This is a 7-year-old male neutered DSH cat presented for bought’ of open mouth breathing following exercise. A 2/6 systolic murmur and an abnormal SNAP pro BNP was noted. Blood work was normal, BCS is 7/9.
Ultrasound revealed mild to moderate hypertrophy of the left ventricle with a prominent septal base along with SAM. Dynamic LVOT obstruction was observed ranging from 3.6 to 5.06 m/s at the septal base and possibly as high as 6m/s( may have caught a little mitral regurgitation at that rate which was not obvious during the study). Heart rates varied from 119-230bpm( avg 178 bpm). Higher rate did not always equal the greater pressure gradients. Left atrial size was normal in all measures (RSA, LAD and RPSLA5C). Mild diastolic dysfunction was observed with reversal of the E:A ratio and a slightly prolonged IVRT. I am considering the use of Atenolol therapy for this fellow following a BP and ECG and the absence of asthma history. I know force of contraction plays a large role in HOCM cats compared to rate alone. What are your thoughts? Thanks for having a look.
Comments
Hi! There is currently no evidence on the effectiveness of Atenolol in these guys in terms of morbidity and mortality. Also it’s still under debate whether DLVOTO is a risk factor or not. Atenolol will likely be able to reduce DLVOTO but no one knows if this will also positively influence the progression of the disease. If the cat is easily pilled I would likely give it a try, if not, I would just continue with watchful waiting
Peter