Tagged with " heart murmur"

The Heart Of The Matter

Jul 11, 2012 by Dr Eliza Sundahl    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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The Decision to Euthanize: When is it Time?

Oct 14, 2011 by Dr Elyse Kent    No Comments    Posted under: Personal Opinion, Tips & Advice

This actual scenario played out in my practice today….Chaka, a once stunning Balinese girl was waiting for an exam and blood tests when I arrived at the clinic this morning. Today Chaka looked like a skeleton with matted hair. Her eyes appeared sunken from dehydration and she struggled to breathe.   Her Dad, Steve, has always been receptive to all the medical recommendations I’ve made over the years.  Sweet Chaka has had more than her share of medical problems, many of which were chronic and required ongoing treatment.

Steve was devoted to her nursing care and follow up visits. Her list of maladies included inflammatory bowel disease that years later transformed into lymphoma (cancer),  fatty liver disease treated with a feeding tube, hyperthyroidism and a life-threatening adverse reaction to the drug used to treat the hyperthyroidism. Her last medical crisis happened a year and a half ago. After a blood transfusion and intensive care, we  started chemotherapy and much to our amazement, Chaka responded favorably and rallied once again! Steve and Chaka enjoyed another long stretch of blissful feline-human camaraderie.

Today I discovered a heart murmur and a chest full of fluid on x-rays…I quickly called Steve to discuss Chaka’s condition and asked him to come down to the hospital right away.  Chaka was looking worse by the moment. My assessment led me to conclude that it was time for the discussion with Steve about sparing Chaka from further suffering. I ran over the options in my mind one more time and reaffirmed that none of the procedures and treatments I could offer for Steve’s approval were likely to lead to good quality time for this kitty. Steve was initially resistant to the idea of euthanasia.  He said he wanted Chaka to “go naturally”.  I explained that cats do not leave this earth gracefully; that they stubbornly cling to life and can suffer for days. In my opinion it has become our sacred responsibility to make the choice to let go when there is little or no hope for recovery.  After all, when felines chose to live inside our homes and we agreed to provide them with safety and food, they ceased to be exposed to predators or severe elements that would  have quickly ended their lives when they were sick or weak.

When a terminally ill or aged cat has been under ongoing veterinary care and close monitoring stops eating, chooses to hide in the closet or under your  bed, stops using the litter box or no longer seeks affection from the family, it is time to consider euthanasia.  In short, the unique daily routine you and your cat have shared has become severely altered.  Your veterinarian may still discuss medical procedures and treatments that could prolong kitty’s life.  However, the final decision is up to you, the pet parent.  It’s best to discuss with family members and friends at what point you will choose euthanasia as the time approaches. Your veterinarian will provide support and counsel through the process.  As feline health care givers, we are committed to assisting  you with humane end of life care and decision-making

Dr Elyse Kent

Dr. Elyse Kent graduated from Michigan State University College of Veterinary Medicine in 1980 and completed an Internship at West Los Angeles Veterinary Medical Group in 1981.

In her early years in practice, Dr. Kent began to see a need for a separate medical facility just for cats, where fear and stress would be reduced for feline patients. In 1985, in a former home in Santa Monica, Dr. Kent opened the only exclusively feline veterinary clinic in Los Angeles, Westside Hospital for Cats (WHFC). Along with other forward-thinking feline practitioners from across North America, Dr. Kent founded the Academy of Feline Medicine in 1991. Through the efforts of these practitioners, feline medicine and surgery became a certifiable species specialty through the American Board of Veterinary Practitioners (ABVP). Dr. Kent became board certified in Feline Practice in the first group to sit for the Feline exam in 1995. She certified for an additional ten (10) years in 2005. There are now 78 feline specialists in the world. Dr. Kent served as the Feline Regent and Officer on the Council of Regents for 9 years. She is currently the immediate Past President of the ABVP, which certifies all species specialists. She also heads up a task force joining certain efforts of the ABVP with The American Animal Hospital Association (AAHA). She currently serves as a Director on the Executive Board of The American Association of Feline Practitioners.

The present day WHFC facility opened in 2000. It was the fulfillment of a vision for a spacious, delightful, state of the art, full service cat medical center that Dr. Kent had dreamed of and planned for over many years.

Westside Hospital for Cats
2317 Cotner Ave.
Los Angeles, CA 90064

Phone: 310-479-2428

Website: http://www.westsidehospitalforcats.com/
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