Wednesday, February 1, 2023

Congestive Heart Failure Cats

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Symptoms Of Heart Disease In Cats

Cat Cough and Congestive Heart Failure

Early onset of the disease can be difficult to identify in cats. Most cats do not display any clinical signs until the disease is advanced, at which point cats tend to become more withdrawn and lethargic.

Below are some of the most common signs of heart disease in cats, however, not every cat will develop all the following symptoms and many cats will have more than one.

  • Difficulty with or discontinuing exercise
  • Regularly elevated heart rate
  • Increased respiratory rate and effort
  • Shortness of breath or difficulty breathing
  • Sudden hind leg paralysis
  • Fainting/collapse

What Is The Prognosis For Congestive Heart Failure In Cats

The prognosis for congestive heart failure in cats depends on how advanced the disease is, as well as how the cat responds to treatment. According to Dr. Faerber, once hypertrophic cardiomyopathy has progressed to congestive heart failure in cats, the prognosis is bleaker: Cats with more severe changes to their heart, congestive heart failure or thromboembolism are at a greater risk for complications and sudden death, Dr. Faerber says.

In general, if a cat receives a timely diagnosis and treatment for congestive heart failure, she may live another six to 18 months, though this timeline could vary based on other factors such as overall health, age and the progression of the disease. Keeping regular veterinary exams, giving your kitty plenty of relaxation and TLC, and adhering strictly to your vets diet and medication recommendations can ensure your cats remaining time after a congestive heart failure diagnosis is as happy and comfortable as possible.

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Types Of Heart Failure

Heart failure can be divided into 4 functional classifications: systolic myocardial failure, impedance to cardiac inflow, pressure overload, and volume overload.

Systolic myocardial failure is a general reduction in the ability of the heart muscle to contract. This can be identified with echocardiography . There is reduced wall motion during contraction of the ventricles. If the reduction is significant, normal blood flow cannot be maintained. It may be caused by nutritional deficiency, genetics, trauma, infection, drugs or poisons, electric shock, heat stroke, or tumors. Some cases have no known cause.

Heart failure resulting from the impedance to cardiac inflow may result in a decrease in blood flow. This may be caused by external compression of the heart , diastolic dysfunction resulting in a stiff ventricle and reduced ventricular filling , or abnormalities of physical structures of the heart.

Heart failure caused by pressure overload occurs as a result of longterm increases in stress to the heart wall during contraction. This leads to thickening of the wall of the affected ventricle. This may result from the obstruction of blood flow from the heart or increased blood pressure throughout the body or in the arteries of the lungs .

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Treatment Options For Congestive Heart Failure

Thankfully, there are several treatment options available to cats suffering from congestive heart failure. If your cat has fluid built up in their chest or belly, your veterinarian may perform an emergency procedure called a thoracocentesis or abdominocentesis where they use a needle and syringe to remove this excess fluid. Removing this fluid can help keep your cat comfortable while they do additional diagnostics to determine the cause of the heart failure and may even save your cat’s life. Depending on the cause of the heart disease, your veterinarian may prescribe one or several medications that work together to prevent future episodes of congestive heart failure. Medications used to treat the congestive signs of heart failure in cats are oftentimes the same medicines used for humans suffering from congestive heart failure.

These medications are often available in pill, liquid or even transdermal forms. Most are even available in generic formulations. Your veterinarian may prescribe medications that help the heart muscles and blood vessels to relax or that aid in removing excess fluid from the lungs. Your veterinarian may also consider prescribing a mild blood-thinner to reduce your cat’s risk of developing dangerous blood clots.

Though it can be alarming to hear that your cat is in heart failure, there are a number of drugs available. Therefore, it may take some tweaking to find a medication plan that suits your cat best.

How Can I Help My Cat With Congestive Heart Failure

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Changes to your cats diet may help with treatment, though your cat may still need certain medications like diuretics to remove excess fluid, vasodilators to improve circulation, or positive inotropes which increase heartbeat force. Many cats with congestive heart failure require medication for the rest of their lives.

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Treating Congestive Heart Failure

The treatment of heart failure depends on the severity and progression of the disease. If caught early, your vet may recommend a diet for your cat that reduces its salt intake. They may also prescribe medicine to improve the flow of blood in your cat. In extreme cases, your cat may need to be hospitalized to increase the oxygen in its blood. Sometimes heart surgery may be performed. If your cat has to undergo surgery, I recommend checking out this article to see how long does a cat need to fast before surgery.

In order to improve your cats heart, you should make sure your cat stays active but make sure it is regulated and doesnt over exercise. You should also prevent your cat from being in stressful situations. I recommend finding a toy that your cat really enjoys.

Understanding & Managing Congestive Heart Failure In Cats

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Cats can develop heart disease just as humans can and congestive heart failure is one of these shared conditions. This condition occurs when a cat’s heart fails to pump as effectively as it should, resulting in the buildup of fluid in places where fluid should not be causing signs of congestive heart failure in cats. This misplaced congested fluid leads to a kitty going down hill quickly, often struggling to breathe. While congestive heart failure affects both dogs and cats, cats have their own unique set of diseases that often lead to this condition.

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Diagnostic Imaging For Cardiac Abnormalities

Dr. Stepien noted that radiology is more useful than echocardiography for assessing congestive heart failure, but echocardiography is needed to evaluate cardiac anatomy. Many cats with cardiac disease lack significant atrial and/or ventricular enlargement on radiographs but will show enlargement when imaged by echocardiography. Obese cats frequently deposit fat in the pericardium, thus enlarging the cardiac silhouette on radiography even in the absence of cardiac disease. In such cases, Dr. Stepien advised examining the pulmonary vessels as an additional indicator of cardiac disease. She also noted that if the heart touches the diaphragm, it is likely enlarged.

Thoracic ultrasound can also detect the presence of lung infiltrates related to heart disease, as in cases of pulmonary edema. The dorsal lung field offers an ideal location to view lung tissue by orienting the ultrasound probe between the ribs. Although the appearance of white horizontal lines, or A lines, is normal on thoracic sonography, fluid in the lungs will cause white vertical lines or rockets that descend vertically from the probe location.

Although echocardiography remains the gold standard for diagnosing heart disease in cats, Dr. Stepien acknowledged that many veterinarians lack access to this tool. That doesnt keep you from being a good practitioner, she assured the audience. Recent advancements in cardiology include measurement of cardiac stress markers, she said.

What Types Of Heart Disease Do Cats Get

Cat with congestive heart failure

Heart disease is a serious medical condition in dogs, cats, and humans. Cats do not normally develop the common diseases of humans with heart disease.

In general terms, heart disease can be divided into two categories, congenital and adult onset forms.

In congenital disease, the heart defect is present at birth. Although signs of congenital disease are often seen at a young age, in some cases congenital heart disease can go undetected for many years.

“In congenital disease, the heart defect is present at birth.”

Congenital heart disease may be caused by a developmental problem that causes malformation of the heart as the embryo develops. This type of congenital heart disease may only affect a single kitten in the litter. Congenital heart disease may also involve a genetic or hereditary disorder, in which case the problem may develop in more than one kitten in the litter.

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Symptoms Of Heart Problems In Cats

There are several possible symptoms of heart problems in cats that cat owners can be on the lookout for, including:

  • Lethargy/weakness/inactivity
  • Difficulty with or discontinuing exercise
  • Shortness of breath or difficulty breathing possibly accompanied by fluid buildup in the lungs and chest
  • Sudden paralysis of the hind quarters
  • Fast breathing during dormancy
  • Fainting/collapse
  • Chronic coughing
  • Regularly elevated heart rate

The above symptoms can indicate one of many possible conditions, including feline heart disease and potentially something unrelated to the cardiovascular system. If you notice any of the above symptoms, we recommend scheduling an appointment with our veterinary cardiologist immediately.

Signs Of Heart Failure

Signs associated with heart failure depend on the causes of the heart failure and the heart chamber that is affected. With left-side congestive heart failure, signs are associated with a backup of pressure in the vessels delivering blood to the left ventricle. This causes fluid to accumulate in the lungs and in the chest cavity outside the lungs . Coughing and difficulty breathing are the most common signs, although cats with heart failure are far less likely to cough than dogs with the disease. Increased breathing rate, loss of appetite, or reluctance to exercise may also be noted. The decreased volume of blood pumped out of the heart can cause the paws and ears to feel cold and can lower a cat’s body temperature. Cats with left-side congestive heart failure often breathe faster than healthy cats. Your veterinarian may direct you to count the number of breaths your cat takes within a minute when it is sleeping or resting . This sleeping respiratory rate can then be regularly monitored to identify early heart failure and response to medications.

Right-side congestive heart failure results in increased pressure in the bodyâs veins and capillaries. This can result in an accumulation of fluid in the abdomen, chest cavity, liver, or limbs. Right-side heart failure is uncommon in cats.

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Diagnosing Congestive Heart Failure In Cats

If you believe your cat may be exhibiting the symptoms of Congestive Heart Failure, your first priority needs to be making them an appointment with a licensed veterinarian. Once you arrive at your appointment, you will need to provide your veterinarian with a thorough medical history. A complete medical history will often include information about age, overall health, preexisting medical conditions, medications they are taking, as well as the duration and severity of their symptoms. During this discussion, the veterinarian may inquire whether or not you have any theories as to what may be causing your cats symptoms and may also share if they have any theories based on their initial analysis of the history and symptoms. Once you and your veterinarian have discussed your cats medical history, they will weigh your cat and conduct an initial physical examination. Part of this physical examination will include listening to your cats heart rhythm. If there is a significant amount of fluid built up within the lungs, the veterinarian will hear the congestion. Despite being able to hear heart rhythm abnormalities and fluid built up in the lungs, it is likely that your veterinarian will conduct additional tests to confirm their diagnosis.

What Is The Life Expectancy Of Cats With Heart Disease

How Long Can A Cat Live With Congestive Heart Failure

Cats suffering from structural heart disease will generally develop recurring signs of congestive heart failure over time and require medical attention for life. In general, the average prognosis for a cat that has been diagnosed with congestive heart failure is 6 to 12 months of life.

Cats that have been diagnosed with congestive heart failure will need frequent veterinary follow-up visits and additional tests may be performed in order to monitor the cat’s heart health.

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What Are The Stages Of Congestive Heart Failure In Cats

In stage A, a cat has heart disease, but doesnt have any symptoms. Stage B is when heart disease is present, but there arent any occurring symptoms. In stage C, heart disease symptoms have manifested themselves. Stage D is when a cat is experiencing congestive heart failure and treatment is necessary.

Longer Term Management Of Congestive Heart Failure

Following diagnosis of congestive heart failure, echocardiography should be performed. Although most cats with heart disease have hypertrophic cardiomyopathy, in fact there is huge phenotypic variability and treatment options are best guided using information obtained from echocardiographic assessment.

Cats diagnosed with congestive heart failure will usually require chronic diuretic therapy however, it is sometimes possible to reduce or withdraw diuretic therapy altogether in some cases.

Frusemide is generally used at 1-2mg/kg twice daily, but this should always be reduced to minimum effective dose. Response to diuretic therapy should be monitored using echocardiography and chest radiographs however, minimum effective dose can often be determined using owner observations of resting respiratory rate and effort at home.

Cats with severe left atrial dilation and poor atrial contractility, or cats with history of aortic thromboembolism, should be treated with clopidogrel at 14 x 75mg once daily which has been shown to improve survival . Clopidogrel is not always well tolerated in cats because of its bitter taste, in which case aspirin should be used at 14 x 75mg every three days, although it is less effective than clopidogrel.

Angiotensin-converting enzyme inhibitors and spironolactone can be useful in management of chronic congestive heart failure. Their benefit is well established in people and dogs but studies are lacking in cats.

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How Is Heart Disease Treated In Cats

Unfortunately, there is no cure for heart disease like hypertrophic cardiomyopathy in cats. The damage caused to the structure of their heart muscle cannot be reversed. In some cases, however, where your feline friend’s heart disease is a secondary condition caused by another, treatable, condition, their symptoms may be alleviated once their primary condition has been addressed.

Your veterinarian will be able to prescribe your act will different kinds of medication to help to reduce their risk of congestive heart failure. These medications may fo anything from slowing their heartrate and relaxing the muscles of their heart to decreasing the workload of your cat’s heart. Your cat will also often be prescribed diuretics in order to reduce the overflow of fluids.

In addition to medication, other types of treatment may be recommended by our cardiologist including a low-sodium diet, oxygen therapy, taurine supplementation, or surgical procedures to remove excess fluid buildup from the chest cavity or abdomen.

What To Do If Your Cat Has Stage D Congestive Heart Failure

Management of acute Heart Failure in cats (1/3)

There are medications your vet can use to help your cat feel more comfortable and to treat these early symptoms. Stage D Stage D indicates moderate congestive heart failure, and long-term treatment is necessary. Medications are prescribed to reduce fluid retention and inflammation of the veins that are both common in stage D.

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Are There Inherited Heart Diseases That Cats Get

Yes, certain breeds of cats are predisposed to some types of heart disease.

Maine Coon. A severe form of heart muscle disease is seen in some Maine Coon cats. Affected cats may begin to develop problems as early as three months of age, while less affected cats show signs of heart failure by two to four years of age. A recent study showed that 33% of Maine Coon cats had a genetic abnormality related to hypertrophic cardiomyopathy.

American and British Shorthair. A less serious form of hypertrophic cardiomyopathy is seen in these breeds.

Persian Cats . This breed also has a high incidence of hypertrophic cardiomyopathy.

Siamese Cats. This breed is more commonly affected by patent ductus arteriosus . The ductus arteriosus shunts blood away from the lungs during prenatal life, and normally closes at birth. If the ductus arteriosus fails to close, or is patent, blood flow to the chest, abdomen, and hind limbs is affected. Siamese Cats have also been diagnosed with another form of cardiomyopathy, dilated cardiomyopathy, where the heart muscle gets thinner as the heart enlarges.

Uncommon Presentation For Heart Disease In Cats

  • Collapsing and syncope

Cats will occasionally present with collapse or syncope signs secondary to heart disease. The mechanism for collapse is not always clear, but is probably related to arrhythmia in most cases. Significant hypotension can sometimes occur with left ventricular out flow tract obstruction seen with hypertrophic obstructive cardiomyopathy, which can manifest as weakness or lethargy.

The true incidence of sudden death secondary to heart disease is unknown in cats. However, in a recent pathology study of 158 cats with unexpected death, necropsy revealed no other cause other than cardiac disease in 55% of cases. Another study reported sudden death in 17/107 cats that died as a result of HCM.

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Causes Of Congestive Heart Failure In Cats

Cardiomyopathies are the most common cause of congestive heart problems in cats. These are diseases of heart muscle, with hypertrophic cardiomyopathy being the leading cause of heart failure. The muscle of the left ventricle of the heart becomes so thickened that it can no longer efficiently pump blood throughout your cat’s body. There are a variety of causes for this type of congestive heart failure.

Hypertrophic cardiomyopathy can be a result of a genetic predisposition in some cat breeds, especially in Maine Coons, Persians, Ragdolls, and some American shorthair cats. Breeders of these purebred cats can do screening to have their male and female parent cats, called sires and dams, tested for this problem.

Other illnesses can contribute to cat congestive heart failure as well, including hyperthyroidism, high blood pressure , and heartworm disease.

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