The title may be a stretch but I have to draw you in somehow! This post will mainly focus on what congestive heart failure means for our feline friends. Heart disease is a relatively common and (often) silent but deadly disease in cats.

Heart disease in cats can be broken down into two main forms, hypertrophic (think a bigger more muscle-ly heart) and dilated (thinner walled, balloon type heart). Neither of which we want, thicker walls take up room for proper blood pumping while thinner, weaker walls also pump blood inefficiently. We want, like Goldilocks, a heart that’s just right. We need our blood, and theirs to flow.

The dilated form of heart disease in cats, is pretty uncommon these days. It is caused by a deficiency in taurine (an essential amino acid). So cats being fed unbalanced commercial or homemade diets, that are deficient in this nutrient are at risk (but typically most responsibly made diets don’t have this issue).

Primary hypertrophic cardiomyopathies (disease of heart muscle) are understood to arise two ways. One is genetics, with certain breeds (Maine Coon, Ragdoll, Rexes, and Sphynx) being at a higher risk. The other is sporadic, happening at really any age (not that comforting, sorry) with no known specific cause. There are of course other ways that a hypertrophic heart may develop, such as hypertension (the body trying to deal with increased blood pressure), hyperthyroidism, and infiltrative diseases such as lymphoma. When the heart disease arises because of other causes we classify them as a secondary disease.

Regardless of whether it is primary or secondary, as the heart muscle starts to get bigger it becomes inefficient in moving blood (heart failure). In the case of left sided heart failure it is unable to move the blood from the lungs into the heart, as the back up builds, fluid pressures within the veins causes accumulation of fluid either in the lung (pulmonary edema) or around the lungs (pleural effusion) resulting in congestive heart failure. I mean, either way sucks and decreases the pets ability for adequate oxygen/carbon dioxide exchange. In dogs we often can see signs such as exercise intolerance but cats, as Garfield demonstrates, go at their own pace (they will possibly just lay around or sleep more, which may not seem out of the realm of a cats normal MO). Signs of heart failure are often silent or non existent in our feline patients.

With physical exams, veterinarians can pick up some cues such as heart murmurs (extra sounds between heart beats) or arrhythmias (abnormal rhythm). However murmurs aren’t always a sign, with only about 50% of pets with murmurs developing disease (and only about 50% of those with heart disease having a murmur). Increased respiratory rates can also be used as a marker. Some veterinarians will have clients monitor their cats respiratory rate at home to track the progression of disease and to determine the need for intervention. Veterinarians will also use blood tests to rule out other diseases that may have caused heart disease. X-rays and ECG are other tools that may be used to help diagnose abnormalities of the heart. The real gold standard (the best test) is echocardiography, using ultrasound to assess the shape and functioning of the heart.

Congestive heart failure, with its impaired gas exchange is often seen as open mouth breathing and sometimes gums and other mucus membranes that turn blue. Emergency treatment of this condition often consists of using oxygen therapy alongside diuretics (to try and eliminate extra fluid from the lungs) and sometimes chest taps to drain the fluid quickly. Often prognosis for these patients is guarded, with an average survival time of 6 – 12 months. With early diagnosis and appropriate therapy it is possible to help prolong these pets lives. Pets that are stable and have been diagnosed with heart disease/ congestive heart failure are often maintained on lifelong treatment with multiple medications. These include diuretics (to drive away excess fluid), ace inhibitors (to widen vessels and lower blood pressure), beta blockers (to slow heart rate), and positive ionotropes (to help strengthen heart contraction). Although this disease is prevalent and challenging (there isn’t a cure), there are options. We have ways of diagnosing and treating pets that help to improve longevity AND quality of life. If you think your cat has issues have a discussion with your veterinarian and have your cat examined (that is what they are there for!).

Moral of the story:

• cats, in general are great at hiding signs when they aren’t well (heart disease is no different)
• regular trips to the vet help us detect changes in these patients early*
• early intervention and diagnosis is ALWAYS better

*regular means regular, we’re talking at least annually! More frequent assessments are recommended in older geriatric patients.

For other posts on cats check out this why keeping cats indoors is great or this on how to feed cats in a new way, or if we want to learn about tests and why early tests are important click here.