Understanding & Managing Congestive Heart Failure in Cats
Cats can develop heart disease just as humans can — and congestive heart failure is one of these shared conditions. This condition occurs when a cat's heart fails to pump as effectively as it should, resulting in the buildup of fluid in places where fluid should not be — causing signs of congestive heart failure in cats. This misplaced congested fluid leads to a kitty going down hill quickly, often struggling to breathe. While congestive heart failure affects both dogs and cats, cats have their own unique set of diseases that often lead to this condition.
Symptoms of Congestive Heart Failure in Cats
The most common symptom of congestive heart failure in cats is difficulty breathing. The most common reason for these cats to have difficulty breathing is accumulation of fluid in their chest cavity, according to Merck Veterinary Manual. As fluid accumulates in the chest cavity, the lungs are unable to inflate properly. In turn, this causes cats to develop rapid, shallow, and distressed breathing. The lungs themselves may also become congested with fluid, impairing their ability to function properly. Compared to dogs, cats with heart disease also have significantly higher risks for developing blood clots in their legs. This more commonly occurs in the hind legs and may manifest as acute, severe pain or loss of normal limb function. Other signs may include:
- Weight loss
- Abdominal bloating (due to fluid accumulation)
- Loss of appetite
- Loss of consciousness
Unlike dogs where valve disease is a common culprit for heart failure, cats usually develop heart failure secondary to damaged heart muscle. In fact, according to the University of Pennsylvania School of Veterinary Medicine one of the most common causes of congestive heart failure in cats is a disease called hypertrophic cardiomyopathy, or HCM. HCM results in thickening and scarring of the heart muscle, preventing the heart chambers from properly filling with blood. This forces the heart to work harder in order to keep pumping the same amount of blood, which exacerbates the injury to the already damaged heart muscle. Although much remains to be learned about how this disease develops, a genetic component has been identified in cats and the two most commonly affected breeds are Maine coon and rag doll cats. A potentially reversible manifestation of this disease can also be seen in cats with thyroid disease (hyperthyroidism). Males do seem to be affected more than females, but no cat is immune from this life-threatening condition.
If you are concerned that your cat is showing signs of congestive heart failure, you should contact a veterinarian immediately as this disease has the ability to become rapidly life-threatening.
Is It Curable?
Unfortunately, most of the damage that occurs in the heart during heart failure is usually irreversible. However, with proper treatment you may be able to temporarily correct fluid buildup in the chest, lungs, or abdomen and start your cat on medications that help slow any further damage to the heart. You'll need to work closely with your veterinarian to determine your cat's prognosis. Common tests your vet may want to run could include blood work, chest X-rays and a heart ultrasound to best identify the root cause of the heart disease. One important exception for irreversible heart disease is that which has occurred secondary to thyroid disease. In these cats, it's possible that by treating the heart failure and underlying thyroid disease you could see long-term resolution of their heart disease. This further emphasizes the importance of working closely with your veterinarian to understand the underlying cause of the heart failure and what treatment options may be available.
Treatment Options for Congestive Heart Failure
Thankfully, there are several treatment options available to cats suffering from congestive heart failure. If your cat has fluid built up in their chest or belly, your veterinarian may perform an emergency procedure called a thoracocentesis or abdominocentesis (chest or belly tap, respectively) where they use a needle and syringe to remove this excess fluid. Removing this fluid can help keep your cat comfortable while they do additional diagnostics to determine the cause of the heart failure and may even save your cat's life. Depending on the cause of the heart disease, your veterinarian may prescribe one or several medications that work together to prevent future episodes of congestive heart failure. Medications used to treat the congestive signs of heart failure in cats are oftentimes the same medicines used for humans suffering from congestive heart failure.
These medications are often available in pill, liquid or even transdermal (absorbed through the skin) forms. Most are even available in generic formulations. Your veterinarian may prescribe medications that help the heart muscles and blood vessels to relax or that aid in removing excess fluid from the lungs. Your veterinarian may also consider prescribing a mild blood-thinner to reduce your cat's risk of developing dangerous blood clots.
Though it can be alarming to hear that your cat is in heart failure, there are a number of drugs available. Therefore, it may take some tweaking to find a medication plan that suits your cat best.
Can Congestive Heart Failure be Prevented?
Unfortunately, when cats are diagnosed with congestive heart failure many will succumb to their heart disease within one year of the initial diagnosis. However, if heart disease can be identified BEFORE congestive heart failure develops, your cat has the potential remain your faithful companion for several years if their heart disease responds well to treatment. As the only person who sees your cat daily, your close attention is paramount. Closely monitor your cat's weight, as both an increase or a drop in weight can be related to heart disease in cats. Ensure that your cat receives a well-balanced diet, as nutrition plays a large part in feline heart disease as well. There are therapeutic cat foods available for cats with heart disease to slow the disease's progression.
Annual exams and routine blood work are also recommended, as this allows your vet to watch for trends of creeping blood values before they are outside the normal ranges. If you have an at-risk purebred cat or a cat who you know has a history or heart disease in their family, an annual heart ultrasound to screen for early signs of heart disease should also be discussed with your veterinarian. There are also genetic tests for HCM available and your veterinarian can discuss whether or not these may be appropriate for your pet.
Dr. Laci Schaible
Laci Schaible, DVM, CVJ, is a small animal veterinarian with over 15 years experience. She is passionate about how technology can innovate the practice of veterinary medicine, improving the lives of the veterinarian, the pet parent, as well as the patient. She works as the Head of Veterinary Medicine at rhapsody.vet.