Hcm Misdiagnosis?

[lilin]

Hey everyone! Have a question about my kitty's heart issues and diagnosis if anyone can help? Pia is currently 6 years old, and has had no other health issues.

About a year and a half ago, a vet found a Grade 3 heart murmur in my kitty, and after a scan, diagnosed her with non-obstructive HCM. She became overly sedated on Atenolol and had a normal BP without it, so we left her off any medication.

This year, I'm living in a different part of town, and I'm also planning to move back to the US (my location is out of date, I'm currently in London). So I wanted to make sure she could fly, and get an update on her heart's condition as well, but I went to a different vet.

THIS vet says her murmur is Grade 2/3, but when he looked at the scan the first vet took, he said he saw no evidence of HCM? He went over it with me and pointed out all the markings they measure on the left ventricle, and that none of hers were thicker than normal. I looked it up myself, and hes' right -- her measurements are normal range, not even really borderline.

I am cautiously thrilled, but I'm doing another scan just to be sure, and to see if anything has changed, but based on her previous scan, he says he would have diagnosed her with just a functional murmur.

Has anyone had this happen? I want to be absolutely certain she's fit to fly and can handle the stress of a long journey, and I don't understand how she got this diagnosis in the first place? Is there something else that would be taken into consideration, apart from the murmur and measurements of her heart walls that? Behaviorally, she's been fine and hasn't had any symptoms of being ill. The first vet said she had slight backflow, but as I understand it, that's true with all heart murmurs including functional ones, isn't it?

Thank you to anyone who can help!

 

[Antonio65]

About a year and a half ago, a vet found a Grade 3 heart murmur in my kitty, and after a scan, diagnosed her with non-obstructive HCM.

[...CUT...]

THIS vet says her murmur is Grade 2/3, but when he looked at the scan, he said he saw no evidence of HCM? He went over it with me and pointed out all the markings they measure on the left ventricle, and that none of hers were thicker than normal. I looked it up myself, and hes' right -- her measurements are normal range, not even really borderline.

Do you have the images of the first scan where the first vet diagnosed the HCM?
If you have them, you could hand them over to the new vet and ask him to compare them.
Are both vets cardiologists? Or are they "plain"vets?

Given the stress of such a long flight, I would ask for more than a second opinion.

 

[lilin]

Do you have the images of the first scan where the first vet diagnosed the HCM?
If you have them, you could hand them over to the new vet and ask him to compare them.
Are both vets cardiologists? Or are they "plain"vets?

Given the stress of such a long flight, I would ask for more than a second opinion.

Yup, that's what I did, I had the old vet send over the scans to this new one. What he said was based on that old scan the first vet took. I am doing another one next week to be sure, but he says based on the scan they sent to him, he didn't see HCM.

The old vet was a regular vet, and this new one is an imaging specialist. I know they also have have a cardiac specialist, so maybe I could ask everything to be checked over by both of them?

 

[Antonio65]

Sorry, I hadn't read your post with the due attention!
Given my past experiences with regular vets and specialists, I would advice you to have your cat checked by a highly skilled cardiologist/ultrasound vet.
Your cats' life is unvaluable, you have to look for the best (or one of the best) doctor in this field. Two opinions are always better than one!

 

[lilin]

Sorry, I hadn't read your post with the due attention!
Given my past experiences with regular vets and specialists, I would advice you to have your cat checked by a highly skilled cardiologist/ultrasound vet.
Your cats' life is unvaluable, you have to look for the best (or one of the best) doctor in this field. Two opinions are always better than one!

Thank you! I think what I might do is ask both him and the cardiology specialist to look at both her old and new scans? A major downside of having only been here a few years is that I'm unsure who to trust. I don't have a vet I've been going to for donkey's years like I did in the States. But, when I looked up the measurements they look at in HCM, and what her scan said, it does seem like her old scan just doesn't agree with an HCM diagnosis.

 

[jcat]

I'd get her checked out by a cardiologist (our last cat had HCM without a murmur). Another tool that can be used in addition to the scan is the
Cardiopet proBNP Test
There's more of an explanation of how it works here.

 

[lilin]

Welp, got a fresh heart scan, and she does indeed appear to have HCM. *sigh*

The good news is that her thickening is still very slight, and her BP is still low-normal, as it was 2 years ago. So, at this point, they continue to recommend no treatment. Apart from the murmur, she continues to not have any functional issues with her heart as of yet.

I have her booked for a dental, as she does have a bad tooth that will likely need to come out. I know cats with murmurs are higher risk for anesthesia, but my concern is that if I don't get on top of it now, she could have more heart problems from infected teeth, and she may not be fit for anesthesia in a couple more years.

They told me they consider her to be ok for anesthesia, and also ok to fly. Does this square with what you guys know about murmurs/HCM? Any stories about having an HCM cat come out of anesthesia ok? I'm just really worried.

Honestly I sort of hate myself for putting her through a move back to the States, but I don't have a choice. My visa situation is just so messed up, it's either go now or wind up crash-landing in poverty in a year or less. As much as it would break my heart, I'd consider adopting her out just to avoid putting her through this if I thought she had any realistic chance, but I know she probably doesn't. I feel like such a terrible pet parent.

 

[Antonio65]

Any stories about having an HCM cat come out of anesthesia ok? I'm just really worried.

Lola, the cat in my profile, was diagnosed with HCM in April 2016 prior to a TC scan that was eventually done three months later.
So, despite her HCM, a slight murmur and other issues, inluding her age, 16 yo, she was put under anesthesia for the TC scan on that Monday at the end of July, then under a new anesthesia for a difficult surgery on Tuesday, just 24h later.
My cat had to undergo several more anesthesia three months later. A new carcinoma developed in her tiny body and she had a new TC scan in early October, on a Monday, and 10 (TEN!) anesthesia in 5 days, two each day, in the following week Mon to Fri for the radiation therapy.
So, my cat with HCM had 13 anesthesia in three months (eleven of them in two weeks time) at the age of 16 and she survived.

I'm not saying that doing an anesthesia in a cat is a walk in the park, but the chance of something bad during them is not so common.

Best of luck for your cat!

 

[lilin]

Lola, the cat in my profile, was diagnosed with HCM in April 2016 prior to a TC scan that was eventually done three months later.
So, despite her HCM, a slight murmur and other issues, inluding her age, 16 yo, she was put under anesthesia for the TC scan on that Monday at the end of July, then under a new anesthesia for a difficult surgery on Tuesday, just 24h later.
My cat had to undergo several more anesthesia three months later. A new carcinoma developed in her tiny body and she had a new TC scan in early October, on a Monday, and 10 (TEN!) anesthesia in 5 days, two each day, in the following week Mon to Fri for the radiation therapy.
So, my cat with HCM had 13 anesthesia in three months (eleven of them in two weeks time) at the age of 16 and she survived.

I'm not saying that doing an anesthesia in a cat is a walk in the park, but the chance of something bad during them is not so common.

Best of luck for your cat!

Thank you!! I'm glad she did so well, and it does make me feel a little better.

 

[Antonio65]

Thank you!! I'm glad she did so well, and it does make me feel a little better.

My cat Lola is now waiting for me at the Rainbow Bridge. Her last carcinoma, though it was treated, took her away from me at the end of March

 

[lilin]

My cat Lola is now waiting for me at the Rainbow Bridge. Her last carcinoma, though it was treated, took her away from me at the end of March

God, cancer sucks, I'm sorry.

 

[lilin]

Well, Pia made it through her dental surgery just fine! She needed a tooth extracted, and I'm gonna start brushing them from now on. I'm not going to bank on her still being fit for anesthesia in a few years.

She hates me now, though. *sigh* She's eating well, but only once I leave the food. She wouldn't let me take her bandage from the IV off for her. Wound up pulling it off herself. I'm sorry, Pia!

 

[babiesmom5]

That is good news about Pia! Yes, the brushing can only help her dental health. You can also wipe her teeth once a day with a piece of sterile gauze. When my HCM kitty got up in years, my vet would perform her teeth cleanings using "gas" to keep her under rather than anesthesia. You cannot keep them under for lengthy periods, nor can you perform extractions, but for brief routine cleanings, it worked fine.

If you will be flying with Pia, I would look into transatlantic airlines which allow pets in the passenger compartment. I believe Luftansa is one; there may be others. I have heard too many horror stories about pets not surviving the trip in the cargo hold, or were lost.
If I had to fly with any cat, I would only fly on an airline which would allow me to have my cat with me in the carrying case under the seat. I would not let my cat out of my sight.

 

[Antonio65]

Very good news, lilin, very good news.
Pia will soon forget the "injustice" you did to her and will be friend again

 

[lilin]

That is good news about Pia! Yes, the brushing can only help her dental health. You can also wipe her teeth once a day with a piece of sterile gauze. When my HCM kitty got up in years, my vet would perform her teeth cleanings using "gas" to keep her under rather than anesthesia. You cannot keep them under for lengthy periods, nor can you perform extractions, but for brief routine cleanings, it worked fine.

If you will be flying with Pia, I would look into transatlantic airlines which allow pets in the passenger compartment. I believe Luftansa is one; there may be others. I have heard too many horror stories about pets not surviving the trip in the cargo hold, or were lost.
If I had to fly with any cat, I would only fly on an airline which would allow me to have my cat with me in the carrying case under the seat. I would not let my cat out of my sight.

Thank you! Yes, I'm going to stay very on top of that from now on so I'm not kicking myself later. She seems prone to dental issues, which caught me off guard. My first kitty was one of those that just always had good teeth, and still had all of them when she died at 15.

She is booked into the cabin with me. It took some doing and a lot of expense, as most airlines won't fly cats out of the UK in cabin (it's legal, but since it's not legal to fly them IN in the cabin, most airlines just don't do it out of being overcautious of the UK's admittedly somewhat confusing border control). I couldn't find a Lufthansa-operated flight that got me where I need to go, but Air Canada will do it too for future reference to any UK cat owners!

I won't fly her in the hold either. I flew with her to France and just drove through the Chunnel, when I entered.