Heart Murmur?

[marc999]

So, I picked up my cat less than a week ago from the local shelter. According to their policy they only adopt out healthy cats. 

I took my 4-yr. old boy cat into the Vet. office and within 30 sec. listening to his heart, he said there's a Level 4-5 / 6 heart murmur. 

Are you kidding me? How the heck could the shelter have missed that? That's extremely poor play in my opinion.  

I have the option of getting a full refund within 14 days of adoption which I am contemplating.   Either way, I"m never going to recommend that shelter again and am seriously contemplating publicizing this information in my community. 

Or, cough up the $700+ for an echocardiogram to determine prognosis.  

Obviously I'm venting and am quite ticked off.   He was doing quite a bit of head and ear scratching & his eye has an infection - both of which I will be applying drops for.   

Once again - sloppy vet. work at the shelter. 

Would you get a second opinion? 

 

[shaheena]

Oh no, poor cat. I'm so sorry to hear that!  Have you talked to the shelter? This grade  is high, how could they have missed that? 

I have heard that heart medication is not that expensive. Surely ultrasound, x-ray, echocardiogram are.

Maybe the shelter would be willing to perform these diagnostics and heart check ups  for free if you keep him. You would only have to get him the medication . This condition must have been preexisting, it wouldn't develop within a few days. It would be fair if they would collaborate.

I hope he does not come from a kill shelter. He might end up on the euth list next morning with this condition if you return him. 

Is he insured? Some shelters (rescues) provide a free 3 month trial insurance that comes with the adoption contract. 

 

[hexiesfriend]

I wouldn't. Over 50% of the cats I have had in my 25 years cat history have had a heart murmer. It creates complications for anesthesia procedures with some vets. I have never had a cat die of a heart murmer but I can't comment on the degree of murmer mine have had. The one whose murmer was bad enough to warrant a pre surgery cardio gram seems happy and healthy. This was for a dental that a previous vet did on repeated occasions without an echo. I have a feeling that maybe because this may be common the vet at the shelter cleared your cat. Sometimes I hate to say, a vet may try to sell you an echo that may not statistically be needed. I would say if your cat isn't having any extensive surgery don't get the echo. Also I assume the shelter neutered your cat under anesthesia with no problem. If your cat seems short or breath and unhealthy then of course an echo is routine for diagnosis but I'm not hearing that....

 

[marc999]

Oh, thanks for your feedback Hexiesfriend.  You seem quite knowledgeable in this department.  I had no idea heart murmurs were so common. 

You're right - maybe it's a common thing to push for these days. It's a business after all. 

What can I tell you? 

Activity: He has great activity levels during play time - chasing laser pointers, swatting wand toys etc. 

Food: great appetite, loves both wet and dry foods. Eats ~ 200 calories / day, via canned wet and/or dry at night.  Will transition to strictly wet.

Breathing: normal 

Feces/Urine - 1 solid poop and 2-3 solid pees per day. 

Health - head shake / scratching, tested negative for ear mites - nevertheless persistent scratching. Was sold drops to put in ears ever 12 hrs. 

Eye - one is slightly cloudy - apparently inflamed a bit - sold drops to give 3x /day. 

Shaheena, thanks for recommendation.  Although I highly doubt they'd cough up $700 for an echocardiogram, even though it's Level 4-5. They'd likely just shrug and give a refund. They have a policy letter on their front door that they don't euthanize healthy cats. - well, apparently he was healthy enough for them. 

There's no way pet insurance would cover this, because Vet. said it's pre-existing condition.

 

[shaheena]

Shelters usually pay a  "rescue price" for vetting, less than we do, they have their own vets and equipment.

4-5 sounds rather high to me. As I said, heart medication is inexpensive, it's the diagnostics that is pricey.  But an ultrasound may be enough to see if he needs medication or not (ca 150 US Dollar.) I do believe that the shelter might still be responsible  since you found out within the 14 days (means the adoption contract hasn't come fully into effect yet.) 

I'm happy to hear that hexisfriend's cats did just fine with the condition. However I belong to those  who would rather chose to see in each individual case if it would affect the life expectancy and if medication would be recommendable. 

Whatever you decide, healthy food and avoiding stress may be beneficial.

 

[di and bob]

I've had a LOT of experience with 'people' heart murmurs and want to reassure you that almost ALL murmurs aren't especially life threatening. Almost 75% of people over 65 have them and live a long time after, I've had people in their hundreds that have had them for 50 years! It's a scary thing but look it up on the internet to learn more about it. I'm so sorry you have to go through this and wish you all the luck!

 

[stephenq]

Hey there,

I just want to address two issues:

1- The shelter and their policy:   I've been around many shelters and not one has guaranteed the health of any animal because they can't.  They can say this animal has been tested for X, Y, and Z, received theses vaccinations, and (if they have done this) they can say that nothing turned up on an exam.  So if they really guaranteed the health of your cat then I would suggest they over stepped.

If they did an exam, they absolutely should have caught the murmur.  I would ask then them if they will cover the diagnostic workup.  If they don't, you may if you chose to (and i am not suggesting this) return the cat to them if they will do the diagnostic work and treatment if you surrender him.  I work with a shelter that a) does not guarantee the animal's health b) make its the adopter's responsibility to treat the animal post adoption but c) will treat the animal at their cost if they surrender the animal. You didn't sign up for a major illness and if they promise to treat the cat if you surrender him, then that is an option.

2- The Medical Situation: Murmurs can be benign as others have said, or they can be indicative of various diseases some of which can be quite bad and some of which are not.  our cat has a graded murmur that is cause for concern.  There is a significant difference between a level 4 and a level 6, and note that 6 is the highest.  Generally, the higher the grade, the more likely that it is not benign.  Some cats are born with structural defects and still have a good prognosis, others its an acquired illness and the prognosis may be worse.  It is the expensive diagnostics that are unfortunately required to determine what the situation is, and what the treatment if any, may be.

So to sum up, the first question I would ask is what was the exact guarantee that the shelter made, and if it was a clearly stated one will they honor that by covering the costs of diagnosis and treatment?

Please report back and I wish you and your cat all the best.

Stephen

 

[hexiesfriend]

I agree with stephenq. If the shelter will cover the echo great. I'm sorry I don't have too much experience with shelters as all of mine have been strays. I have never had any vet recommend treatment for the murmur. I just looked up my cat princess's medical records and it is a grade 5 murmur, she's 13 years old now and has had it for years. If you can get the shelter to cover all tests go for it. I was just chiming in on whether you should return your cat to the shelter because of a condition that sounds very serious but may not be.

 

[marc999]

Hi Hexiesfriend, thanks again.  Level 5? - so no echocardiogram was done on her?  Interesting...

Sounds like just a personal call of the Vet. in question then.  Damn lol, it's not a cut and dry science is it...

I've put a call in - awaiting call back.  If they don't - I've driving out there tomorrow. 

 

[hexiesfriend]

Nope. Her old vet retired and I had to take her to a new one. When it was time for a teeth cleaning I took her to a new vet who heard her murmur and said a presurgery echo would need to be done, $1200! I asked why, because she had at least 6 previous dentals with the old vet without it. I was told essentially that the vet would be fired if something happened to my cat under anesthesia with no echo. I told them to forget the dental as most of her teeth are gone anyway. The echo has never been recommended for heart treatment. I don't want to seem like I am giving any medical advice on this issue I am just telling you my experience with heart murmurs. Princess, is not the first or probably last one I will have with this problem. I know if it was me it would be hard to give a cat back once I've gone home with him. I'd still see what the shelter could do for you though.

 

[marc999]

Hmm, how about that.  Tomato - Potato.   Everyone has a different opinion or policy.   

I'm going to rest easy then and not lose sleep over it. 

 

[ldg]

We just went through this with our Flowerbelle. She only had a grade 2 / 3 murmur. We work with three different vets, and went to the one we trust the most when it comes to figuring out how to proceed with stuff like this. He recommended a cardiologist ultrasound rather than echocardiogram. Much less expensive.

We found out her murmur is due to mitral valve prolapse (a valve that doesn't always close all the way) - not heart disease. She also has high blood pressure, which we need to manage with medication.

With a grade 4-5 / 6 murmur, I would definitely do something. If your cat does have heart disease, you really don't want to let it go untreated.

 

[marc999]

I should have clarified: 4 or 5 out of 6. 

I'll be in discussion with the shelter tomorrow regarding their supposed health check and adopting out only healthy pets. 

 

[cprcheetah]

I would check with the shelter.  Some shelters administer their own vaccines and the only time the cats see a veterinarian is to be spayed or neutered.  Oftentimes they use spay or neuter clinics who do the bare minimum and you are lucky if they do an exam on the pet before sedating it for surgery.  As said above cats can live healthy happy lives with murmurs, it just depends on what is causing it.  $700 for an echo?  That seems a bit steep.  We have a specialist come in and do them and they are $350 and that includes her travel fee.  You might want to call around to see if someone else would do it cheaper. 

 

[marc999]

Yeah, I've read we get royally screwed here in Canada re: Vet. fees. There's quite a few articles floating around the net on price comparisons.

Heck, another vet. quoted $400-700 depending on level of experience of the Vet. 

I'd be willing to drive to the U.S. somewhere, if it would save a few hundred.

So, if I ever cross that road, I"ll use proper judgement.

 

[scarlett 001]

 
Yeah, I've read we get royally screwed here in Canada re: Vet. fees. There's quite a few articles floating around the net on price comparisons.

Heck, another vet. quoted $400-700 depending on level of experience of the Vet. 

I'd be willing to drive to the U.S. somewhere, if it would save a few hundred.

So, if I ever cross that road, I"ll use proper judgement.

Not sure where you live in Canada, but some cities are even worse than others. The basic rate where I live just to walk in the door to see a vet (non-emergency) is $85. Probably the highest in Canada. Some clinics seem to have put the price up, and then almost every other clinic followed suit. Not sure why Canada is so bad overall relative to the US and the UK for pricing, but it certainly seems to be many times higher to get almost anything done in Canada.

 

[marc999]

Exactly Scarlett. 

I don't think our brothers to the south realize the discrepancy in cost for services. I'm under 2 hr. drive to the border, so anything with a big ticket, I'd likely consider taking a road trip, if/when it comes to that.  Having said that, it's not always possible, but it is an option. 

 

[worriedsomuch]

Hopefully it's okay if I chime in here. Honestly I have heard much different advice regarding heart murmurs from my vet. He told me right away when he heard my cat's murmur which was around 3 or 4 or 3/4 that he most likely thought it was heart disease. He also said the higher it is, the less likely it is to be benign. I did my research as well and came to the same conclusion. I'm sorry about the pricing there for the testing. It can run quite expensive. The echo I had for my cat was around 200 but my vet actually was kind enough to recommend someone who didn't charge quite as much as others. Perhaps you could check around? However, my cat also had EKG, blood pressure, and the exam so with all that, his bill was sometimes around 500-600 dollars. However, it was honestly worth it. At first he went to the vet twice a year, but he did so well, he started to go just once a year. He was diagnosed with moderate-severe HCM but he had an excellent quality of life with medication. The medicine was around 60 dollars a month but I had it formulated into a liquid that could be placed in the food. He lived very healthily for 5 and half years with it, never had a symptom of anything. His heart murmur was even downgraded to a 1-2 murmur. He was diagnosed at 8 (almost 9) and lived to be 14. His heart disease wasn't the cause of his death either. One kind thing the vet told me when it was his time was that I certainly took excellent care of his heart and he died with a healthy one.

 

[marc999]

By giving medication - Are you extending the life of your cat, or easing the pain during his remaining years for that heart murmur? 

Interesting opinions guys, thanks for all the feedback.  The difference of opinion is quite something. 

 

[stephenq]

With some of the drugs you're hoping to extend the life.  Also there is more than one way to die of HCM. Because of poor heart function there is a tendency for some blood to pool in the lower chamber where it to some extent re-circulates inside the chamber.  This blood is at risk of forming clots which if it happens will either kill the cat immediately or cause a very painful paralysis  that usually results in euthanasia, so one of the drugs used is to help prevent this clot and therefore this form of early death.

HCM by itself isn't painful.  If the cat progresses into congestive heart failure (which is reversible for at least a period of time) then the cat will be in discomfort because the fluid build up in the lungs makes it hard to breathe.  It's the fluid build up that is essentially the definition of a cat in heart failure.  A cat can often be brought out of heart failure within a few hours by the timely use of diuretics which cause the cat to pee, thereby draining the lungs.

Bad news is that the use of diuretics over time can put the cat into kidney failure, and the normal treatment for that is sub Q fluids, but you can't do that with a cat in this condition because the fluids go straight to the lungs, which would put the cat back into heart failure.  There is a more complicated technique for getting the cat out of kidney failure, the problem being that a cat with serious disease may bounce back and forth between heart failure and kidney failure, and keeping the cat in balance is the key.

As to the care being more $$$ in canada, ironic given that you have great health care for people!