation by A Boswood to the World Small Animal Veterinary Association World Congress 2007 which discusses the use of the NTproBNP test.

Cardiology: making the diagnosis (2001) is a presentation by Dr P Pion to the World Small Animal Veterinary Association World Congress explains more about how to diagnose heart problems.

 


Heart Murmurs                                                                                                   Back to Page Index


 

A heart murmur occurs when blood flows through the heart turbulently rather than smoothly. Heart murmurs are graded from 1 to 6 depending upon their severity: 1 is the lowest level at which a murmur can be heard by the vet, while 6 is the most severe and is an extremely loud murmur which is often audible without a stethoscope. 

 

A heart murmur is initially detected via a stethoscope, but if your vet wishes to investigate it further, additional tests can be performed, such as x-rays or ultrasound.

 

Heart murmurs may or may not need treatment, depending upon their cause and their severity. Both anaemia and hyperthyroidism may cause a heart murmur which disappears following treatment of the underlying problem.

 

Some cats have heart murmurs because they have a type of heart disease called hypertrophic cardiomyopathy, but it is also possible to have a heart murmur without having HCM - Prevalence of cardiomyopathy in apparently healthy cats (2009) Paige CF, Abbott JA, Elvinger F & Pyle RL Journal of the American Veterinary Medical Association 234(11) pp1398-1403 found that "in apparently healthy cats, detection of a heart murmur is not a reliable indicator of cardiomyopathy." Nevertheless, Prevalence of echocardiographic evidence of cardiac disease in apparently healthy cats with murmurs (2011) Nakamura RK, Rishniw M, King MK & Sammarco CD Journal of Feline Medicine & Surgery 13 pp266-71, found that 53% of the apparently healthy cats with heart murmurs in their study had cardiomyopathy, so concluded "identification of a heart murmur on routine physical examination in apparently healthy cats warrants further investigation."

 

Merck Veterinary Manual has detailed information on heart murmurs.

Colorado State University lets you listen to feline heart sounds.

Pet Place has some information on heart murmurs (no need to register, just click Close at the bottom of the annoying pop up).

Veterinary Partner has information on heart murmurs and allows you to listen to a normal heart and to one with a murmur.

University of California at Los Angeles lets you listen to the different types of heart murmur - turn your speakers up loud for best effect. This is a human site but it should still give you an idea of what to listen for.

 


Arterial Thromboembolism (Saddle Thrombus or Blood Clot in the Legs)           Back


An arterial thromboembolism or saddle thrombus is a blood clot in the aorta which stops the blood supply to the legs. Symptoms include:

  • Limping or an inability to use the leg.

  • The affected leg is likely to be cold to the touch.

  • Often only one leg is affected, but in some cases a pair of legs (e.g. both rear legs) may be affected.

  • The affected leg is usually a rear leg, though I have heard of one cat who developed a blood clot in a front leg.

  • Weak legs (as opposed to limping) may also have other causes, see Index of Symptoms and Treatments

A saddle thrombus is life-threatening so you should consult a vet as soon as possible. If your vet proposes a treatment plan, make sure it includes painkillers because this is an extremely painful condition.

 

Heart medications such as Plavix (clopidogrel) and blood thinners are also commonly prescribed. The Winn Feline Foundation is funding research into the use of a drug called Bosentan to see if it helps cats with saddle thrombus.

 

Plasma homocysteine, B vitamins, and amino acid concentrations in cats with cardiomyopathy and arterial thromboembolism (2000) McMichael MA, Freeman LM, Selhub J, Rozanski EA, Brown DJ, Nadeau MR, Rush JE Journal of Veterinary Internal Medicine 14(5) pp507-12 found that cats with heart disease who have thrown a clot have significantly lower levels of vitamin B6, vitamin B12 and arginine, an amino acid. The study concludes "We interpret the results of this study to suggest that vitamin B12 and arginine may play a role in CM and ATE of cats." You may therefore wish to discuss using methylcobalamin (vitamin B12) with your vet.

 

Drs Foster & Smith explain more about thromboembolism, and provide a helpful diagram.

University of California at Davis has some information on blood clots in cats.

Manhattan Cats also has some detailed information on blood clots, including possible treatment options.

Pet Place has a good overview of saddle thrombus (no need to register to read it, just click the Close button at the bottom of the pop-up).

Systemic arterial embolism in cats (2007) is a presentation by Dr C Atkins to the World Small Animal Veterinary Association World Congress 2007 which discusses treatment and prevention.

Feline thromboembolism - new clinical perspectives (2007) is a presentation by Dr PR Fox to the World Small Animal Veterinary Association World Congress 2007 which discusses treatment options.

The American Association of Feline Practitioners reports on a trial led by Dr Dan Hogan of Purdue University College of Veterinary Medicine into the use of Plavix versus aspirin in cats who have previously thrown a clot. New applicants are welcome.

 


Congestive Heart Failure (CHF)                                                                       Back to Page Index


 

As heart disease and/or kidney disease progress, congestive heart failure (CHF) may develop. In CHF, the heart is really struggling to cope and fluid may accumulate:

  • in the lungs (pulmonary oedema)

  • around the lungs (pleural effusion)

  • in the abdomen (ascites) 

Signs of fluid build up, which are often a sign of congestive heart failure, include:

  • sudden weight gain

  • coughing

  • difficulty breathing

  • fast breathing (see Diagnosis for normal breathing rates)

  • open mouth breathing

  • loss of appetite (the fluid makes the cat feel full)

  • The cat may sit up and refuse to lie down; this is because it is easier to breathe in this position

  • A low body temperature may also be seen in congestive heart failure, so the cat may seek out warm places

If you suspect CHF, you should seek veterinary help as soon as possible. X-rays are the only way to diagnose congestive heart failure. If your cat has CHF, it is worth asking your vet to teach you to listen to your cat's heart so you can monitor for any changes that might indicate an approaching crisis. Regular x-rays can also be helpful to avoid crises, though you need to balance the need for these against the stress of vet visits. See below for treatments.

 

Sadly, many cats with CHF only have a short period to live, but if you can find and treat the cause, your cat's chances are much better. The risk of CHF is higher if a cat has anaemia. It may also occur if a cat is overhydrated via too much sub-Q fluids. Sub-Qs are not a benign treatment and should only be given when necessary and not in large quantities. You can read more about what to watch for here.

 

If your cat develops CHF within a week of starting corticosteroids, this might possibly be the cause. One study, Corticosteroid-associated congestive heart failure in 12 cats (2004) Smith SA, Tobias AH, Fine DM, Jacob KA & Ployngam T The International Journal of Applied Research in Veterinary Medicine 2 (3) pp159-170 found that some cats developed a unique form of CHF within seven days of starting steroids. Five of the cats died, but the seven that survived did much better than the typical CHF patient once taken off the steroids.

 

It is usually worth trying to control the condition because, as with CKD, some cats do better than others. If left untreated, fluid build-up can kill, so the fluid should be removed. For immediate relief, thoracocentesis (needle aspiration) may be performed: this entails inserting a fine needle into the chest and drawing the fluid off. It sounds horrible, but my cat had this done to remove ascites (fluid in the abdomen) and he didn't even flinch. However, it is a delicate procedure, and skill is required to insert the needle in the right place and remove the correct amount of fluid.

 

Once the excess fluid has been removed, medications known as diuretics are commonly used to prevent the fluid building up too much in the future. These are often used in conjunction with other heart medications, especially ACE inhibitors. Research is currently underway to see if a medication called pimobendan might not only help cats with CHF but also help with CKD generally.

 

Effect of coenzyme Q10 therapy in patients with congestive heart failure: a long-term multicenter randomised study (1993) Morisco C, Trimarco B, Condorelli M Clinical Investigation 71 (8 Supp) pp134-6 demonstrated that in humans "the addition of coenzyme Q10 to conventional therapy significantly reduces hospitalization for worsening of heart failure and the incidence of serious complications in patients with chronic congestive heart failure". The effect of coenzyme Q10 on morbidity and mortality in chronic heart failure. Results from the Q-SYMBIO study (2013) SA Mortensen, A Kumar, P Dolliner, KJ Filipiak, D Pella, U Alehagen, G Steurer, GP Littarru, F Rosenfeldt European Journal of Heart Failure 15 (S1), S20 found that in humans, "CoQ10 treatment was safe with a reduced all cause mortality rate. CoQ10 should be considered as a part of the maintenance therapy of patients with chronic HF." There is more information about CoQ10 here.

 

Pet Place explains more about thoracocentesis.

Pet Place has some information about pleural effusion (you don't need to register to read the article, just click on the Close This Window link at the bottom of the registration pop-up).

Macmillan Cancer Support explains more about pleural effusion.

Pet MD discusses pulmonary oedema in cats.

Pet MD has information about ascites.

My Optum Health explains more about ascites.

Warning signs for congestive heart failure is a helpful site by an individual whose cat, Coco, had both CKD and heart problems, and gives useful information on what to watch for. Coco lived with CHF for quite some time.

Emergency respiratory assessment (2001) Hughes D is a presentation to the World Small Animal Veterinary Association World Congress 2001. It is rather technical but may still be of use.

 

Vetgo discusses the usual treatments for congestive heart failure.

Mar Vista Vet has information on long term therapy for heart failure.

 


Hypertrophic Cardiomyopathy (HCM)                                                                  Back to Page Index


 

Cardiomyopathy means disease of the heart muscle, and in hypertrophic cardiomyopathy the left ventricle of the heart, which pumps blood through the aorta, the body's largest artery, is thickened. This thickening stops the heart expanding properly. 

 

HCM may be caused by an hyperthyroidism (an overactive thyroid) - in fact, Gulf Coast Veterinary Specialists claim that 87% of hyperthyroid cats will have some degree of HCM. Other possible causes include high blood pressure or CKD, while in some breeds, such as Maine Coons, Ragdolls or Sphynx cats, HCM is a genetic problem - The Winn Feline Foundation explains more about this. However, it is also possible for a cat to have HCM without any associated disease. 

 

HCM cannot be cured but it can be controlled by way of medications. Unfortunately many drugs which help the heart condition put strain on the kidneys, so if your cat has both heart disease and CKD, discuss which drug to use with your vet. It must be emphasised that it is essential to treat heart disease if it is present, and that treating the heart disease must take precedence over treating the CKD, which is an academic problem if the heart stops beating. 

 

Even if your cat appears stable once medication has begun, it is a good idea to have an ultrasound examination of your cat's heart undertaken once every year (or more regularly if your cardiologist advises it) and to review medication at that time if appropriate.

 

The International Cat Care in conjunction with the Veterinary Cardiovascular Society has set up an HCM screening scheme for UK cats.

Veterinary Partner has an overview of HCM.

Feline cardiomyopathy - establishing a diagnosis (2002) Fuentes VL, is a presentation to the 26th Annual Waltham/Ohio State University Symposium.

Feline cardiomyopathies - an update (2009) is a presentation by Anne French to the World Small Animal Veterinary Association World Congress which describes the various types of cardiomyopathy.

 


Commonly Used Heart Medications                                                               Back to Page Index


 

HCM is usually treated with drugs and it is fairly common to use more than one heart medication at a time. The different drug classes are:

 

Feline cardiomyopathies (2001) is a paper presented by Dr Paul Pion to the World Small Animal Veterinary Association World Congress in 2001, which gives typical heart drug dosages.

 

Some people also use an antioxidant called Coenzyme Q10 or CoQ10. There is more information about this here.

 

Beta Blockers


Beta blockers are used to slow a fast heart rate. Atenolol is commonly used in the USA. In the UK, a similar drug called Propranolol may be used.

 

Pet Place has an overview of atenolol. 

Pharmacokinetics of atenolol in clinically normal cats (1996) Quinones M, Dyer DC, Ware WA & Mehvar R American Journal of Veterinary Research 57(7) pp1050-3 discusses the effects of atenolol on cats.

 

ACE (Angiotensin-Converting-Enzyme) Inhibitors


These are drugs which prevent the conversion of a hormone called angiotensin I into another hormone called angiotensin II, the role of which is to constrict blood vessels. Therefore by using these drugs the blood vessels relax and this makes it easier for the heart to pump blood through the body. You should be careful if you are using ACE inhibitors at the same time as potassium supplements, because they may cause potassium levels to become dangerously high.  

 

ACE inhibitors are a popular treatment for heart disease, and a commonly used one is enalapril, the trade name of which is Enacard. Mar Vista Vet has information and cautions on the use of Enalapril, including when using it in conjunction with diuretics such as frusemide (US: furosemide) (see below). 

 

Another ACE inhibitor, benazepril, is licensed under the trade name of Fortekor for the treatment of CKD in cats in the UK, Europe and Australia, even for cats without heart disease. Further information about this can be found in the Treatments section. 

 

An ACE inhibitor called Ramipril (marketed as Altace or Vasotop) is available in the UK and Europe, though I only know of a couple of people who have used it for their cat. The efficacy, tolerance and safety of the angiotensin converting enzyme inhibitor ramipril in cats with cardiomyopathy with or without hypertension (2002) Schille F & Skrodski M is a paper presented to the World Small Animal Veterinary Association World  Congress 2002.

 

It is not unusual for cats suffering from congestive heart failure to be given both an ACE inhibitor and a diuretic.

 

Calcium Channel Blockers


Calcium channel blockers work by slowing the passage of calcium into muscle cells; this makes muscle in the blood vessels relax, so the blood vessels open wider. The most commonly available one is called Diltiazem. Another member of the calcium channel blocker family, amlodipine, is the best choice for controlling hypertension in cats.

 

Bronchodilators


Bronchodilators are used in asthma, but may occasionally be used to treat heart problems - they open up constricted airways in the lungs. Millophyline-V (etamiphylline) is commonly used in the UK; theophylline is commonly used in the US and may also be offered in the UK. 

 

Veterinary Partner has information on the use of theophylline.

 

Diuretics


Diuretics may be used for congestive heart failure in order to rid the body of excess fluid. They are also used occasionally when a cat in the end stages of CKD has stopped urinating (anuria), in an attempt to "kickstart" the kidneys. The most common diuretic used in the UK is a drug called frusemide (furosemide in USA), which is commonly sold under the name of Lasix, although the name is currently being changed to Salix.  Lasix is very hard on the kidneys, but some people have found that another diuretic, spironolactone, is gentler. However, Lasix is the best choice during times of crisis.

 

It is not unusual for cats suffering from congestive heart failure to be given both an ACE inhibitor and a diuretic.

 

Lactulose may exacerbate the effects of diuretics. Drugs has more information about this.

 

Mar Vista Vet has more information on Lasix (frusemide or furosemide), including cautions about using diuretics at the same time as ACE inhibitors.

Pet Place has more information about spironolactone.

 

Aspirin


Aspirin may be used in an attempt to reduce the chances of blood clots forming. Occasionally it is also used to help with proteinuria.

 

Aspirin can be toxic to cats, who can only metabolise it very slowly, and should only be given to a cat on veterinary advice; it is usually only given in very low doses once every three days. In the USA, cats with HCM are routinely given carefully assessed doses of aspirin in addition to other medications, but if the cat reacts badly, then aspirin is stopped.

 

Mar Vista Vet has information on aspirin.

Pet MD has some information about aspirin poisoning in cats.

 

Pimobendan


This is a heart medication which is commonly used in dogs and which is now being assessed in cats, particularly for the treatment of congestive heart failure. Research is also underway into its effectiveness in treating CKD in cats. There is more information about it here.


Links                                                                                                                         Back to Page Index


 

Veterinary Links


Long Beach Animal Hospital - explains how the heart works, and the Specific Diseases link discusses HCM.

Vetinfo an overview of feline heart problems and medication by a US vet.

Vetinfo - this is a reply by the same vet to a query about the use of the usual heart medications in cats with CKD, particularly ACE inhibitors such as enalapril (Enacard) or benazepril (Fortekor).

The heart-kidney axis with a special focus on renal function in heart failure (2007) Lefebvre HP  State of the Art in Renal Disease in Dogs and Cats Proceedings, Vetoquinol Academia, reports on how heart and kidney problems interact (go to page 44).

Cardiorespiratory diseases of the dog and cat is the online version of a detailed book by a veterinary cardiologist.

 

Other Links


International Cat Care - an overview of HCM by the UK feline charity.

Boo Boo's Story - this is a site about Boo Boo, a cat who was treated for both CKD and HCM using holistic methods.

Ragdolls - Ragdolls (and Maine Coons) can be prone to HCM, and this site has good  pictures of a healthy heart and an HCM-affected heart.

Jody Chinitz's site - this site is by a lady who lost a cat to HCM.

Feline Heart Group - a support group for people with cats with heart conditions, where you can obtain feedback on treatments, and support on living with HCM and other feline heart problems. (Note: this group has open archives, meaning anybody can read what you write).

 

Back to Page Index

This page last updated: 22 September 2013

Links on this page last checked: 02 April 2012

 

 

The group is hosted on yahoo!groups, part of yahoo. It has its own address separate from Tanya's website. You can either click here or copy and paste this link into your browser:

 

http://pets.groups.yahoo.com/group/tanyas-ckd-support/

 

If you are already familiar with yahoo!groups, just click on the link and apply to join (and don't forget to complete the short questionnaire you'll be sent), but if you'd like to know more about how the group works, read on.

 

I own and run the group, but I am ably assisted by two moderators, Anne V and Anne A. They help with membership queries, approve messages, and do lots of boring admin stuff behind the scenes to help the group run smoothly for the members.

 

The group has various sections, including a photos section and a realtime chat function but for most people the most important part of the group is its message section. Basically, a member who wants support, vet recommendations, or to hear how others are coping with a particular problem, sends a message to the rest of the group. Other members then respond if they can. All messages sent to the group are stored in a message archive which members can search if they wish.

 

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Here are the steps to follow. Don't worry, this all sounds far worse than it is! You should find that in practice it all works more smoothly than it sounds when you're trying to explain it in writing:

 

Existing yahoo! ID

  1. Go to the group website: http://pets.groups.yahoo.com/group/tanyas-ckd-support/

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  5. There is a little box for you to tell me why you would like to join the group. You don't need to be inventive or fancy, it's not a competition, it's just an extra check by yahoo!groups to keep spammers out.

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  6. Before you click on the Continue button on the Congratulations! page, untick the box that makes yahoo! your homepage (unless that is what you want).

  7. Also click on the Edit Marketing Preferences link below the Continue button. This takes you to another page where they helpfully opt you in to everything, so go through and set it as you wish.

  8. Then on the same separate page click on Account Info at the top of the page. You will be asked for your password again and taken to the Account Info page. Click on Profile and opt out of the various choices as you wish. The key thing is, you do have choices here, you can make things as public or private as you wish.

  9. Now click on the Continue button on the original page. You will be taken back to the group page to choose your membership settings.

  10. Choose the e-mail address you wish to use for the group (see below).

  11. There is a little box for you to tell me why you would like to join the group. You don't need to be inventive or fancy, it's not a competition, it's just an extra check by yahoo!groups to keep spammers out.

  12. Choose your message delivery options (see below).

  13. Scroll down and click on the blue Join button at the bottom right of the page.


Membership Settings                                                                                          Back to Page Index


 

There are various choices you need to make regarding your membership of the group. The most important are which e-mail address to use, and which way you read messages sent to the group by group members.

 

Membership Settings: Your E-mail Address


You need to decide which e-mail address you wish to use for the group. If you have created a yahoo! ID, yahoo!groups will normally have also set up a free yahoo! e-mail account for you based on your new yahoo ID. You can use this e-mail address to access the group if you wish, but it's not essential, you can use any e-mail address you wish. Since yahoo! is now scanning messages for advertising purposes (similar to gmail), I would recommend not using yahoo! e-mail if possible (though it would probably be better than using your work address for private stuff).

 

If you do not want to use your free yahoo! e-mail address, click on Add e-mail address to add a different one. Be aware, if you don't add a new address here, yahoo! will use the yahoo! e-mail address as a default address. So if you don't receive the membership questionnaire, it may well be because it's gone to your new yahoo! e-mail address.

 

If you ever wish to change the e-mail address you are using for the group, you can do that here:

http://pets.groups.yahoo.com/group/tanyas-ckd-support/join

 

Membership Settings: Message Delivery


This sets up how you will access messages that are sent to the group.

 

This is a pretty active group. If you're looking after your CKD cat, you want support but you probably don't want a full inbox all the time. To help you manage this issue, you have three options for messages, and you can switch between them all as you wish:

  1. Individual E-mails

  2. Daily Digest

  3. Web Only (No e-mail)

Individual E-mails


This is the default setting. If you apply to join the group via e-mail, you will end up with this setting. If you apply to join the group via the group's webpage, if you don't choose one of the other settings, this is the one you will end up with.

 

This setting means that as soon as somebody sends a message to the group, it is sent directly to your inbox. It's a good choice if you might want to know immediately if somebody has responded to you, or if you would like to store some of the group messages for your reference. It's also good for being able to quickly delete messages which don't interest you.

 

The downside is that this is a busy group, averaging 50-100 group messages each day, so your inbox can quickly get full. One solution is to create a folder to use for group messages. All messages sent to the group have a tag in the subject line [tanya-crf] so you can filter all messages from the group to a new folder using this tag if you wish.

 

With both individual e-mail and message digest options, you can also choose the format of messages sent to you (Display Format), either Fully Featured (html, pretty colours etc.) or Traditional (plain text).

 

Message Digest


This means that you receive e-mails from the group, but yahoo!groups waits until there are about 25 messages available and sends them to you all in one go. With this option, you would therefore only receive 2-4 e-mails a day from the group, but it means you have to wait for responses (though you can still check on the group website for messages) and it can be more difficult to find what you are looking for within each digest.

 

With both individual e-mail and message digest options, you can also choose the format of messages sent to you (Display Format), either Fully Featured (html, pretty colours etc.) or Traditional (plain text).

 

Web Only (No Mail)


This means that you receive no messages at all from the group. This is a wise choice if you are using a work e-mail address, or if you cannot cope with the group's message volume. With this system you simply go to the group's website and read the messages that interest you there. Even if this is not your usual choice, it can be helpful to use this option if you are going on holiday.

 

So make your choices, then click the Join button at the bottom right of the page.

 


Important: Membership Questionnaire                                                           Back to Page Index


OK, so you've successfully applied to join the group. However, there is one more thing you need to do in order to join. I want to protect the group members from spammers, so whichever way you apply to join the group, you will receive a short questionnaire asking:

  1. Your first name

  2. The country where you live

  3. Your CKD cat's name and age

You need to respond to this before your membership will be approved.

 

Please don't worry about saying "the right thing." This is not a test to see if you are "good enough" for the group, everybody is welcome here, whoever they are or wherever they come from, as long as they want to help their cat. This questionnaire is basically just to reassure us that you are a real person applying to join rather than somebody trying to sell stuff and spam the group, but it also enables us to tailor our responses to your group messages e.g. if we moderators know where you live, we will not suggest treatments not available there.

 

Please note, only the two Annes and I can see your responses to these questions. The group will not know anything about you unless you choose to introduce yourself.

 

Once you respond to the questionnaire, your membership application should be approved very quickly (most people are approved within two hours or less).

 

Occasionally the questionnaire goes missing. You think we haven't sent it, and we think you haven't responded! If we haven't heard from you five days after you apply to join, we will send you a reminder. Unfortunately, we can only use the address you've used to sign up for the group, so if you've accidentally used your new yahoo e-mail address without realising it (see above), you won't see either the questionnaire or our reminder. If you don't hear from us, please simply write to us at tanyas-ckd-support-owner@yahoogroups.com and let us know. Please respond to the three questions in your response and we will either approve you (if your membership is pending) or send you a personal invitation to join the group (if your membership application has disappeared into a black hole).

 


Messages                                                                                                                                          Back to Page Index


 

Message Options: Sending Messages


You don't have to post, you can just lurk if you prefer.

 

If you wish to change the name that appears on messages you send to the group, Yahoo! explains how you can do that.

 

Starting a Thread


  1. You can simply send an e-mail to ask your question by sending it to tanyas-ckd-support@yahoogroups.com.

  2. You can go to the group website, click on Post Message in the sidebar on the left, and then write your message there.

Replying to an Existing Message


Messages sent in response to another message on the group also go directly to the group, not to the individual to whom you are replying. Therefore if you wish to respond to a message somebody else has sent, you can simply click reply on your e-mail programme. If you reply via the group website, you can click on the message in the group archives, then click reply which is top left above the message.

 

If you're changing the subject, or replying to a Digest (which have the subject line of Digest No. xxx), please change the subject line appropriately to something more meaningful. And please remove everything except that to which you are replying.

 

If you wish to reply privately to somebody, you will need to press reply, then delete the group e-mail address and paste their personal e-mail address into the To: line if you are using e-mail. If you are replying via the group website, you will see a little envelope over on the right under the person's name. If you click on that, your message will go to that person.

 

Message Content


You are welcome to discuss anything relating to care of your CKD cat. We do have a few guidelines we ask people to follow though:

  1. Please do not refer to vets or vet clinics by name for legal reasons. Just say "my vet" or "Dr J".

  2. Please do not ask for money or other donations.

  3. Since this is a very busy group, we ask that condolences are sent privately to the bereaved group member. Certain other messages should also be sent privately e.g. short "me too" messages, off topic posts etc.

  4. Please trim your posts.

Moderation of Messages


When you first join the group, your messages will be moderated for a short while. This means that they will not reach the group immediately, but will first be read and approved by one of the moderators. We do this to ensure that:

  1. you are not a spammer;

  2. you are keeping to other group guidelines (e.g. not naming your vet publicly);

  3. you are trimming your messages appropriately.

If you comply with the group guidelines sent to you when you join the group, you will be taken off moderation quickly. The main reason people stay on moderation is because they do not trim their posts. So please read up on this in the group guidelines. If you get stuck, just ask for help.

 


Leaving the Group                                                                                                Back to Page Index


 

Some people decide to leave the group. Their cat may have died, or they may find the message volume is too much, or they simply decide it's not the place for them. Leaving is fine, but if you're thinking of leaving simply because you cannot cope with message volume, please consider changing your message options first, such as by going no mail. This means your inbox will not be full, but you can still reach out for support quickly when you need it.

 

If you are leaving because your cat has died, please consider joining our sister group, Tanya's Feline Loss Support:

http://pets.groups.yahoo.com/group/tanyas-feline-loss/

 


Conclusion                                                                                                            Back to Page Index


I do hope you've decided to join Tanya's CKD Support Group! It can give you support, it can give you hope. It can make you smile too - where else would people share your thrill at hearing that your constipated cat has pooped? (Believe me, when you've been dealing with CKD for a while, things like this are real triumphs which can absolutely make your day).

 

I personally read every message sent to the group. I don't respond to every post (my priority is running this website) but I do keep an eye on things and post occasionally if I can add to what has already been said.

 


Group Quick Links                                                                                               Back to Page Index


Some of these only work if you are already a member of the group.

 

Weblinks


Group homepage:                                                 http://pets.groups.yahoo.com/group/tanyas-ckd-support/

Managing your membership options:                  http://pets.groups.yahoo.com/group/tanyas-ckd-support/join

Messages archive                                                 http://pets.groups.yahoo.com/group/tanyas-ckd-support/messages

 

E-mail Addresses


Sending a message to the group via e-mail:        tanyas-ckd-support@yahoogroups.com

Group owner e-mail address:                                 tanyas-ckd-support-owner@yahoogroups.com

Joining the group via e-mail:                                   tanyas-ckd-support-subscribe@yahoogroups.com

Leaving the group via e-mail:                                  tanyas-ckd-support-unsubscribe@yahoogroups.com