Cat restrictive cardiomyopathy (RCM)? non classified ?

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Cat restrictive cardiomyopathy (RCM)? non classified ?

  • 14 years persian
  • Dyspnea
  • Pulmonary edema, bi-atrial dilation
  • Hepatomegaly + ascites) and pleural effusion
  • 220 heart rate in resting
  • Blood pressure 120 mmHg
  • ECG suggest just enlargement
  • Furosemide + clopidogrel + pimobendam?

Comments

EL

Sorry for the different fonts

Sorry for the different fonts but cut and pasted form my notes and Peter’s Lectures:

EL Notes:

RCM criteria: severe left or biatrial enlargement, normal left ventricle size,  normal to slightly thickened left ventricle symptom-free wall.

The slightly subnormal fraction shortening

Fibrous bridges between the septum and free wall

Peter’s notes:

  • ¤  Bi-atrial enlargement

  • ¤  “almost normal” wall thickness of left ventricle

  • ¤  normal or slightly subnormal systolic function (cut-off FS 30%)

  • ¤  restrictive inflow profile ….

 
UCM
 
EL notes:
Usually biatrial enlargement and normal LV wall thicknesses with volume overload. Consdier cortizone load induced cmy as well as they look the same. FS% in normal to subnormal range.
 
Peter’s Notes on UCM
 

  • ¤  Garbage can

  • ¤  Every primary cardiomyopathy that does not match

    HCM, RCM, DCM or ARVC

  • ¤  Would rather call it „cardiomyopathy“

  • ¤  Definition a bit operator-dependent (differentiation from other cardiomyopathies)

EL: I often say either or because you really dont treat it any differently… treat what you see. Volume overload and failing? then treat like canine C1 valve disease (triple tx) and add plavix.

I’m sure Peter can be more eloquent here.. Ill see if he can chime in.

 

 

Peter

Hi!
I completely agree:

Hi!

I completely agree: Pimobendan for systolic dysfunction, Furosemide and Clopidogrel. You may add an ACI + Spironolactone once the cat is stable enough for pilling. Did you get any TI gradients? Since the right ventricle is large, pulmonary hypertension could as well be an issue here (in this case Sildenafil would be an option). Moreover, I recognise that the heart rate is low. If the heart rate is 140/min in a situation of CHF, I would always give a shot of Atropine to increase cardiac output and renal/coronary perfusion. 

I would likely call this RCM in case there is no PHT present. Otherwise some myocardial failure due to ischemia etc could be the case. Basically I does not matter how you call it as long you recognise the associated pathophysiological changes – like you did.

Best regards

 

PEter

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