Cat cardiology

[poltroon]

I have a cat that experienced a saddle thrombus, a blood clot from the heart resulting in semi-paralysis of his hind legs. Fortunately, and honestly to everyone’s surprise, it resolved quickly with what we expected was hospice care, and he had full function back the next day. We may have to rename him 10%.

The cat is young (5) and very active and happy. He does have a new murmur discovered at the time of this incident.

So now that he survived, I’m aware that the prognosis is still pretty terrible. I have a referral to the feline cardiologist. In the meantime, the vet has prescribed aspirin for him.

However, my reading on this suggests… that there is a high likelihood of a recurrence, with a pretty terrible prognosis, no matter what we do. Other cats related to this cat have also shown signs of heart disease.

I’m not against taking him to the cardiologist, but I’d like to have a feel for what they can actually do to benefit him before I commit down this path. I know he won’t enjoy the visits nor an hour and a half car ride each way per visit. It won’t be cheap, either. I’d like to understand what kinds of things they can find with the diagnostics and what that would tell us about treatment options, and whether these treatments have any chance of making much difference. My vet felt he was worth the workup, as a young and otherwise healthy and lovely cat, and that maybe the cardiologists have some new medications and additional experience that would benefit him.

The information I’m finding is pretty much, “you should do a lot of expensive and uncomfortable diagnostics, and then we’ll give you this expensive medication your cat won’t enjoy that may or may not give him a slightly better chance of living a couple of years.”

Pointers, experience, thoughts appreciated.

[keh]

I’m really sorry. Does your vet have an idea as to the source of the murmur? Our 5 yr old had a heart attack in front of my husband. I wouldn’t wish that on anyone. We missed the murmur because she used to purr so loudly at the vet’s. We had an autopsy done because she literally just keeled over. She had a faulty valve causing her heart to be enlarged. The vet felt this was genetic & said there was medication we could’ve used, had we known. I would ask your vet if it’s ok to transport your pet that long & if he thinks it’s ok, then try. There may be something you can give him to keep him calm for the trip. I wish your kitty the best.

[CindyCRNA]

I have heard that cats are hard to anticoagulate but there may be something new, experimental or off label. Talk to the cardiologist and just see what your options are. But the underlying problem needs to be address
Here is an easy read. Asprin and Plavix seems to be used . http://www.cathealth.com/cardiovascular/aortic-thromboembolism-in-cats

[DrBeckett]

Basically they will want to do an echocardiogram - they will be looking at the inside of the heart to look for thickening of the muscle, making the heart less efficient, or thinning of the muscle, also making the heart less efficient. They will look at the valves to see if it is a valvular disease (more common in dogs than cats). The will look at the chordae tendinea, which are the cord-like tendons connecting the papillary muscles of the heart to the two valves. Torn chordae is very serious problem.

They will probably want to do an EKG, which looks at the electrical system of the heart.

The problem with cats and heart murmurs and other cardiac problems is that, quite often, the first sign that there is a problem is sudden death. If you take your cat to the vet yearly, they might be able to find the murmur, do a work-up before sudden death. Also cats will present with difficulty breathing - rapid breathing, or open-mouth breathing. Most of the time that indicates a heart problem more than a respiratory problem. Dogs, on the other hand, will start with coughing and exercise intolerance, giving a head up that something is wrong.

I would strongly recommend the referral, but I understand not everyone can afford one. And medicating cats is never fun, so that’s something to think about also.

Keep us updated. Best of luck.

[syreino]

As a mom of two* special cats with their own cardiologist, and one that died at the age of three of a heart attack, I suggest the referral to the cardiologist is needed to find out what is going on and prognosis. Even if you choose to do nothing afterwards, you will know and be able to prepare for what might come down the road.

I won’t get the whole story right, but my childhood cat, who became my parents favorite child when my sister and I were at college, if I remember correctly, developed something similar. The vet put him on aspirin, my mom had a sign up for which day was aspirin day (every third day, as every day can kill a cat) and he lived to the ripe old age of 18 and never had another issue (but being the favorite child, he got spoiled rotten so I don’t know how that played into it). Not saying your cat will be as lucky, but Iggy certainly was lucky!

My two that see a cardiologist now both have murmurs and the sister of the one who died at 3 has cardiomyopathy in addition - she was going every six months for a while to determine progression of the disease with her meds - and now it’s a yearly check where she gets loved on by the cardiologist group and a diagnosis of “no disease progression”. She’s 7 now, and I have been told her life expectancy isn’t great (12-13), but to look at her, you wouldn’t know she’s gotta take atenolol twice a day or she’d be dead by now. My other one, her heart murmur is only noticeable occasionally and she’s had two echocardiograms over the years, but now that she’s 8, they are suggesting yearly to follow up. Both murmurs are mild, so that helps in their cases.

An echocardiogram is an ultrasound of the heart - maybe uncomfortable for them to remain still, but both mine come back with reports of how good they were and Mia actually was purring and making it hard for them to do their job. EKG, Jordan had that the first visit I believe, and I don’t remember hearing horror stories. A visit to the cardiologist now (full exam, including echo) runs around $450 for each cat. The atenolol has really saved Jordan’s life, and I am grateful to have that option for her and wish I had that option for her sister as well. And the atenolol is cheap - my regular vet gets me a bottle of 100 pills, and she gets 1/4 tablet twice a day so it’s around $25 for 200 days of medicine.

Good luck and hugs to your boy.

*I have multiple cats, so I do have cats that aren’t as special in needing their own cardiologists. I’m just lucky enough to be owned by two that are special in that way.

[DoubleClick]

So sorry that your young cat suffered this. We just lost a ten year old cat to this a little under a month ago. The prognosis is scary and sad, and I wish your guy the best.

[Laurierace]

I lost a cat to that years ago. He was fine one minute and paralyzed and screaming literally in agony the next. He was euthanized within minutes of arrival at the emergency vet. I wonder if the fact that he survived is a good sign for at least a little bit of hope? Best of luck to you both.

[Beckham03]

I’m glad your kitty survived. I highly hope you can go and see what they can do. I have also lost kitties to cardiac issues. But working at a specialty hospital, I’ve seen kitties do well. She probably won’t completely love the visit, but we are all equipped to help the grumpy cardio kitties. They will help him through!

[vxf111]

I lost a cat to this a few years back and at the time Ryan (UPenn) was doing a study. You might contact them.

[GoodTimes]

As someone who works in human echo I’d just like to clear something up. There are a lot of people who hear heart and get all worked up about murmurs. Please stop. Almost everyone has mild regurgitation of at least one valve, it’s harmless. If you can hear the murmur when you’re sitting beside someone? Then you have a problem.

I’d also like to clear up the mechanism behind thrombus in the heart. Clots or thrombus form when blood is stagnant. This is caused by moderate to severe systolic dysfunction (the left ventricle stops pumping as well), or from arrhythmias that cause the left atrium to dilate and thus stop contracting as regularly. In most cases these mechanisms are caused by underlying cardiomyopathies, in very few feline cases would the chambers dilate as a result of a murmur. More commonly, the murmur is a result of the valve annulus dilating after the ventricle itself dilated.

I understand my post is probably confusing for those with little cardiac background. I won’t get into the details of the different cardiomyopathies. I would suggest that you go see the cardiologist. You’ll want to know the mechanism behind the clot forming so that you can medicate appropriately.

[poltroon]

So, GoodTimes, ARE there medications that can make a real difference then in some of these cases? That is what I’m really trying to suss out here.

I don’t want to put the cat and myself through these visits if from the information already in hand we know there’s not much we can do for his survival or quality of life. It would be a little different for me if there was a feline cardiologist nearby and there wasn’t so much travel.

That said, the cat looks great right now.

[CindyCRNA]

[QUOTE=poltroon;9005560]
So, GoodTimes, ARE there medications that can make a real difference then in some of these cases? That is what I’m really trying to suss out here.

I don’t want to put the cat and myself through these visits if from the information already in hand we know there’s not much we can do for his survival or quality of life. It would be a little different for me if there was a feline cardiologist nearby and there wasn’t so much travel.

That said, the cat looks great right now.[/QUOTE]

There are in people but cats are tricky. Plavix is a human drug but I think it has limited use and efficacy in cats. My friends cat threw a thrombus to a front leg which later had to be amputated and was put on Plavix. Long story short cat only lived a month longer due to other issues so i know it is used I just don’t know how successfully.

[Simkie]

Perhaps it would be worthwhile to have a phone consult with the cardiologist before putting the cat through the stress of travel for the appointment?

[GoodTimes]

[QUOTE=poltroon;9005560]
So, GoodTimes, ARE there medications that can make a real difference then in some of these cases? That is what I’m really trying to suss out here.

I don’t want to put the cat and myself through these visits if from the information already in hand we know there’s not much we can do for his survival or quality of life. It would be a little different for me if there was a feline cardiologist nearby and there wasn’t so much travel.

That said, the cat looks great right now.[/QUOTE]

I understand your dilemma. They’ll likely anticoagulate regardless of what they find. The problem with skipping the echo or even the ECG is that there’s no way of knowing what the mechanism behind the clot was. I’m not familiar with feline medications so I can’t really be of much help. But in humans there are lots of medications that can help improve the function of the heart, which keeps blood moving, and decreases the chances of a clot.

[Darkwave]

FWIW, my cat Aramina was diagnosed with an enlarged heart and significant heart murmur in 2003 (age 4). Prognosis uncertain. So we went with meds (beta blockers, in her case).

[the diagnosis at the time, based on ultrasound, was HCM; several years later it was revised to a heart defect and high blood pressure, and we modified her beta-blockers slightly)

She lived, happily and loved, until January 2015. That was 12 additional wonderful years I had with her.

No question I’d go ahead with the visit.

[SquishTheBunny]

A discussion with a cardiologist will be invaluable for you. Yes, there are medications that can help cats with heart disease maintain a good quality life - of course no medication will work in 100% of cats and overall heart disease is progressive. A consult will do nothing more than assess your kitty and give you prognosis and treatment protocols - something probably worth the $.

[khall]

One of my cats was diagnosed with a pretty serious heart murmur early on. She was on aspirin to prevent the saddle thrombosis and never experienced any problems related to a blood clot. I did have to euthanize her at a fairly young age (9) due to serious kidney disease.

We did not go to a cardiologist, just our regular vet who did a EKG over the phone and I believe consulted with a specialist. She was also on heart meds her entire life.

Good luck, glad your guy came out of the clot easily. Hope you can get some answers.

[Rudy]

[QUOTE=khall;9021838]
One of my cats was diagnosed with a pretty serious heart murmur early on. She was on aspirin to prevent the saddle thrombosis and never experienced any problems related to a blood clot. I did have to euthanize her at a fairly young age (9) due to serious kidney disease.

We did not go to a cardiologist, just our regular vet who did a EKG over the phone and I believe consulted with a specialist. She was also on heart meds her entire life.

Good luck, glad your guy came out of the clot easily. Hope you can get some answers.[/QUOTE]

So your cat was put on cardiac medications and aspirin without an echo? Ugh. A loud heart murmur does not equal a cardiomyopathy. I vehemently dislike people putting animals on medications for their heart without a cardiologist being involed especially considering the medications involved can ruin kidneys.

I had a case the other week where the dog had a 5/6 left apical systolic murmur, had never been in congestive heart failure(but was on furosemide), had never had an echocardiogram and no blood work to monitor kidney function for the 3 years she had been on them. Once a year her vet would listen to her heart, declare the murmur was louder and upped the medication. She came to me on emergency for severe lethargy and not eating … her creatinine was over 8. We got to have a discussion that if the dog does indeed have serious cardiac disease that she cannot get fluids, but without fluids I can’t address her kidneys well because I would put her in to failure, yet if I didn’t address her kidneys she’d continued to decline. It was a great conversation. I especially loved the use of furosemide, benazepril, AND chronic Capron use and NO bloodwork in 3 years!!!

[Rudy]

*furosemide, benazepril, and carprofen. The post won’t let me edit.

[redfield]

My cat experience a saddle thrombus event last 4th of July. His left back leg was paralyzed for about a week. I took him to several vets and the only service they offered was to put him to sleep. I did as much research as I could in such a sort amount of time and I had a local vet write me prescription for plavix. He started his first dose 48 hours after the saddle thrombus occurred and is still taking plavix over a year later!

When this first happened his back leg was cold, but the vet could still detect a faint pulse. My cat would crawl to his food and water bowl and I helped him use the litter box. While we was recovering I had him sleep near my head so I’d wake up if he needed anything, and now over a year later he still sleeps next to my head. Great for my allergies, lol. He has a slight limp but he can still run full blast when he wants to at 2am and for the most part is fully back to normal.

It took about a week for his leg to become warm again, and another 2 weeks before he could walk more than 5 feet, and around this time all the fur came off his leg. It was a very bad experience, but I believe the plavix saved his life. He takes 1/4th of a pill every day. If anyone is reading this and is going through a saddle thrombus event, please, please, please get plavix.