How worried should I be about a cat with an enlarged heart?
October 7, 2008 8:30 PM   Subscribe

An emergency vet said that my cat has an enlarged heart (discovered via chest x-rays). How worried should I be?

I came home after work yesterday to find my usually very-friendly 3 year old cat Sammy in apparent pain--unusually quiet (usually you can't shut him up) except when I touched him, when he freaked out completely. I took him to the emergency vet and they decided it was probably an abscess, as his side was swollen and he'd been fighting lately with the neighborhood bully cat. I was given antibiotics and pain medication for him, and he seems to be feeling a lot better today, aside from the fact that he's ticked at me for not letting him outside.

While checking him up, the vet was worried about his heart murmur--previously acknowledged by our vet (who said it might be something I should get looked at "eventually") at the last check-up; she said it seemed loud for a 3-year-old cat and asked for my permission to to take x-rays, which I agreed to. She said that the x-rays revealed that his heart was "a little enlarged" and recommended that I see a vet. cardiologist in the next month or two. There was no fluid in the lungs or anything like that, so it's not congestive heart failure. YANAV and YANMV--in fact, Sammy will be seeing our vet, who I plan to give a copy of the x-rays to and discuss this with further, tomorrow morning. However, google has me a bit of a confused, panicked mess over the whole thing. Other than last night's apparently unrelated illness, he's completely asymptomatic. I'm looking for answers from those who might have been in the same boat, especially with a young cat. I get the idea that treating an enlarged heart might be expensive, but how expensive? What kind of quality of life can he be expected to enjoy? Is this the death sentence that the internet makes it out to be?

Even though YANAV, feel free to take a gander at his adorable little bones and big ol' heart here and here.
posted by PhoBWanKenobi to Pets & Animals (5 answers total) 1 user marked this as a favorite
We lost our last cat at around that age, very suddenly and traumatically, after a saddle thrombus related to an enlarged heart. (Bloody mall-store breeders.) It's not a good thing. Catching this early should improve the prognosis as far as extended preventative care is concerned -- your vet will probably want to prescribe an ongoing regimen of medicine to prevent clots -- but the Bad Stuff associated with it can show up without warning, and is generally not treatable in a way that provides any long-term quality of life.
posted by holgate at 11:52 PM on October 7, 2008

What you should do is try to stay as calm as possible. You don't have a concrete diagnosis other than "enlarged heart". It's great that you are taking your cat to your vet in the morning. The first thing that you want to achieve is a diagnosis, which generally means an ultrasound of the heart. Your regular veterinarian most likely cannot provide such a specialized diagnosis and will likely refer to the closest local specialist, which judging from your profile would be here. However it is still a good idea to keep the appointment with your normal vet. The reason to keep the appt. with your vet is to help assess the level of progression of the heart murmur (they have heard the heart murmur previously and therefore are able to evaluate any changes), as well as to assist you in cost assessment. Your regular vet should be able to contact the specialist hospital and get an estimate for you of how much it is going to cost to diagnose your cat's heart disease. As things stand right now, your primary cost is going to be in diagnostics. Get an estimate first. If you can afford the cost of this, do it. Early prognosis will help you to get a step up on any possible heart disease and give you a better idea of what exactly you will looking at in the coming years as far as expense and life span. Good luck.
posted by citizngkar at 1:42 AM on October 8, 2008 [3 favorites]

It may or may not be related to this, but hypertrophic cardiomyopathy is something that I had to deal with several times while working at a feline only vet. The diagnosis usually started out as "enlarged heart" and moved on to this.
Feline hypertrophic cardiomyopathy (HCM) is the most common heart disease in cats; the disease process and genetics are believed to be similar to the disease in humans.[31] In Maine Coon and American Shorthair cat breeds, HCM has been confirmed as an autosomal dominant inherited trait.[32] The first genetic mutation (in cardiac myosin binding protein C) responsible for feline hypertrophic cardiomyopathy was discovered in 2005 in Maine Coon cats.[33] A test for this mutation is available.[34] About one third of Maine Coon cats tested for the mutation have been shown to be either heterozygous or homozygous for the mutation, although many of these cats have no clinical signs of the disease. Some Maine Coon cats with clinical evidence of hypertrophic cardiomyopathy test negative for this mutation, strongly suggesting that a second mutation exists in the breed. The cardiac myosin binding protein C mutation has not been found in any other breed of cat with HCM.

While there is no cure for HCM, early detection, regular echocardiograms, and daily medicine (e.g., Atenolol, Lotensin, Plavix) is key to prolonging an affected cat's life. Early signs may include a murmur or even heart failure. Unfortunately, death may occur without any other signs present, making the disease a difficult and often deadly one.
posted by mabelcolby at 3:04 AM on October 8, 2008

Thanks for the answers, guys.

Vet's visit went OK today. Confirmed that his heart is enlarged. The vet sent out a heart worm test, and in two weeks (after we get the results from that back) wants him back for more tests, including an EKG and ultrasound. Luckily, it turns out that she treats feline heart disease at her office in conjunction with local veterinary cardiologists, which is nice. Trying to stay zen about the whole thing, glad we caught this when we did and that everything, right now, is fine (he's sleeping on my lap right now). Anyway, send happy brain thoughts our way, please. :)
posted by PhoBWanKenobi at 7:27 PM on October 8, 2008

Possibly final update: I took Sam Katz to the feline cardiologist. This is what the visit/tests revealed, according to the doctor:
Echocardiography demonstrated left ventricular wall and chamber dimensions as well as left atrial dimensions to be within normal limits. Left ventricular chamber dimensions were at the upper limit of normal for this patient, however the patient was relatively large and the upper limit of normal for chamber dimension is most likely normal for this patient. Color Doppler and pulsed-wave Doppler echocardiography demonstrated turbulence in the right ventricular outflow tract.

[. . .]

These findings indicate the presence of dynamic right ventricular outflow tract obstruction which is typically incidental in many cats, however may also be associated with hyperthyroidism (highly unlikely in this patient at this age), or early cardiomyopathy.

There is no indication for cardiac medications at this time. A recheck echocardiogram is recommended in 4-6 months.
Apparently, because of his size (he's a fifteen pounder!) it's difficult to tell if there's any valve thickening associated with heart disease, or if his valve sizes are normal--hence the need for a recheck in six months. The doctor was very reassuring and said that, even if it is heart disease, it's at a very early stage and he frequently treats pets successfully for years with heart disease. He also said that he thinks the information on the web worries people unnecessarily about this, and there's no reason that cats with heart disease can't live long, happy lives. Lesson? Stay calm and talk to your doctor. If you're in central Florida and are having similar problems, I'd highly recommend Dr. Davin Borde at the Institute of Veterinary Specialists in Gainesville.
posted by PhoBWanKenobi at 3:54 PM on November 9, 2008

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