Feline Hypertrophic Cardiomyopathy: Diagnosis & Treatme

1. Hyperthyroid Cardiomyopathy (a condition caused by hyperthyroidism)

2. Hypertensive Cardiomyopathy (resulting from hypertension)

3. Feline Restrictive Cardiomyopathy

4. Feline Dilated Cardiomyopathy

5. Congenital Heart Disease

6. Moderate to Severe Anemia – Anemia can lead to heart enlargement or failure in cats suffering from heart disease.

7. Overperfusion of Fluids – Fluid therapy can lead to heart failure in cats with heart disease.

8. Primary Pericardial Disease (illness affecting the sac surrounding the heart and the roots of major blood vessels)

9. Excess Growth Hormone

10. Mediastinal Masses (tumors located between the membranes that enclose the lungs and line the chest cavity)

Deepening Diagnosis

Diagnosis tests are essential for identifying HCM. These may include:

1. Comprehensive physical examination and medical history review, including a stethoscope examination of the chest.

2. Chest Xrays to detect heart enlargement, identify fluid in the chest, and rule out other causes of breathing difficulties (such as pneumonia, asthma, or tumors).

3. Electrocardiogram (EKG) – records of the heart's electrical activity, useful for detecting irregular heart rhythms or identifying heart enlargement.

4. Thyroid tests, especially important for cats over 7 years old.

5. Blood pressure measurements to diagnose hypertension, which may be a cause of heart abnormalities.

6. Complete blood count to diagnose anemia (low red blood cell count indicates anemia).

7. Blood tests to detect organ function and electrolytes, particularly important for severe heart failure, thrombosis, or other systemic complications.

8. Echocardiogram (heart ultrasound) – a definitive diagnostic test to confirm HCM after excluding other causes of heart enlargement. Note that this test should be performed by a professional veterinarian or a feline cardiologist, as they can better execute the test and interpret the results, often requiring referral.

Deepening Treatment

1. Treatment is not recommended for very mild cases without symptoms, but regular veterinary followup is crucial.

2. For severe cases, such as congestive heart failure (with fluid in the lungs or chest), arrhythmias, blood clots, kidney failure, and low blood pressure or shock, hospitalization is typically advised on the same day.

3. Initial treatment for congestive heart failure may involve providing oxygen, diuretics, or nitroglycerin ointment.

4. If fluid in the chest is interfering with breathing, it may need to be removed through a procedure called thoracentesis.

5. Complications from blood clots may require additional medication for pain and clot control. Note that thrombolytic drugs (TPAs) can be effective in cats but have very serious side effects.

6. Dietary adjustments may be recommended for cats with significant heart failure, such as prescription or drug diets with limited sodium content.

7. Betablockers can lower heart rate, minimize the impact of stress, and reduce obstruction at the ventricular outflow.

8. Diltiazem (a calcium channel blocker) may be used if congestive heart failure or abnormal myocardial relaxation is evident, usually taken once daily.

9. ACE inhibitors, such as enalapril or benazepril (used to lower blood pressure), may be recommended for cats with heart failure to reduce the activity of harmful hormones and reduce sodium retention.

10. Diuretics (which promote urine production) can be used to relieve fluid accumulation in the body.

11. If breathing difficulties or issues with home medications arise, nitroglycerin can be applied topically (using gloves to apply the medication to hairless areas, such as the inside of the ears).

12. For highrisk thrombosis cases, aspirin or warfarin may be used for treatment.

Followup Care for Cats with Hypertrophic Cardiomyopathy

The best treatment for a pet with HCM requires a combination of athome care and professional veterinary care, with followup being crucial. Your veterinarian will prescribe medications, and if you encounter any issues during treatment, please contact them promptly. Followup care includes:

1. Followup depends on the severity of your cat's disease, their response to treatment, your veterinarian's advice, and your preferences. This may include followup visits every 6 to 9 months, with more frequent checkups in the first few months to monitor treatment progress.

2. Regular chest Xrays to monitor the response to treatment.

3. Regular blood tests to monitor the impact of medications on the kidneys and electrolytes (such as potassium).

4. Regular blood pressure measurements for cats on diuretics or ACE inhibitors.

5. Echocardiograms and repeat them regularly (such as at 36 months and 912 months after diagnosis).

In summary, as the disease can change rapidly, monitoring the progression of the disease will impact decisions about treatment and prognosis.