How to Recognize Feline Heart Disease
Take note if your cat seems lethargic., Feel for an abnormally high respiratory rate., Look for panting., Watch out for the air hunger position., Know that a poor appetite is a cause for concern., Take note of any fainting., Look or feel for fluid...
Step-by-Step Guide
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Step 1: Take note if your cat seems lethargic.
When a heart is balanced between coping and not coping, it tends to make the cat lethargic.
This is because even a slight increase in activity, such as walking or going up stairs, places increased demands on the circulatory system.
If the circulation is inadequate then the cat feels light-headed, dizzy, and weak.
Thus the cat learns it's best not to move around much and tends to rest instead. -
Step 2: Feel for an abnormally high respiratory rate.
Another early warning sign of heart disease is if the cat breathes more quickly, even at rest.
This is known as an increased respiratory rate.
If you are suspicious about your cat breathing quickly, watch him and count the number of breaths taken in one minute.
Repeat this several times to be certain that you are getting a true figure.
This information is valuable to your vet, because many cats hyperventilate at the clinic which makes it difficult to get an accurate reading.
The normal respiratory rate in the cat is between 20-30 breaths a minute.
More than 35-40 breaths a minute at rest is considered high, and over 40 is definitely abnormal.
The cat breathes more quickly because of fluid accumulation in the lungs which makes oxygen exchange across the lung tissue inefficient.
In order to get enough oxygen the cat has to take more breaths, to make up for the poor oxygen transfer. , Another sign of trouble is mouth breathing or panting.
It is unusual for a cat to breathe through her mouth (unless she is very stressed, or she has been playing vigorously).
Mouth-breathing is an attempt to pull more oxygen down into the lungs and a sign that oxygen exchange is impaired. , If the cat is short of air she may adopt the "air hunger" position.
The cat crouches on her belly with her head and neck extended in a straight line.
Her elbows are held away from her chest, in order to let her chest expand as much as possible with each breath. , Many cats with heart disease have poor appetites.
When the cat swallows she has to stop breathing.
When her heart is struggling and she is finding it hard to breath, the cat won't take the time out from breathing to swallow. , Sadly, as feline heart disease progresses the signs and symptoms become more severe.
One late-stage symptom of heart disease is fainting.
The cat may be prone to fainting episodes when the circulation cannot maintain blood supply to the brain. , Another sign of advanced heart failure is fluid building up in the belly as a result of fluid changes within blood vessels that allow fluid to leak out into the body cavities. , Another very serious sign of heart failure is hind limb paralysis.
In the advanced stages of heart failure blood clots develop which commonly lodge at a point where the main artery to the back legs divides in two.
The clot blocks the circulation to the back legs, leaving them paralyzed. , If you notice any of the above-mentioned symptoms then get your cat checked out by a veterinarian.
As part of the examination the vet will listen to the cat's heart with a stethoscope, and based on what she finds, suggest the most appropriate tests. , To get an overview of how sick the cat is, the veterinarian may ask to watch the cat as she rests in the basket or box.
This is to gauge her breathing whilst she is as relaxed as possible, before the stress of an exam.
The vet counts the respiratory rate, and also assesses how the cat is breathing. , With a healthy cat it is sometimes difficult to see the chest moving in and out.
If the cat is having difficulty breathing (either because of heart or lung issues) the chest moves in an exaggerated in-out movement which is clear to see.
Another hint that points toward abnormal breathing is if the cat's tummy is going in and out with each breath.
This is known as "abdominal breathing" and is a sign that the cat is struggling to draw air into the lungs.
It's important to note that cats rarely cough as a result of heart disease.
This is in contrast to dogs where coughing is a common indication of a cardiac problem.
Cats seem to lack airways receptors that trigger a cough as a result fluid in the lungs. , Your vet will want to know if the cat has previously been diagnosed with a heart murmur.
The presence of a heart murmur in younger life indicates pre-existing cardiac pathology, which has the potential to deteriorate.
However, the absence of a heart murmur in younger life does not mean the pet cannot develop one at a later stage.
If a cat with no history of a murmur suddenly develops one and is in respiratory distress, then finding a new murmur could be significant. , The veterinarian will listen to the cat's heart in order to assess whether a murmur is present or not, how loud the murmur is, and to check the heart rhythm and rate.
Most cats with heart disease will have a heart murmur.
The murmur is caused by turbulent blood flow within the chambers of the heart.
Pathology within the heart such as thickened valve leaflets or thickened walls causes the turbulence that is heard as a murmur.
While it is true that heart disease in cats is often associated with a murmur, the opposite is not true.
For instance, a cat with a murmur does not necessarily have heart failure.
Many murmurs are "innocent" which means they cause no significant circulatory problems. , The heart rate is an important guide as to whether the heart is struggling or not.
The normal heart rate for the cat is approximately 120-140 beats per minute.
However, there is a certain amount of leeway in this because a stressed cat will have a faster heart rate.
In the clinic environment most vets consider up to around 180 beats per minute to be normal.
Above 180 is definitely too fast.
This is significant because a diseased heart has a reduced stroke volume (the volume of blood it pushes out with each beat is lower than normal).
To compensate and maintain blood pressure the heart beats more quickly, (a higher number of beats multiplied by a lower stroke volume, maintains the circulation). , An abnormal heart rhythm is a warning signal that the heart is struggling.
A healthy heart rhythm falls into one of two patterns.
Firstly, the beat is regular with exactly the same time interval between beats.
Secondly, the cat has a "sinus arrhythmia".
This refers to a normal acceleration and deceleration of the heart beat which is synchronized to the cat's respiratory and expiratory breaths.
An abnormal heart rhythm is erratic.
It might consist of a string of normal heart beats followed by erratic pattering.
This happens if the heart muscle is damaged and scar tissue interferes with the electrical signals in the heart wall that give instructions about when to contract and relax. , A cat's gums should be a healthy pink color, just like our own.
The veterinarian checks the gum color for indications of circulatory problems.
If the heart is failing and the circulation poor, the gums tend to be pale or even white.
However, this sign is not exclusive to heart disease and gums can be pale because of anemia or pain. , The vet may do something that looks pretty odd, which is to wet the fur on the cat's neck with surgical spirit.
She does this in order to see the outline of the jugular veins which contain blood returning to the heart.
These veins run up the neck and if the heart is struggling, blood tends to accumulate downstream of the heart and cause the jugular veins to distend. , It is likely that additional tests will be needed to confirm a strong suspicion of heart disease, to work out the cause, and gauge the severity of the illness.
The tools most commonly used in the diagnosis of feline heart murmur are a specialized blood test (proBNP), chest radiographs, and cardiac ultrasound. , This blood test measures the levels of "cardiac bio markers" in the blood.
Cardiac biomarkers are proteins that are released from distressed heart muscle cells.
The results are allocated to one of three groups:
Low indicates heart disease is not causing the cat's clinical signs, normal range means heart disease is less likely at that time, and high which means the cat has significant heart muscle damage.
ProBNP has a place in eliminating the heart as a source of problems (low readings) and also to help monitor treatment in cats with heart disease (high levels should decrease once successful treatment is started). , The veterinarian takes two views of the cat's chest: one from above and one from the side.
This gives a cross reference as to the size and shape of the heart.
Radiographs can be of limited value because one of the common feline heart conditions, hypertrophic cardiomyopathy (HCM), involves the heart muscle thickening inwardly.
Because x-rays only show the heart silhouette, rather than what's going on inside, HCM can be missed with radiography alone.
However, radiographs are useful to look for fluid patterns within the lungs, such as pulmonary edema, which can indicate a failing heart, and also to rule out other conditions such as feline asthma or lung tumors. , This is the gold standard for identifying and diagnosing heart disease in the cat.
A cardiac scan allows the operator to visualize the chamber of the heart, to watch the heart contract, to follow blood flow through the heart, and check the health of the heart valves.
Ultrasound also detects problem such as fluid in the sac around the heart, which can go undetected on x-ray.
Ultrasound also allows the clinician to measure the dimensions of the different heart chambers.
In turn this allows her to make calculations which predict if the heart is pumping effectively or struggling. , These include the following:
Ventricular Wall Thickness:
One of the parameters the veterinarian measures is the thickness of the wall of the ventricles.
The condition HCM is associated with severe thickening, which fills the space that should fill with blood.
Left Ventricular:
Aortic Ratio:
Using the ultrasound picture the clinician measures the width of the left ventricle, the main chamber from which blood is pushed round the body.
The width of the aorta is also measured and a ratio between the two measurements calculated.
The result of this calculation gives a reliable indication of whether the left ventricle is dilated or not.
This is significant because in some forms of heart failure the heart muscles become exhausted and baggy, which leads to the pressure of blood within it rising, causing the ventricle to stretch excessively and dilate.
Fractional Shortening:
Another useful calculation made during the scan is fractional shortening.
Measurements are taken of the width of the ventricle when it is fully relaxed and then fully contracted.
This gives a percentage figure which is compared against a table of normal values.
Fractional shortening values above or below the normal range indicate a failing heart. -
Step 3: Look for panting.
-
Step 4: Watch out for the air hunger position.
-
Step 5: Know that a poor appetite is a cause for concern.
-
Step 6: Take note of any fainting.
-
Step 7: Look or feel for fluid in the belly.
-
Step 8: Know that hind-leg paralysis is a possibility.
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Step 9: Bring your cat to the vet for a physical exam.
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Step 10: Watch the cat to assess her breathing.
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Step 11: Check for abnormal breathing.
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Step 12: Inform the vet about any history of heart murmur.
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Step 13: Allow the vet to listen for heart murmurs.
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Step 14: Ask the vet about the cat's heart rate.
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Step 15: Ask the vet about the cat's heart rhythm.
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Step 16: Make sure the vet checks the cat's mucous membrane color.
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Step 17: Observe as the vet checks the cat's jugular vein distension.
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Step 18: Know that additional tests will usually be required to make a diagnosis.
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Step 19: Allow the vet to perform a Pro BNP blood test.
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Step 20: Let the vet take radiographs of the cat's chest.
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Step 21: Give the vet permission to do heart ultrasound scans.
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Step 22: Understand that the vet will use the ultrasound to check for a number of important factors.
Detailed Guide
When a heart is balanced between coping and not coping, it tends to make the cat lethargic.
This is because even a slight increase in activity, such as walking or going up stairs, places increased demands on the circulatory system.
If the circulation is inadequate then the cat feels light-headed, dizzy, and weak.
Thus the cat learns it's best not to move around much and tends to rest instead.
Another early warning sign of heart disease is if the cat breathes more quickly, even at rest.
This is known as an increased respiratory rate.
If you are suspicious about your cat breathing quickly, watch him and count the number of breaths taken in one minute.
Repeat this several times to be certain that you are getting a true figure.
This information is valuable to your vet, because many cats hyperventilate at the clinic which makes it difficult to get an accurate reading.
The normal respiratory rate in the cat is between 20-30 breaths a minute.
More than 35-40 breaths a minute at rest is considered high, and over 40 is definitely abnormal.
The cat breathes more quickly because of fluid accumulation in the lungs which makes oxygen exchange across the lung tissue inefficient.
In order to get enough oxygen the cat has to take more breaths, to make up for the poor oxygen transfer. , Another sign of trouble is mouth breathing or panting.
It is unusual for a cat to breathe through her mouth (unless she is very stressed, or she has been playing vigorously).
Mouth-breathing is an attempt to pull more oxygen down into the lungs and a sign that oxygen exchange is impaired. , If the cat is short of air she may adopt the "air hunger" position.
The cat crouches on her belly with her head and neck extended in a straight line.
Her elbows are held away from her chest, in order to let her chest expand as much as possible with each breath. , Many cats with heart disease have poor appetites.
When the cat swallows she has to stop breathing.
When her heart is struggling and she is finding it hard to breath, the cat won't take the time out from breathing to swallow. , Sadly, as feline heart disease progresses the signs and symptoms become more severe.
One late-stage symptom of heart disease is fainting.
The cat may be prone to fainting episodes when the circulation cannot maintain blood supply to the brain. , Another sign of advanced heart failure is fluid building up in the belly as a result of fluid changes within blood vessels that allow fluid to leak out into the body cavities. , Another very serious sign of heart failure is hind limb paralysis.
In the advanced stages of heart failure blood clots develop which commonly lodge at a point where the main artery to the back legs divides in two.
The clot blocks the circulation to the back legs, leaving them paralyzed. , If you notice any of the above-mentioned symptoms then get your cat checked out by a veterinarian.
As part of the examination the vet will listen to the cat's heart with a stethoscope, and based on what she finds, suggest the most appropriate tests. , To get an overview of how sick the cat is, the veterinarian may ask to watch the cat as she rests in the basket or box.
This is to gauge her breathing whilst she is as relaxed as possible, before the stress of an exam.
The vet counts the respiratory rate, and also assesses how the cat is breathing. , With a healthy cat it is sometimes difficult to see the chest moving in and out.
If the cat is having difficulty breathing (either because of heart or lung issues) the chest moves in an exaggerated in-out movement which is clear to see.
Another hint that points toward abnormal breathing is if the cat's tummy is going in and out with each breath.
This is known as "abdominal breathing" and is a sign that the cat is struggling to draw air into the lungs.
It's important to note that cats rarely cough as a result of heart disease.
This is in contrast to dogs where coughing is a common indication of a cardiac problem.
Cats seem to lack airways receptors that trigger a cough as a result fluid in the lungs. , Your vet will want to know if the cat has previously been diagnosed with a heart murmur.
The presence of a heart murmur in younger life indicates pre-existing cardiac pathology, which has the potential to deteriorate.
However, the absence of a heart murmur in younger life does not mean the pet cannot develop one at a later stage.
If a cat with no history of a murmur suddenly develops one and is in respiratory distress, then finding a new murmur could be significant. , The veterinarian will listen to the cat's heart in order to assess whether a murmur is present or not, how loud the murmur is, and to check the heart rhythm and rate.
Most cats with heart disease will have a heart murmur.
The murmur is caused by turbulent blood flow within the chambers of the heart.
Pathology within the heart such as thickened valve leaflets or thickened walls causes the turbulence that is heard as a murmur.
While it is true that heart disease in cats is often associated with a murmur, the opposite is not true.
For instance, a cat with a murmur does not necessarily have heart failure.
Many murmurs are "innocent" which means they cause no significant circulatory problems. , The heart rate is an important guide as to whether the heart is struggling or not.
The normal heart rate for the cat is approximately 120-140 beats per minute.
However, there is a certain amount of leeway in this because a stressed cat will have a faster heart rate.
In the clinic environment most vets consider up to around 180 beats per minute to be normal.
Above 180 is definitely too fast.
This is significant because a diseased heart has a reduced stroke volume (the volume of blood it pushes out with each beat is lower than normal).
To compensate and maintain blood pressure the heart beats more quickly, (a higher number of beats multiplied by a lower stroke volume, maintains the circulation). , An abnormal heart rhythm is a warning signal that the heart is struggling.
A healthy heart rhythm falls into one of two patterns.
Firstly, the beat is regular with exactly the same time interval between beats.
Secondly, the cat has a "sinus arrhythmia".
This refers to a normal acceleration and deceleration of the heart beat which is synchronized to the cat's respiratory and expiratory breaths.
An abnormal heart rhythm is erratic.
It might consist of a string of normal heart beats followed by erratic pattering.
This happens if the heart muscle is damaged and scar tissue interferes with the electrical signals in the heart wall that give instructions about when to contract and relax. , A cat's gums should be a healthy pink color, just like our own.
The veterinarian checks the gum color for indications of circulatory problems.
If the heart is failing and the circulation poor, the gums tend to be pale or even white.
However, this sign is not exclusive to heart disease and gums can be pale because of anemia or pain. , The vet may do something that looks pretty odd, which is to wet the fur on the cat's neck with surgical spirit.
She does this in order to see the outline of the jugular veins which contain blood returning to the heart.
These veins run up the neck and if the heart is struggling, blood tends to accumulate downstream of the heart and cause the jugular veins to distend. , It is likely that additional tests will be needed to confirm a strong suspicion of heart disease, to work out the cause, and gauge the severity of the illness.
The tools most commonly used in the diagnosis of feline heart murmur are a specialized blood test (proBNP), chest radiographs, and cardiac ultrasound. , This blood test measures the levels of "cardiac bio markers" in the blood.
Cardiac biomarkers are proteins that are released from distressed heart muscle cells.
The results are allocated to one of three groups:
Low indicates heart disease is not causing the cat's clinical signs, normal range means heart disease is less likely at that time, and high which means the cat has significant heart muscle damage.
ProBNP has a place in eliminating the heart as a source of problems (low readings) and also to help monitor treatment in cats with heart disease (high levels should decrease once successful treatment is started). , The veterinarian takes two views of the cat's chest: one from above and one from the side.
This gives a cross reference as to the size and shape of the heart.
Radiographs can be of limited value because one of the common feline heart conditions, hypertrophic cardiomyopathy (HCM), involves the heart muscle thickening inwardly.
Because x-rays only show the heart silhouette, rather than what's going on inside, HCM can be missed with radiography alone.
However, radiographs are useful to look for fluid patterns within the lungs, such as pulmonary edema, which can indicate a failing heart, and also to rule out other conditions such as feline asthma or lung tumors. , This is the gold standard for identifying and diagnosing heart disease in the cat.
A cardiac scan allows the operator to visualize the chamber of the heart, to watch the heart contract, to follow blood flow through the heart, and check the health of the heart valves.
Ultrasound also detects problem such as fluid in the sac around the heart, which can go undetected on x-ray.
Ultrasound also allows the clinician to measure the dimensions of the different heart chambers.
In turn this allows her to make calculations which predict if the heart is pumping effectively or struggling. , These include the following:
Ventricular Wall Thickness:
One of the parameters the veterinarian measures is the thickness of the wall of the ventricles.
The condition HCM is associated with severe thickening, which fills the space that should fill with blood.
Left Ventricular:
Aortic Ratio:
Using the ultrasound picture the clinician measures the width of the left ventricle, the main chamber from which blood is pushed round the body.
The width of the aorta is also measured and a ratio between the two measurements calculated.
The result of this calculation gives a reliable indication of whether the left ventricle is dilated or not.
This is significant because in some forms of heart failure the heart muscles become exhausted and baggy, which leads to the pressure of blood within it rising, causing the ventricle to stretch excessively and dilate.
Fractional Shortening:
Another useful calculation made during the scan is fractional shortening.
Measurements are taken of the width of the ventricle when it is fully relaxed and then fully contracted.
This gives a percentage figure which is compared against a table of normal values.
Fractional shortening values above or below the normal range indicate a failing heart.
About the Author
Daniel Hayes
Brings years of experience writing about home improvement and related subjects.
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