Dear Dr. Thompson,
My 2-year-old cat Brady was first diagnosed after going into heart failure in December, 2012. He was put on Atenolol, 6.5 mg every day and the same amount of aspirin twice a week, with a fish oil supplement. As recently as a month ago his cardiologist said he was looking great and the meds were working well. On Monday night I noticed him breathing heavily and took him to the emergency veterinary hospital nearby. They gave him a diuretic and had him in an oxygen chamber until the next day.
When I went to pick him up that evening, they showed me his X-rays where his heart was very large and he had been in heart failure again. They basically told me he will not live longer than a few more months, and I’ll be giving him Lasix every eight hours for a few days, then every 12 hours. I am to take him to his regular vet in two weeks, and the cardiologist in three months. I am absolutely devastated beyond words to hear this prognosis. I love Brady so much and have only had him a year and a half. I was just wondering if you might have any suggestions or ideas how to prolong Brady’s life, comfortably of course.
I am sorry to hear that he is having so much trouble at such a young age. What you are describing sounds like a genetic disease where the muscle of the heart gets progressively thicker with age called hypertrophic cardiomyopathy. Unfortunately, as the muscle gets thicker it interferes with the normal function of the heart, resulting in the symptoms he developed triggering the trip to the ER.
Lasix is a diuretic that lessens the workload for his heart and the aspirin is to prevent blood clot formation. Atenolol is a beta-blocker to lower his blood pressure and avoid abnormal heart rhythms. The combination of medications can do a good job of managing the symptoms but do not reverse the thickening of the muscle.
This condition most commonly affects young to middle-aged male cats and some breeds like Maine Coons. His symptoms develop as the lower chamber of the heart, called the ventricle, can’t fill properly and high blood pressure coupled with poor flow causes fluid to accumulate in his lungs.
X-rays can sometimes diagnose the enlarged heart, but occasionally a cardiac ultrasound is needed to evaluate and measure the thickness of the heart. Other diseases like an overactive thyroid or primary hypertension can lead to hypertrophic cardiomyopathy, but to be afflicted at such a young age it is most likely congenital.
This terrible disease is progressive and it sounds like you are doing everything you can to help him and are in capable hands. The dosage of his medications may be able to be adjusted to control his symptoms, but do not make any changes without consulting your primary veterinarian or the veterinary cardiologist.
Questions for Dr. Gary Thompson can be emailed to firstname.lastname@example.org or mailed to The Blade, Attn. Ask the Vet, 541 N. Superior St., Toledo, OH 43660. Dr. Thompson regrets that he cannot answer individual letters.