The Heart Of The Matter

Jul 11, 2012 by     No Comments    Posted under: Tips & Advice

examining a cat

Probably one of the most frustrating things to come out of my mouth are the words “ I hear a heart murmur and it may or may not be a problem. “  So why can’t I just tell you straight up if there’s trouble or not? Well, just like that recent movie title, it’s complicated.  Why is it so frustrating?  Because it’s really important to know if the cat in front of you has a problem and you can’t tell that without doing more stuff.  About 40% of the cats with murmurs or gallops have significant disease. That may mean that you need to treat, manage other disease and anesthesia differently, or avoid anesthesia all together.  The other 60% have murmurs for other reasons and those cats may be just fine. You may even know people who are walking around with murmurs that don’t have a sick heart. But the thing is, you don’t know which cats are which on the exam table.  Cats are very different than other creatures in how they show you that they’re in trouble. While a dog or person might have a gradual onset of signs like cough, exercise intolerance or swollen legs, cats are fine one minute and in a crisis the next.  It is the primary reason to find a cat dead with no warning. It’s pretty easy to push a cat into heart failure if there’s significant disease with too much fluid, certain medicines and stress, so if your cat has a murmur,  your vet will  want to know what’s going on before doing certain treatment plans or surgery. And they look just fine before there’s trouble. There are a lot of cats out there with significant heart disease that don’t even have murmurs or gallops. Just like a cat, to hide every sign of illness it can.

On top of everything else, getting an accurate diagnosis of just what’s going on in your cat’s heart isn’t easy. The only definitive test is a cardiac ultrasound performed by someone who is thoroughly familiar with cat hearts. X rays, ECGs and some newer blood tests can pick up sick hearts if they’ve progressed far enough into the disease, but those tests can be normal even when there’s a problem. So for my money, if I really need to know the status of my patient’s heart, I’m going to tell you to get a heart ultrasound so that you know for sure. Then we can develop a treatment plan that best manages the situation. Or.. go celebrate because everything looks great.

You can stop reading now if you want. But if you are a detail person and need a little more explanation about what’s going on, keep going.

Vets get that worried look on their brow if they hear any kind of abnormality when they are listening to your cat’s heart. Most of the time, that abnormality is in the form of a heart murmur or a three beat rhythm called a gallop. A murmur just means that you can hear the turbulence of blood as it courses through the heart.  You get it any time a flowing liquid meets up with an obstacle.  I kind of like the babbling brook analogy.  Water running through a nice clear PVC pipe doesn’t make much noise, but water running in a stream bed full of pretty rocks and boulders makes a pleasant, relaxing babbling sound. That stream has a murmur. How does that happen in a heart? In cats, the usual culprit is blood slapping up against a bulge of muscle that occurs when the heart contracts. Other things can happen too and the type of problem that causes it can be very different from animal to animal. When the heart muscle gets big, it’s called hypertrophy.  Parts of the heart can get so big that it actually impedes the out flow of blood and that’s when your cat gets in trouble.  Now sometimes, the electrical current that runs through the heart that coordinates all the opening and shutting of the valves, gets all messed up because of the muscle hypertrophy. That’s when you can hear the funny 3 beat rate called a gallop. That probably happens because the big heart muscle doesn’t let the electrical current pass through it evenly. So the valves may not close in tandem, and voila, you get 3 clear heart sounds.  Most of the time the pump (the heart), is doing its job trying to keep pushing blood through. But with hypertrophic cardiomyopathy, one of the most common heart diseases,  the problem really is that the amount of blood that can be pumped out is so low because the big, stiff heart muscle getting in the way. It may be fine when a cat is resting, but when that heart rate increases, the muscle scrunches up and doesn’t let any blood get through.

So there you have it. That’s why I’m going to tell you that your cat may or may not have significant heart disease. But I’m always going to recommend that you get it checked out because I don’t want your cat to be in that 40% that needs special attention.  I’m a happy vet when the ultrasound report says no problem.

Dr Eliza Sundahl

Dr. Eliza Sundahl completed her veterinary studies at Kansas State University in 1978 after graduating from Boston University. She has spent a great deal of her professional life promoting feline medicine and continues to do so. She has held many positions in The American Association of Feline Practitioners, including 2 years as president. She was involved in establishing board certification in feline medicine through the American Board of Veterinary Practitioners and worked with that organization for many years to help veterinarians through the certification process.

Dr. Sundahl started at the KC Cat Clinic in 1978 and became owner in 1979. She has been happily working with the wonderful clients and patients at the clinic ever since. She feels like she has the best job in the world. She shares the clinic with Boo and Simon and her home with Babycat, Ferrous, Boo (another one), and Angelo.

Kansas City Cat Clinic
7107 Main St.
Kansas City, MO 64114

Phone: 816-361-4888

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