Re: [FH] Re: my cat Hotspur (We're new here.)
I tend to agree with Sarah -- five year survival with RCM would be very
My own experience -- my Baby Boy was initially diagnosed on August 27th with
HCM, which made sense given his initial symptoms, the ultrasound and the fact
that it's the most common form. A repeat ultrasound done in October looked
more like end-stage RCM to the cardiologist who read it (it was done at my
vet's, he sent it to the cardiologist). I took him to Tuft's Veterinary Hospital
in November, and as it turns out, it's DCM -- and it's very obviously DCM, all
four chambers are markedly dilated.
The point is that as the heart remodels due to the disease, it can look
different depending on what stage the disease is at. I was present at the first
and last ultrasounds, and I can easily see how his diagnosis changed, because
his heart looked completely different 3 weeks ago than it did in August. The
skill of the ultrsound operator has a lot to do with it as well.
How many ultrasounds has Hotspur had? I understand the rationale behind not
repeating ultrasounds, due to costs, especially when there is obvious
hypertrophy of the ventricle which tends to indicate definite HCM. Thanks to an
inheritance from my cat-hating grandmother who died in July (oh, the irony!) I was
able to do the multiple ultrasounds without too much stress financially, and
my God, it was definitely worth it.
Do you know what Hotspur's measurements are? I hope he's feeling better too
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> Kearra was dx'd with HCM in 1995 and put on Atenolol. At somepoint
> after that (few years) her murmur disappeared. IIRC she was takenoff
> Atenolol but kept the aspirin.That's interesting because one hypothesis is that RCM is end stage
> In 1999 or 2000 she was dx'd with RCM (we kept up with the
> ultrasounds). She was put on Enecard. 3 weeks after her 2001
> ultrasound she threw a clot and went into CHF while at the vets.
HCM. With HCM, the ventricular wall is thickened, but with RCM, it
isn't. So to go from HCM to RCM means that the model of the heart
has to have changed drastically.
One interesting point - the resolution of ultrasounds is variable.
Morag was originally diagnosed with HCM when she had the ultrasound
done at the regular vet by a very reputable ultrasound technician.
But when we took her to the cardiologist, she was diagnosed with
RCM. I asked, why was she diagnosed with HCM just a month ago and
now it's RCM? The answer - "here at the university, we have a very
high resolution ultrasound machine", i.e. expensive machine.
The reason she had been diagnosed with HCM originally is that with
RCM, the shape of the ventricle is abnormal. The walls aren't
thickened, but there is fibrous material in the ventricle and the
wall sometimes protrudes inward. The cardiologist drew me a
picture. With the lower resolution machine, where the wall was
bulging inward, it was misinterpreted as the wall being thick
because the resolution of the machine wasn't high enough to
differentiate between wall thickness and wall abnormalities.