Cardiomyopathy in a cat
Berry Haven Veterinary Group Medical Case
Max, a 5 year old cat, was presented with sudden shortness of breathing. He was mouth breathing and had a very rapid breathing rate (Respiration Rate- RR).
These symptoms in a cat are very serious as cats can normally live with approx. 3/4 of their lungs "missing" and appear normal. It's not until they are down to their last 1/4 of healthy lungs that symptoms appear.
On examination, we detected a feint heart murmur. His colour was pale and slightly blue (cyanotic). His chest was dull when we percussed it by tapping our fingers against the chest wall. It had lost the "hollow" sound you hear when someone taps on your own chest. We suspected he was in acute heart failure from cardiomyopathy.
ANY cat that is mouth breathing and/or has a rapid RR is treated as an emergency
We gave Max an injection of a diuretic, Lasix (Frusemide) to try and shift fluid out of his lungs. Max was given some Nitro-glycerine ointment on the inside surface of his ear to try and lower his blood pressure and help reduce the amount of blood pooling and flooding his lungs.
An oxygen mask was made using an Elizabethan collar, some Cling wrap and an oxygen tube poked through the collar just below his nose. We connected the tube to a large cylinder of oxygen and "bubbled" the oxygen through water to give it some moisture so it would not dry out his nose and throat.
After 20 minutes, Max was more settled and able to be examined a bit more closely.
A very quick chest X-ray showed massive amounts of fluid inside his lungs (pulmonary oedema). They were a bit like a wet sponge. We repeated the Lasix injection and continued the oxygen therapy.
At 1 hour, he had continued to improve. His gums had a pink tinge instead of the pale slightly cyanotic appearance at presentation. His RR was dropping towards normal and he was much more relaxed. Repeat X-rays showed a large amount of the fluid had been removed from the lungs.
At 3 hours, a repeat x-ray showed even less pulmonary oedema and he was much happier in himself. We continued the oxygen therapy overnight.
At 24 hours, Max was back to his normal self. Chest x-rays showed a nice clear chest with an easily seen heart surrounded by nice black air-filled lungs.
On day 2 we performed a cardiac ultrasound examination on Max.
It showed thickening of the left ventricle wall and an enlarged left atrium. The heart was contracting within the normal range. Blood tests for hyperthyroidism were negative.
We suspected Max had primary Hypertrophic Cardiomyopathy.
We started Max on beta blockers, Inderal, and continued the Lasix. We also placed him on Aspirin to prevent blood clots forming in his enlarged left atrium- a common complication of cardiomyopathy in cats and people.
Max lived on very well for approx. 8 weeks but eventually succumbed to heart failure.