Kitten with enlarged right side of the heart

[Pepper&Pillow]

Hi Everyone! I'm new to this so please accept my apologies in advance. My kitten is around 6.5 months old named Pillow. We got her just last May 14 in addition to our one-year old cat. Due to improper care by the previous owner, she was never vaccinated nor seen by the vet. I will try to provide a detailed description of our vet visits, medications, and her symptoms.

May 14 - First Vaccine and Deworming (Everything is normal). However, after two days she started having nasal discharge and sneezing. It continued until the fifth day so we decided to go for a check-up. She was given an injection(Fever) and antibiotics(possible URI). Seven days of treatment but no signs of improvement so we follow up and the doctor increase the dosage of antibiotics for another one week. The sneezing and cold slightly improve but goes on and off so we have her tested for the possibility of FIV. She came back negative and all blood tests were good.

Then she got the second booster shot of the vaccine but still the sneezing, nasal discharge, and cough on and off. I started to do my own research and gave her l-lysine in the hopes that it could help her. However, skip until her third booster shot last Monday, the problem with cough and nasal discharge is still persistent so we asked the doctor to have her X-ray. This was when we found out that she has an enlarged heart in particular to the right side (as per the doctor).
The doctor told us that they will provide the medicine today as it was not available by that time and that we will have to do the x-ray once again after two weeks. There is no available vet cardiologist here in Bahrain so we asked for more details as the doctor seems not worried about it. Like what was the exact problem and what caused it? Is there any prohibition now as to food? Does she have a shorter life expectancy? All the possible things to help us understand the real problem.

I would appreciate any advice or comments.

 

[Pepper&Pillow]

 

[fionasmom]

Jamie who is 4 has hypertrophic cardiomyopathy and does see a veterinary cardiologist. I am going to attach a couple of articles which may give you some background information and help you to know what to ask your vet.

Will your vet correspond with any other cardiac practitioners in other locations? That would provide at least some distanced support. Can he do an ultrasound/echocardiogram as opposed to xrays? This is really the gold standard for diagnosis of heart conditions in cats. His skill in interpreting the results is important here though.

Jamie was put on atenolol and plavix immediately by the veterinary ultrasonographer and the vet owner of the practice. The cardiologist took him off of both meds as she said his case was not that advanced, but that she would continue ultrasounds every 6 months to monitor. However, I want to add that HCM affects the left side of the heart, and your cat is affected on the right side, so I am not saying that what applied to Jamie necessarily applies to yours.

There can be causes of heart conditions in younger cats which seem to resolve with age, but I am concerned that you are just not being given enough information. Is the vet acting as if he is interested in successful treatment or is he writing this off as heart disease which will run its course?

So, I have not been much help because what you need, as you said, is more concrete answers.

Diagnosis: Heart Disease

Heart Disease in Cats

Enlarged Heart (Dilated Cardiomyopathy) in Cats | PetMD
Your cat more than likely does not have a taurine deficiency, which used to be the accepted cause of DCM, but there is still some information here which may be helpful.

 

[Pepper&Pillow]

Jamie who is 4 has hypertrophic cardiomyopathy and does see a veterinary cardiologist. I am going to attach a couple of articles which may give you some background information and help you to know what to ask your vet.

Will your vet correspond with any other cardiac practitioners in other locations? That would provide at least some distanced support. Can he do an ultrasound/echocardiogram as opposed to xrays? This is really the gold standard for diagnosis of heart conditions in cats. His skill in interpreting the results is important here though.

Jamie was put on atenolol and plavix immediately by the veterinary ultrasonographer and the vet owner of the practice. The cardiologist took him off of both meds as she said his case was not that advanced, but that she would continue ultrasounds every 6 months to monitor. However, I want to add that HCM affects the left side of the heart, and your cat is affected on the right side, so I am not saying that what applied to Jamie necessarily applies to yours.

There can be causes of heart conditions in younger cats which seem to resolve with age, but I am concerned that you are just not being given enough information. Is the vet acting as if he is interested in successful treatment or is he writing this off as heart disease which will run its course?

So, I have not been much help because what you need, as you said, is more concrete answers.

Diagnosis: Heart Disease

Heart Disease in Cats

Enlarged Heart (Dilated Cardiomyopathy) in Cats | PetMD
Your cat more than likely does not have a taurine deficiency, which used to be the accepted cause of DCM, but there is still some information here which may be helpful.

Thanks, Fionasmom for your response. We found another clinic that has the capabilities for ECG/Ultrasound and said they will consult with some specialists abroad. We're just going to transfer Pillow to another vet and see if we can have some answers. I've read also some articles but just can't find the same case (the right side of the heart).

Attached are the images below for her X-ray.

When was Jamie diagnosed with HCM? Is she having on and off cough/nasal discharge ?

 

[fionasmom]

I think that you have answered your own question. Getting an ultrasound/ECG is really what you need and if the vets are willing to consult that should be a big help.

I know what you mean about googling articles because some of them do seem to switch between left and right side of the heart randomly and I know that in real practice there is a difference.

Jamie had no symptoms. He had, when he was about 2, a blood test which showed that he had high BUN and creatinine. For about 2 years we treated this as a kidney issue although his US on that area of his body showed absolutely nothing. Did subQ fluids, retested, etc. Nothing. Finally, his vet said that there can be a connection between HCM and kidney issues so we did the ECG which showed the HCM. Ironically, at the end of the day, the cardiologist said that she thinks that his kidneys are a separate issue and have nothing to do with the HCM. Go figure.

I am not great at interpreting xrays. Your vet saw what he believed was an enlarged right side? Proceeding with the US will be a big help. Please let us know what you find out. Were you given meds today or did you decline them in favor of waiting for the tests?

 

[Pepper&Pillow]

Hi. Sorry for the late response. We transferred her to another vet and after series of tests and procedures, the heart problem was ruled out. She was initially treated for possible fungal infection but it also didn't work. Now she's one week on prednisolone and gonna start today another series of medicine as the vet just called on me.

Another problem because my other cat suddenly started wheezing and showing the same symptoms Pillow has. We really don't know what to do anymore. We haven't even solved the problem with Pillow and yet, the same thing happens to Pepper.

 

[fionasmom]

I suppose that the good news is that heart conditions have been ruled out but you are still facing this problem....and now with the other cat. What is the new medication for? Did the vet think that there was another diagnosis aside from the heart and fungus, both of which did not pan out. Do you think this could be an allergy or some sort? They can be so hard to pinpoint, but it is odd that two very well cared for cats have the same thing.

 

[Pepper&Pillow]

The vet provided the same, just a little more. I thought it would also be a new medicine. They gave prednisolone good for 30 days and they said they will check after that. So far, the steroids lessen the coughing and wheezing, although there are still mild episodes ( around 1 to 2 times a day) and the nasal discharge from like 10 to 1. However, it is still too early to tell as she was also like this with her previous medications. Improvement within a week and then back to where we started again.

Honestly, we really don't know what could be causing this. Especially now that it seems to be transferred or had infected my other cat as well. I'm trying to eliminate one by one any possible allergens. Pillow is mainly on a canned wet food diet while Pepper is on raw. I've been using the same cat litter ever since and cleaning on a daily basis. It's just so frustrating and I'm just hoping that they both finally got better again.