By top rated Long Island NY Small Animal Internal Medicine Veterinarian Diane Levitan, VMD
Cats can be victims of several types of heart disease. Understanding heart disease in cats will help you better cope with your pet’s illness as well as recognize warning signs to avert an emergency situation. Veterinary cardiac care has come a long way in the last 20 years and pets with heart problems are living longer, happier lives as a result. The prognosis will vary based on the type of problem, but overall, your pet can live a happy comfortable life with well managed heart disease.
Heart disease in cats can be something a cat was born with (congenital) or something that develops over time in the heart. There can be electrical abnormalities (which can result in structural changes) and or there can be structural abnormalities of the heart. Examples of congenital structural heart disease are valvular defects of any of the major heart valves, holes in the heart, circulatory irregularities or other malformations. These tend to be more serious problems that carry poorer prognosis than some acquired issues. However, some types of congenital malformations are surgically correctable. Today, special interventional radiology techniques allow for holes in the heart to be patched without open heart surgery.
The most common acquired heart disease in cats is hypertrophic cardiomyopathy. Other cardiomyopathies can be seen such as restrictive or unclassified cardiomyopathy or dilated cardiomyopathy. Secondary heart diseases can occur such as hyperthyroid myocardial disease and hypertensive myocardial disease or heartworm disease. There are breeds with a predisposition to heart disease such as the domestic short hair, Maine Coon, American Short Hair, and Persian cats. In most of these problems the heart muscle becomes too thick and the heart muscle is unable to relax and the chambers unable to adequately fill. This leads to inability to pump blood effectively and congestive heart failure can ensue.
The most common finding associated with heart disease in pets is a heart murmur heard by your veterinarian on examination. The clinical signs of heart disease (what you will notice if your pet’s murmur is causing a problem) in cats are difficult to recognize and are often not present until they are very serious. Most cats with murmurs have no symptoms and some have no measurable heart disease, however, if disease is present and progresses, the symptoms can be very serious and can range from difficulty breathing to sudden death. Although there are different underlying causes, almost all share the same signs when in heart failure. Unlike heart disease in dogs, cats rarely cough. Instead, their chest cavity often fills with fluid resulting in a fast respiratory rate, panting easily, difficulty breathing, decreased appetite, occasionally a swollen belly, and sometimes paralysis can occur from blood clots secondary to heart disease (aortic thromboembolism) and sudden death without warning is not uncommon.
Diagnosis of feline cardiac disease requires a cardiac ultrasound. Heart diseases are diagnosed using a variety of skills and tests. Firstly, a heart murmur is often heard by your veterinarian on an annual exam. A newly developed blood test, B-type natriuretic peptide (BNP), can help to characterize the severity of the disease. Next, chest x-rays and an electrocardiogram can be helpful but the gold standard diagnostic test is a cardiac ultrasound to visualize the inside of the heart, measure the motion and sizes of the chambers, thickness of the walls and analyze the blood flow.
Mainstays of treatment for heart diseases in cats are oral medications. Oxygen can be a powerful aid in emergency situations. The diuretic furosemide is key. An Angiotensin II inhibitor such as enalapril or benazepril is recommended. Drugs to relax the cardiac muscle, decrease blood pressure and control abnormal rhythms such as diltiazem, atenolol are also commonly instituted. A new drug called pimobendan has been shown to benefit to some cats with certain forms of heart disease. Supplements such as vitamin E, omega 3 fatty acid supplements, Coenyzme Q10, some amino acids and antioxidants such as XanGo (mangosteen juice) can be helpful as adjunctive therapies in some cases. Aspirin and/or Clopidogrel (Plavix) may be recommended to prevent the development of fatal blood clots.
Although feline heart disease can be very serious, early diagnosis and treatment of heart disease in your cat today is not necessarily a death sentence. Understand your pet’s condition. Work closely with your family veterinarian and get a consultation from a specialist who can help you and your veterinarian best control your pet’s problem. Know how to recognize an emergency and have a plan should one arise (know your nearest Pet ER). Take advantage of the medications of today and diagnostic capabilities that can help you and your pet share a great future together!
If you believe that your cat may have heart disease and you are in or near Long Island New York visit www.peacelovepets.org