Tagged with " heart disease"

My Cat Has a Murmur?

Jul 3, 2013 by     No Comments    Posted under: Tips & Advice

What this abnormal cardiac sound means for your cat

Your kitty appears perfectly healthy. You take it in for a routine physical exam and the veterinarian informs you that your precious family member has a murmur.  How can this be?  What does this mean?  He runs around the house, eats like a horse and is borderline heavy on his weight.  This is a perfectly healthy cat!

A heart murmur is an abnormal sound that occurs as blood moves through the heart and the valves.  Your veterinarian detects it with a stethoscope during examination. Murmurs can be caused by congenital defects, acquired diseases such as hyperthyroidism, high blood pressure, anemia or primary heart muscle or valvular diseases.

Some murmurs occur due to stress or excitement and elevated heart rate.  These murmurs are considered benign or innocent and do not cause problems with your kitty’s health.

Studies have shown that as many as 22% of “healthy” cats can have murmurs, unfortunately, the innocent murmurs cannot be differentiated from cats with actual heart disease. In addition, as many as 50% of cats with primary heart muscle disease (cardiomyopathy) that present to the veterinarian in heart failure will not have a murmur prior to presentation.

So, what should you do? Follow your veterinarian’s advice.  If your kitty seems anxious at the clinic and the heart rate is elevated, your veterinarian may ask to just recheck your kitty on a different day or ask you to leave your kitty for the day so he/she can become acclimated to the hospital.

Your veterinarian may ask to run tests to rule out diseases outside the heart that can cause murmurs, such as checking blood pressure, a thyroid test or a CBC to screen for anemia.  In some cases, a blood test called an NT-pro-BNP may be performed as well.  This test looks for stretching or damage to the heart muscle.

If your cat has evidence of elevated or abnormal respiratory sounds, or if the NT-pro-BNP test is abnormal, your veterinarian may request to check thoracic (chest) x-rays or perform a cardiac ultrasound.

If blood testing is abnormal, treatment of the underlying disease can often times eliminate the murmur. If your cat is diagnosed with cardiomyopathy it may be mild and just require monitoring. If disease is more severe medication may be prescribed.

In some cases, no disease will be identified, but most importantly, by following your veterinarian’s advice, you will be armed with information regarding your kitty’s health that allows you to have peace of mind and be pro-active in his/her care for life.

Dr Cindy McManis

Dr. Cynthia McManis received her Doctorate of Veterinary Medicine from Texas A&M University in 1985. She developed her interest in cats during her first year post-graduation. She began to actively pursue more education and information regarding feline health care and joined the Academy of Feline Medicine in 1989. When the American Board of Veterinary Practitioners approved feline practice as a specialty board in 1995, she was in the first class to sit for the exam. She is 1 of 90 board certified feline practitioners in the country at this time. Dr. McManis founded Just Cats Veterinary Services in 1994.

Outside of her clinic cases, she is a feline internal medicine consultant for Veterinary Information Network, a web based resource for veterinarians all over the world. She has also served on several committees within the American Association of Feline Practitioners and the American Board of Veterinary Practitioners (ABVP). She established an ABVP residency site at Just Cats in 2008 and mentors new graduates as well as seasoned practitioners who are interested in achieving ABVP certification.

Dr. McManis is an avid triathlete and is constantly training for races. She completed her first Iron Man in May of 2012. She is owned by 2 home kitties- Amante (“Monty”) and La Mariquita (“Mari”), and 2 hospital kitties- Momma Kitty and O’Malley.

Just Cats Veterinary Services
1015 Evergreen Circle
The Woodlands, TX 77380

Phone: (281) 367-2287
Email: vets@justcatsvets.com

Website: http://www.justcatsvets.com/
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Ultrasound or Radiographs (x-rays) – What’s The Difference?

Feb 21, 2013 by     No Comments    Posted under: Personal Opinion, Tips & Advice

Unlike radiographs, ultrasound uses sound waves to generate a picture of the internal organs. Ultrasound is completely safe and painless and does not require anesthesia or sedation in most cases.

Ultrasound may be recommended after a physical examination, blood test or x-ray indicates an underlying problem. Ultrasound is commonly used in both veterinary and human medicine for a wide variety of problems, including diseases of the liver, kidneys, bladder, stomach, intestines, pancreas, heart, and other organs. As with people, it can be used safely during pregnancy.

Ultrasound can “see” many things that can’t be seen on x-rays. For example, if there is fluid build-up in the chest or abdomen, the organs can’t be seen clearly on x-ray because fluid and tissue have the same density. However, they appear quite clearly on ultrasound, because we can see through the fluid. In addition, while x-rays are helpful to see the shapes and sizes of the internal organs, ultrasound can get a picture of the internal structure.

If an x-ray shows an enlarged heart, we can’t tell from the x-ray if the walls of the heart are thick with narrowed heart chambers (where the blood flows) or if the walls are thin and weak with big chambers or if there is fluid build-up between the heart and the sac that surrounds it. Ultrasound can readily give us this information, which is critical, as these scenarios represent different types of heart disease, with different prognoses and treatments.

Ultrasound is not effective at seeing through air or bone, so it does not replace x-rays but rather is complementary. In some cases both x-rays and ultrasound are needed in order to get a complete picture of what is going on with a patient.

Ultrasound equipment is specialized and quite expensive, so not all veterinary hospitals have an ultrasound machine. Many hospitals have specialists that come to perform the examinations. Other hospitals refer their patients to a hospital that can provide this level of care. In some cases of complex heart disease, evaluation by a veterinary cardiologist may be needed.

Due to the specialized nature of ultrasonic exam and evaluation, it is critical to have a veterinarian who is experienced in obtaining and reading ultrasound images to perform the examination, and make this information apply to each patient in a meaningful way in terms of prognosis and treatment recommendations.

What happens during an ultrasound?

The hair over the area to be evaluated will be shaved, as hair will interfere with the images. A gel (water soluble and safe) will be applied to the skin to help the sound waves generate a good picture. A transducer (similar in size and shape to a TV remote control) is placed on the patient’s skin and slowly moved around over the area to be examined. The ultrasound is computerized, so it can be used to accurately measure the tissues as needed. In addition, images can be stored electronically.

In order to perform a thorough exam, the patient needs to stay relatively still, though some wiggling is fine. Although some cats may be slightly anxious initially, most relax and remain calm once they realize that nothing painful is happening. For cats that are very anxious, your veterinarian may recommend a sedative.

What should I do to prepare for the ultrasound procedure?

Please do not feed your cat for 8-12 hours prior to the examination. Water is permitted. In the case of an abdominal ultrasound, an empty stomach allows for proper imaging of the area near the stomach. There are some diseases/situations where food should NOT be withheld; contact your veterinarian for specific instructions. If your cat is having an abdominal ultrasound, please try not to let your pet urinate for the 3 hours prior to your appointment. This will help get a better picture of the bladder.

What will the ultrasound tell us?

An ultrasound examination will provide a lot of information about your cat’s health. Together with the internist, we look at information from lab tests, x-rays, examinations and medical history to make medical recommendations.

  • A specific diagnosis: often ultrasound can provide us with a diagnosis (or a reason for your cat’s illness).
  • A Partial diagnosis: While ultrasound shows us the shapes and consistencies of the internal organs, it cannot see microscopic changes. This means that while an ultrasound examination can identify abnormal tissue, including growths, it cannot always determine if the tissue is cancerous or what type of cancer it is. For some patients, this information will affect how they are treated and a biopsy may be recommended. In some cases, this biopsy may be performed as an ultrasound guided needle sample under light anesthesia. In other cases, a surgical biopsy is needed.
  • No Diagnosis/ Disease Exclusion: For some patients, the organ changes are not visible enough to pinpoint the problem. We are able to exclude (or rule out) certain diseases, but are left with a list of possible diseases that are causing your cat’s illness. This can be both relieving and frustrating. We will discuss options for therapies based on the available information and will recommend the best path for additional testing to obtain a diagnosis if indicated and desired.

If you have additional questions about whether ultrasound or x-rays are appropriate for your cat, please contact your veterinarian.

Dr Diana Lafer

Dr. Diana Lafer founded Cats Limited in 1995. She earned her bachelor’s degree in biology from Wesleyan University and her veterinary degree from Cornell University. Dr. Lafer has a cat (Sparky), and a dog (Lucy). She enjoys spending time with her daughters, horseback riding, skiing, hiking, participating in triathlons, and volunteering for the Lakeville Pony Club.

Cats Limited Hospital
1260 New Britain Avenue
West Hartford, CT 06110

Phone: (860) 561-9885
Email: cats@catslimited.com

Website: http://www.catslimited.com/
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Tough Talk About Teeth – Part 2

Feb 10, 2013 by     No Comments    Posted under: Tips & Advice

If you missed it: Tough Talk About Teeth – Part 1

Remember Rufus?  He’s the young cat who needed radical dental surgery to correct very diseased teeth and gums.  When he came into my practice, he had the 30 teeth most cats have, but when he left later that evening, not a single one remained.

I was confident he’d do very well, but no one likes to see their cat lose so many teeth.  Even though our typical pampered house pets don’t need to hunt for their meals, teeth still serve a function and this guy’s days of chewing on hard treats or crunchies were going to be a thing of the past.

Does anyone remember getting your wisdom teeth out?  If you had to get them removed by your dentist, you probably don’t have happy memories of the aftercare.  Extractions hurt!  So one of the prime considerations with Rufus was how were we going to control any pain or discomfort during the healing process?  Would he want to eat?  We certainly didn’t want his gums to be so sensitive that even watered down canned food would be too uncomfortable to lap up.

I think most of us tend to put ourselves in our cat’s shoes and imagine how we would feel if we’d had something similar done to us, but that’s not necessarily the best way to approach a problem.  Rufus had no idea that he was supposed to have teeth.  Before his surgery, he was a cat with a serious mouth problem and it affected his life.  What he knew is his mouth really hurt, and eating and grooming wasn’t a pleasure and he could only manage to chew just the minimum amount of food he needed to survive.  Licking his fur meant his tongue was going to move against those inflamed gums, and he knew that the pain and discomfort stopped if he stopped licking.  So that plush and wonderful coat grew matted and dull.  This was his reality.  Bad teeth hurt!

What else happens with bad teeth and infected mouths?  We know in people that mouth inflammation can actually ratchet up the body’s overall level of inflammation, which can result in systemic disturbances, including an increased risk of coronary artery disease.  Could something similar happen in cats?  Perhaps changes might happen in other organs like the sensitive kidneys?  It certainly makes sense.  Could vigilant dental care help protect our cats against other inflammatory diseases?

When we extracted all those diseased teeth and turned off the source of inflammation for those hot and angry gums, we stopped his mouth pain and took away his never-ending discomfort.  It completely eliminated that awful situation.  Unfortunately, though, surgery always creates another source of pain that occurs when any place on the body is cut or injured.  The nice thing is we now have healthy tissue and healing will happen.  All we need to do is make sure to control any mouth-associated discomfort until his gums are completely healed and he is able to eat comfortably.

Rufus took all his pain medications and was a very good patient, and once his parents realized that he didn’t care that he didn’t have any teeth, and that he could and did eat normally, and that he purred exactly the same as he’d always done, well, they were happy too.

I saw Rufus recently for his follow-up visit, and one look at him convinced me that sometimes you really do need to be radical to make progress.  He’d put on that one pound he’d lost before his mouth surgery, and his lovely coat was back to its fluffy and glorious self.  His eyes were bright and shiny, and his whole attitude was more relaxed and friendly.

He was eating normally—and even sneaking a crunchie or two—and much more social and engaging than he’d been for the past year.  In fact, the change was so remarkable that his parents thought that Rufus hadn’t been right for much longer than we’d suspected, and they said they were kicking themselves for not doing the dental work the first time it had been suggested.  It struck them as funny in a way because nothing he had done at home when his mouth was so diseased was obviously indicative of a problem—it was only when the problem was removed that the return of his normal, happy self showed us what an impact discomfort can have on the personality.

This time when I opened his mouth to peek inside, all I saw was pink healthy tissue without a sign of any inflammation.  His breath was fresh and sweet.  And our boy was purring so loudly that the biggest challenge was being able to hear his heart over the noise!

Dr Cathy Lund

Cathy Lund, DVM, owns and operates City Kitty Veterinary Care for Cats, a cat practice located in Providence, RI. She is also the board president and founder of the Companion Animal Foundation, a statewide, veterinary-based nonprofit organization that helps low-income pet owners afford essential veterinary care. She lives in Providence, and serves on several architectural and preservation commissions in the city, and is on the board of directors of WRNI, RI’s own NPR station. But her favorite activity is to promote the countless virtues of the “purr-fect” pet, the cat!

City Kitty
18 Imperial Pl # 1B
Providence, RI 02903-4642

Phone: (401) 831-6369
Email: email@city-kitty.com

Website: http://www.city-kitty.com/
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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
Email: kccatclinic@gmail.com

Website: http://www.kccatclinic.com/
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