KERRY SIMPSON, FAB Lecturer in Feline Medicine at the University of Edinburgh, looks at ways of recognising heart disease and of helping cats at home

Cats can suffer from a wide range of heart diseases which can result in a wide range of clinical signs. Often cats don’t show any signs of having heart disease until the problem is serious. Then signs may arise rapidly and require emergency veterinary treatment. Therefore, it can be useful to monitor for these signs and recognize them as serious complications.

Recognition of congestive heart failure
Cats with congestive heart failure often have difficulty breathing (dyspnoea). In this situation it is not uncommon for fluid to accumulate in the chest cavity (usually between the body wall and the lungs), rather than in the lungs themselves. As the cough receptors are located within the lungs themselves, this means that cats with cardiac disease rarely cough. Congestive heart failure is not the only cause of breathing difficulties in the cat, but any problems breathing should be investigated. If there is fluid accumulation outside the lungs, this may need to be removed, so that the lungs can expand properly.

Early recognition of breathing difficulties can be useful in cats with known heart disease. It is useful to count the number of breaths that he/she takes in a minute when at rest. Also look at the way that your cat breathes, as the respiratory pattern also changes with breathing problems. If the pattern is altered and the rate increases (even only a small amount), there may be the start of fluid accumulation either in the lungs or around them, and your cat’s medications may need to be altered.

Thromboembolism
Cats with heart disease can form blood clots within their heart. When this happens pieces can break off the clot and enter the circulation, where they can lodge in the arteries. This typically occurs in the arteries supplying the hind limbs, but can occur in the arteries supplying either of the front legs too. If this happens it is initially very painful, and cats may limp, and often vocalise. At this time the affected paw(s) will be cold and have a bluish colour. This also requires emergency treatment to ease the pain and manage the consequences of renewed blood flow to the paw. In addition, drugs that decrease the cat’s ability to clot its blood are useful as these can stop further expansion of the blood clot and help the blood flow back to the affected limb(s).

Giving medication
Cats are often prescribed several medications and it may be useful to work out how best to medicate your particular cat. Some cats will take a single capsule, which can be made up especially and may contain several medications. Other cats will prefer liquid medications. These can also be useful in small cats, as many cardiac medications are in fact made for humans, and breaking them into cat-sized pieces can be problematic. Of the more common cardiac medications, frusemide is available as a liquid medication (Frusol); as this is made for infants, it is often easier to dose in cats than the tablets.

There are some cardiac medications formulated for cats which are designed to be palatable, although not every cat agrees! Fortunately, for many of the cardiac medications there are several different formulations and in many cases it is just a case of finding the best ‘fit’ for you and your cat.

If your cat is having problems breathing, it can be very hard to give oral medications, and there is a greater risk of your cat inhaling these medications. In such instances it is usually advisable that your cat is hospitalised so that it can receive oxygen therapy and injectable medications.

In cats which have had a blood clot or which have lots of fluid accumulation within the abdomen (which can make the intestines swollen and therefore absorption of medication difficult) injectable medications may be prescribed. These are administered under the skin, in much the same way as insulin.

Other considerations
Cats with heart disease do suffer from arrhythmias and can have myocardial infarction (heart attacks). Therefore, it is best to avoid things you know will cause stress to the cat. However, these are rare complications and not all stressful situations can be avoided without compromising the cat’s lifestyle.

Veterinary examinations
Your vet will best advise you how frequently your cat should be re-examined, as this will vary greatly depending on the type and the severity of the heart disease. In general cats which don’t show signs of heart disease and remain stable will only need to have annual check ups, unless there is any change in their behaviour or health. Cats which have signs attributable to their cardiac disease may require more frequent monitoring.

July 2010