- Our kitten,5 months old when first diagnosed with a murmur has had
The first vet said definitely hypertrophic cardiomyopathy.
We opted for a second opinion.
The second said it could be hypertrophic cardiomyopathy, but he
thought more likely it was LV/Mitral dysplasia and changed the baby's
meds from diltiazem (60mg per day) to atenolol (12.5 mg per day).
He recommended an ultrasound in nine months. If there is no
deterioration in the condition he thinks we're dealing with the
Has anyone else had a similar experience? Should we test sooner?
I am posting here the recent echocardiogram of my cat. It would be interesting to know what some of you think of these results. What is CRT <2 sec., Attitude BAR?
In this part of the diagnosis "R/O normal for this patient vs. early/mild cardiomyopathy" does he mean rule out normal or what?
Thank you ahead of time,
History/Clinical Findings:Cardiology Consultation
History: WC is a 5 year old, female spayed, Savannah presenting to LVVSC cardiology for evaluation of a grade II/VI murmur. The owner reports that the murmur was first heard in December 2015 prior to her spay. WC's blood work in December 2015 and January 2016 were normal. The owner mentioned that WC started showing signs of decreased activity, feet tucked when laying sternal and squinting in March 2016. The owner is concerned that she is in pain and that the only abnormal finding is the heart murmur. Radiographs were within the normal limits also. WC has displayed some respiratory congestion during the colder days this year but has been breathing 30-35/min during her sleep. The congestion has disappeared with the warmer days.
Weight: 11.5 lbs.
Temperature: 99.6 Fº
Pulse: 144 BPM
Respiratory Rate: 44
Mucous Membranes: Pink/moist
CRT: <2 sec
Cardio-Pulmonary: 2/6 left parasternal systolic murmur, fair/synchronous pulses, lungs clear bilaterally, no arrhythmias
Abdomen: soft, no palpable organomegaly
Musculoskeletal System: amb x 4
Neurological System: nsf
Lymph Nodes: nsf
Medications: no current medications
Laboratory / Diagnostic / Imaging Findings:
Echocardiogram (see faxed report)
Diagnosis: High end normal LV wall thickness, few false tendons in LV. R/O normal for this patient vs. early/mild cardiomyopathy
Recommendations to owner:
I talked to the owner about the findings. Overall, I am not concerned about the changes that I'm seeing on WC's ultrasound. Based on the type of heart conditions that cats are predisposed to (cardiomyopathies), it can be challenging to definitively diagnose them in the very early stages of the disease process. The changes that I currently see can be considered normal - but I can not completely rule out an early cardiomyopathy.
My general recommendation in these cases is to follow up with them in 1-2 years to see if there is evidence of any progression. Even if WC does have cardiomyopathy, I would not expect to see progression/clinical signs within that period of time. There is no evidence of cardiac chamber dilation so the risk of congestive heart failure or thromboembolic disease is very low.
No medications are indicated at this time.
We discussed WC's other symptoms and that I think it is highly unlikely that they would be due to any cardiac disease. Based on the description of these episodes and concern for pain, if they persist a neurological evalution may be the next step.