Heart Disease: Symptons, Diagnosis And Treatment

Our cats are susceptible to heart problems, just like we are and because they are living longer lives than their predecessors, heart disease is becoming increasingly more common. Heart problems can occur in any breed, age or sex of animal, but some cat breeds, such as the Persian, Maine Coon, Siamese and Ragdoll seem to be more susceptible to heart disease than others.

Heart problems may be present from birth (congenital), or may happen as our pets get older.

1. Congenital: Heart conditions can be caused as the embryo develops in the mother’s womb or may be a hereditary (passed on from the mother or father). In this case the problem is present at birth but signs may go undetected for a while.
2. Adult onset: These conditions occur as a result of damage to the heart which prevent it functioning properly and may be caused by

• General wear and tear with age
• Increased stress on the heart from concurrent illnesses, such as hyperthyroidism, high blood pressure, taurine deficiency, poisoning and obesity
• Hereditary conditions which do not present until the animal is fully grown.

How The Heart Works

Like all mammals, cats have a four chambered heart which is made up of three layers.

1. Pericardium – a fluid-filled sac that surrounds the heart
2. Myocardium – a middle layer of muscle
3. Endocardium – the inner lining

The right atrium and left atrium are the upper chambers of the heart and the right ventricle and left ventricle are the lower chambers. A muscular wall called the septum separates the right and left sides of the heart. Each of the chambers has valves in order to make sure that the blood flows in the correct direction.

The different sides of the heart have different functions.

• On the left side of the heart, the upper chamber (left atrium) fills with oxygenated blood from the lungs. It is then pumped via the lower chamber (left ventricle) into the aorta and around the body to provide cells with the oxygen they need.
• On the right side of the heart, the upper chamber  (right atrium) fills with oxygen-depleted blood from the body and pushes it via the lower chamber (right ventricle) and the pulmonary artery back to the lungs where it can be oxygenated again.

The heart muscle contracts to squeeze blood out of the heart

• In the first stage the upper chambers (atria) contract at the same time, pushing blood down into the ventricles.
• In the second stage, the ventricles contract to push this blood out of the heart to either the body via your main artery (aorta) or via the pulmonary artery, which leads to the lungs, to pick up oxygen.

The heart then relaxes. Blood fills up the heart again, and the whole process, which takes a fraction of a second, is repeated.

Symptoms Of A Heart Problem

In the initial stages of a heart problem the body often learns to cope with the changes, so many cats don’t show clinical signs until the heart problem is quite advanced (cats are also very good at hiding illnesses!) Some of the most commonly seen symptoms include

• Tiredness
• Increased respiratory effort and rate (heavy breathing / panting)
• Weight loss
• Appearance of weight gain (due to fluid building up in the chest and abdomen)
• Cold extremities (paws)
• Collapse / fainting
• Behavioural changes
• Stunted growth (kittens)

If you see any of the above symptoms in your pet, or you are concerned about his or her health for any reason, please take them to see your vet.

Types Of Heart Problems

Heart Murmur: This is caused by turbulent or fast blood flow within the heart or associated vessels. There are lots of causes for heart murmurs; some are not associated with any structural heart disease and can be caused by stress or high temperatures, other murmurs can be caused by abnormal blood flow associated with a variety of cardiac diseases, including abnormal heart valves and different congenital defects. If murmurs are not associated with heart disease they often disappear in a few months.

Valvular Disease/Insufficiency: Heart valves normally form a perfect seal when closed. However, in valve disease one or more of these valves “leak,” allowing blood to be pumped backwards.

Bacterial Endocarditis: This is caused by a bacterial infection of the heart valves or of the membrane lining the cavities of the heart.

Dilated Cardiomyopathy: The muscle of the heart becomes thinner and gradually weaker, causing the heart chambers to stretch, which prevent it from pumping blood around the body as effectively as it should.

Hypertrophic Cardiomyopathy: The heart muscle becomes thicker, resulting in a reduction of chamber volume, which means that the heart pumps less blood around the body. This is the most common form of heart disease found in cats.

Restrictive Cardiomyopathy: Caused by fibrosis (scarring) of the heart muscle, which results in a chamber that can no longer expand in the normal way.

Feline aortic thromboembolism: A blood clot (thrombus) develops in the heart chamber and can then move on to block blood flow in small arteries. This may occur as a result of existing heart problems because the blood is not flowing normally through the heart.

Congestive Heart Failure: This is unfortunately the usual end result of most heart conditions. As the heart loses its ability to pump blood around the body properly it becomes congested, resulting in fluid build-up in the abdomen and chest cavities, which lead to abdominal enlargement and interference with the other organs. If fluid builds up in the lungs it results in coughing and breathing difficulties.

How Heart Problems Are Diagnosed

This will vary from patient to patient and will also depend on the clinical signs, but usually two or more of the following tests are performed

• Auscultation: The vet will listen to your pet’s heart with a stethoscope to detect any murmurs or irregular rhythms.
• Ultrasound: Allows the vet to examine the heart while it is in motion. It can be used to measure the chambers and walls of the heart and see the heart valves, so can provide a very accurate diagnosis.
• X-rays: these can show your vet if the heart is enlarged or has changed shape and show if there is any fluid in chest or abdominal cavities.
• Electrocardiogram (ECG): Shows the electrical activity of your pet’s heart to measure and diagnose abnormal heart rhythms
• Blood and urine tests: These are done to assess general health and ensure that there are no problems with other organs in the body, for example the kidneys or liver.

Treatment For Heart Problems

In early stages of heart disease there may be no clinical symptoms and your cat may just need an adjustment to diet and exercise along with regular check ups by your vet. If there is a concurrent illness, treating that may help the heart problem as well. Medication can be given in the later stages and will depend on the heart problem and associated symptoms . Recommended treatment may include

• Changes to your pet’s lifestyle, for example more controlled exercise and activities to prevent over exertion.
• Medication to improve the strength of the heart beat or change the heart rate and, if necessary, to help remove excess fluid from the chest and abdominal cavities.
• Dietary changes may be recommended by your vet depending on the type of heart disease present, especially if your pet is currently overweight.
• Some congenital heart defects can be corrected by surgery so your vet may recommend this.

How To Keep Your Pet Healthy

ensuring your cat is fit and healthy is not only a great way of helping to prevent heart disease but it can also help pets that have been diagnosed with heart problems to stay healthier for longer.

• Make sure your pet is eating a well-balanced, healthy diet, this is as good for your pet’s heart as it is for yours.
• Watch your pet’s weight; being overweight makes the heart work much harder. You are responsible for the amount of calories your pet eats and it is down to you to help your pet maintain a healthy weight! If you are unsure whether your pet is overweight and how much he or she should weigh, ask your veterinary nurse for advice.
• Make sure your pet receives regular, good quality exercise; this will improve overall health and fitness in your pet and prevent excess weight gain.
• Take your pet for annual check-ups with the vet (twice yearly for senior pets). Early detection will improve your pet’s chances.

If you have any questions about heart problems or any concerns about your pet’s health, please contact your veterinary practice for advice.