Case Study

Mild restrictive cardiomyopathy (RCM) with mild biatrial enlargement in a 10 year old FS DSH cat

This 10 year old FS DSH cat has a history of with weight loss, vomiting and polyphagia of 4 months duration. Presented with inappetance, vomiting, dehydration. Abdominal ultrasound showed mild tri-cavitary effusion. Precison PSL elevated 4 months ago, otherwise CBC/Chem wnl. 2 weeks ago P increased. Current medications include metronidazole, prednisolone, weekly B12 injections and SQ fluids

Image Interpretation

Mildly increased LV diameter with normal myocardial function. Normal LV wall thickness, however the endocardium appears hyperechoic consistent with fibrosis. The papillary muscles are asymmetric, with some degree of atrophy and remodeling. Mild left atrial dilation (LA:Ao 1.5). Moderate subjective right ventricular dilation. Trace pericardial effusion. Trace pleural effusion noted

DX

Mild restrictive cardiomyopathy (RCM) with mild biatrial enlargement

Outcome

With only mild to moderate atrial enlargement however, the trace tri-cavitary
effusions are LESS likely to be primary cardiac in origin and more likely to be
neoplastic, etc. as a primary etiology. Sampling and cytology of the effusions is
recommended for a more definitive answer.
Regardless of diagnosis, this older cat has significant risk for fluid overload, and
breathing rates should be monitored closely at home while going forward with steroids
and SQ fluid therapy.
Recheck echocardiogram is recommended in 2-3 months to reassess status.