Cardiomyopathy + CHF in a cat

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Cardiomyopathy + CHF in a cat

  • 8 year old FN DSH presented with star gazing, dyspnoea, tachycardia and gallop rhythm
  • Responded to furosemide and 02
  • Echo shows biatrial enlargement and asymmetriacl LV hypertrophy with areas of thinning and a subjective hyperechoic endocardium. I think there is a restrictive pattern on mitral inflow but difficult to interpret as E and A waves merged. 
  • How would you classify this cardiac disease please?

  • 8 year old FN DSH presented with star gazing, dyspnoea, tachycardia and gallop rhythm
  • Responded to furosemide and 02
  • Echo shows biatrial enlargement and asymmetriacl LV hypertrophy with areas of thinning and a subjective hyperechoic endocardium. I think there is a restrictive pattern on mitral inflow but difficult to interpret as E and A waves merged. 
  • How would you classify this cardiac disease please?

Comments

EL
June 25, 2019 at 8:42 am -

Your MV view is too dark cant

Your MV view is too dark cant really tell but the rest looks like hcm with SAM and chf.

I was always taught to tx what you see and less on putting the cmy in a category as its hcm onne day then rcm later or UCM later..depending on how they respond to tx.

Lasix, plavix for sure and there is no real consensus after that on tx because you dont want to rate limit when in chf they need the HR to survive but maybe atenolol once stable. ACEi are controversial but in north america we use them in these cases. Pimo recently showed no difference in MST with HCM cases from a talk at ACVIM this year but Ive used it in these cases with some sucecss but limited follow up since I’m mobile.

veteurope1
June 25, 2019 at 12:46 pm -

Thanks EL. 

Thanks EL. 

Peter
June 25, 2019 at 8:17 pm -

Hi!
I completely agree with

Hi!

I completely agree with Eric. 

To me it looks like HCM – but I would not try too hard categorizing these phenotypes because what you treat is what you see.

I would go for Furosemide (lowest effective dose), Clopidogrel  – and I almost always use ACEI+Spironolactone (the latter must not be used in Maine Coons!!). 

I give Pimo is there’s refractory CHF or evidence of marked systolic dysfunction

Heart rate is ok for me.

comment: I would recommend increasing your sweep speed in M-Modes!

Peter

veteurope1
June 25, 2019 at 8:19 pm -

Great, will do. Thanks

Great, will do. Thanks Peter. 

Pankatz
June 27, 2019 at 12:36 pm -

Hi Peter
Just eavesdropping

Hi Peter

Just eavesdropping on this thread.  Why must the latter (sprinolactone?) not be used in Maine Coons?

Jacquie

franklinanimalclinic
June 28, 2019 at 3:06 pm -

Also eavesdropping…
 If

Also eavesdropping…

 If it’s possible, could you indicate where you’re seeing the SAM? 

 

Thanks,

Sam

franklinanimalclinic
June 28, 2019 at 3:06 pm -

Also eavesdropping…
 If

Also eavesdropping…

 If it’s possible, could you indicate where you’re seeing the SAM? 

 

Thanks,

Sam

EL
June 28, 2019 at 4:09 pm -

Its not present in m mode

Its not present in m mode here you have to scroll through the rt ps long axis and watch the ant mv leaflet hangs up during LV systole and that thick lv septum prior to the lvot is causing a bit of fixed lvot obstruction as well.

veteurope1
June 28, 2019 at 4:16 pm -

Thanks. Spironolactone caused

Thanks. Spironolactone caused facial pruritis in Maine Coons but I believe many have been ok on it more recently. Im sure we will hear from Peter.

KV CVT SonoPath
June 28, 2019 at 6:42 pm -

It’s interesting, humans on

It’s interesting, humans on Spironolactone have also reported side effects of Seborrheic dermatitis.

veteurope1
June 28, 2019 at 6:44 pm -

And yes EL I can see the SAM

And yes EL I can see the SAM on m mode.

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