Cat w/ Heart Issue - Need Help w/ Identifying the Disease

[chenxiaoshuai]

Hello folks, I'm posting this for someone's 9-month female kitty with heart issues, potentially HCM. 

The problem is that this cat is currently in China and the owner can't find any animal hospital with ultrasound capability in her city. Therefore even if there are some clear symptoms (as following), her vet couldn't identify the actual illness and has been relying on passive treatment approach only (Q10)

I'm hoping that with the symptoms and x-ray photos provided, someone could possibly help identifying the disease for the kitty to receive more effective treatment. 

Symptoms: 

1. Heart murmur

2. Fast breathing - 70/min down to 52/min throughout 1 month of treatment

3. larger heart than usual

Below are the x-ray photos.  Also, the person I'm posting for would appreciate very much any medical and diet recommendations. Right now the kitty is on Hills prescription food specifically for cats with heart issues. 

Thanks a lot. 

photo 1.JPG

• chenxiaoshuai
• Jun 8, 2014

photo 2.JPG

• chenxiaoshuai
• Jun 8, 2014

 

[vball91]

I feel for your friend's situation, but unfortunately, we are not vets here and cannot diagnose or make medical recommendations. I would suggest that your friend consult with the Cornell Vet School, Camuti I believe. Your friend or her friend can send the cat's medical history and tests and get a consult/second opinion.

 

[stephenq]

Hi @chenxiaoshuai

50-70 breaths per minute, assuming it is the result of fluid in the lungs due to congestive heart failure (as a result of HCM) is very bad.  Even 50 is dangerous.  If the vet believed there was fluid in the lungs they would be likely prescribing a diuretic like Lasix to cause the cat to pee and drain the fluid.  This is a common medication.

It is hard to help people who are requesting help through another person, so if possible it would be great if the owner could make an account on TCS and post directly, but assuming that isn't practical, we will give you all the help we can.

Can you or the owner make a phone call to the USA and do you or the owner have a credit card that can make charges in the US? If yes, and as vball91 suggested, there is a consultation service with the Cornell Vet School. Details below.  If you can't place a toll free call as described in the link, I can get you the direct toll line.

http://www.vet.cornell.edu/FHC/health_resources/camuti_service.cfm

The Camuti Consultation Service is available on Mondays, Wednesdays, and Fridays from 10AM to 12PM and from 2PM to 4PM ET (excluding holidays)
(1-800-548-8937)

Because of the time difference and the limited days of operation, you would want to calculate accurately the right time to call.  You can speak to the receptionist for free and she can explain everything to you, and if you want to proceed, you email all the records, they set up the consultation which you have with another phone call, the cost is $55 USD.

 

[chenxiaoshuai]

Thank you so much @vball91  and @StephenQ  for responding this inquiry. 

@vball91  -  Will definitely check out the option with Cornell Vet School, thank you for this recommendation!

@StephenQ  - The situation is: I don't know the owner in person, however, I was very touched by the posting she made on a Chinese cat forum and the immense love and affection she showed toward her cat, and decided to help by moving her questions to a larger crowd of experienced cat owners. I will recommend her to create an account with TCS but not sure if she can due to the language barrier. The owner and I do appreciate a lot what you've been sharing and I already feel we've got a few leads here. 

I'm currently in the US, have no problem helping her call Cornell Vet School for consultation if she wants (which I'm sure about). I can call my own vet too. For respiration rate of 70 times/min, I think the owner mentioned there wasn't fluid found in cat's chest. Does that indicate a worse situation than having fluids in? 

 

[stephenq]

Honestly I'm not sure, normally with HCM, you have an increased breath rate because you're having trouble moving oxygen due to fluid in the lungs. But regardless, 70/min is a very bad sign.

But normally it goes like this (simplified): HCM thickens the heart muscle in one of the lower chambers typically.  This thickening reduces the available space for the blood that is being sent down from the upper chamber.  The upper chamber grows in size to hold the extra blood that it can't send to the lower chamber.  In time, the upper chamber can't get any bigger, and the result is the fluid (minus the red blood cells) have to go somewhere so they go to the lungs at which point its now congestive heart failure.  but its a complicated disease and I won't even pretend to understand a fraction of it, even though I had a cat who had it.

When fluid builds up in the lungs, diuretics are given to cause the cat to pee out the fluid.  Sooner or laer it is a loosing battle, but cats, like people, can be maintained for a period of time.

 

[chenxiaoshuai]

@StephenQ  I see. It looks like the only time when people finds their cats have heart issues is when some severe symptom appears and usually it's too late at that point. However, ultrasound is expensive, $400 in NYC where I live. Any way we can detect that earlier without that much cost involved? 

Spoke to the kitty's owner and called two vets in near me for inquiries - vets here don't mind consulting on the issue with health records and examination results provided, but it is still suggested that without ultrasound, how much can be done is limited. The owner needs to discuss with her family members on the next step - whether to move on with consultation or bringing the cat to another city for ultrasound, for which big risk is that the cat can't make it on the journey. 

We'll see what's coming next and what we can do. 

 

[stephenq]

 
@StephenQ  I see. It looks like the only time when people finds their cats have heart issues is when some severe symptom appears and usually it's too late at that point. However, ultrasound is expensive, $400 in NYC where I live. Any way we can detect that earlier without that much cost involved? 

Spoke to the kitty's owner and called two vets in near me for inquiries - vets here don't mind consulting on the issue with health records and examination results provided, but it is still suggested that without ultrasound, how much can be done is limited. The owner needs to discuss with her family members on the next step - whether to move on with consultation or bringing the cat to another city for ultrasound, for which big risk is that the cat can't make it on the journey. 

We'll see what's coming next and what we can do. 

If the cat is "lucky" it will have a heart murmur that will tip off the vet that there is a problem, but you still need to do an echo-cardiogram because you have to image the heart to see what the cause of the murmur is. My cat never had a murmur until he became very sick. Some cats live a year+. although I think once they go into CHF its a year or less. My cat had cardiologists, and the support of a major hospital, emergency room, and my fantastic primary vet and he lived exactly 5 weeks from diagnosis.  That was the really heartbreaking part of it. But every cat is different.

 

[chenxiaoshuai]

 
If the cat is "lucky" it will have a heart murmur that will tip off the vet that there is a problem, but you still need to do an echo-cardiogram because you have to image the heart to see what the cause of the murmur is. My cat never had a murmur until he became very sick. Some cats live a year+. although I think once they go into CHF its a year or less. My cat had cardiologists, and the support of a major hospital, emergency room, and my fantastic primary vet and he lived exactly 5 weeks from diagnosis.  That was the really heartbreaking part of it. But every cat is different.

I see, and I've been long considering whether it's worthwhile to have my cat do a ultrasound testing even though the vet confirmed there was no murmur. Even though it's costly, it helps to detect the deadly disease early. My cat is a maine coon, coming from a backyard breeder (I blindly fell to this common pitfall as a ignorant first time owner). Now I'm crossing my fingers hoping it's a mix so that it can be healthier. Pedigree is the least concern now. 

 

[stephenq]

@chenxiaoshuai

I think you mean echo-cardiogram not ultrasound but perhaps either would work.  Maine coons are more prone to HCM it's true, so if you can afford it, it may be worth it especially as your cat ages.  But there isn't much to do for early stage HCM, so I think you have a reasonable choice to make, and neither is objectively correct, it depends on your comfort level and finances.