Heart disease is most frequently identified in cats that are middle-aged or older. Congenital disease—defects that have existed since birth—is the most typical presentation for younger cats. Heart failure is not always a sign of heart disease. Without taking medication, the majority of cats with heart disease can spend very normal lives and show no symptoms of the illness. But the majority of cardiac conditions worsen over time, and if symptoms appear, your cat will most likely need therapy for the rest of its life.
When will my cat need to start treatment?
There might not be any symptoms in the early stages of heart disease, so your cat might merely need routine checkups from your veterinarian. Heart disease does, however, typically worsen over time, necessitating medication to reduce symptoms.
There is currently no proof that initiating treatment prior to the onset of heart failure is advantageous.
What types of heart disease require treatment?
Heart muscle disease
Cats with heart disease typically have an atypical heart muscle. Hypertrophic cardiomyopathy is the most prevalent condition where the heart muscle thickens and becomes taut. Blood flow is hampered by the heart muscle's inability to relax due to its thickness and tension. Heart failure could eventually result from this. Thickner muscles can also sometimes be a factor in obstructive hypertrophic cardiomyopathy, a condition where the heart's ability to pump blood is impeded. Additionally, the heart muscle may thin and weaken (dilated cardiomyopathy) or grow stiff (restrictive cardiomyopathy).
Drugs to help the heart relax or contract more strongly may be administered, depending on the underlying illness.
Heart failure
Fluid will begin to accumulate once the heart fails, for whatever reason. Fluid buildup in the chest or belly (outside the lungs) may indicate that the right side of the heart is failing. Usually, the left side of the heart fails, which causes fluid to accumulate either inside the lung or outside of it in the chest.
Not every animal should take every medication, so your veterinarian will determine the best course of action for your cat and go over your options with you. Drug combinations are frequently required, and medication dosages can vary over time. Typically, your cat will require therapy for the remainder of its life once it has begun. Every medication has certain side effects, so you should see your own veterinarian for more information if you have any concerns about any part of your cat's care or any symptoms it may be exhibiting.
There is no proof that it is advantageous to begin treatment for the majority of disorders before heart failure symptoms appear.
Clot formation and embolism
Cats with heart disease that have a markedly enlarged heart may be susceptible to internal clot development in their heart. These clots may disintegrate and move through the arteries, eventually obstructing them (thrombosis). Although it can occur everywhere in the body, this typically occurs in the arteries that supply blood to the rear limbs. When it happens here, the cat feels excruciating pain and abruptly becomes paralyzed.
Heart rhythm disturbance
An irregular cardiac beat can occasionally develop in a sick heart. It will be necessary to take some drugs to lower the heart rate if the average heart rate is high. Drugs that speed up the heart rate may be required if the heart rate is too low.
What drugs are used in the treatment of heart disease?
Heart failure in animals can be treated with a variety of medications. The most popular combination is that of an ACE inhibitor plus a diuretic.
Diuretics, frequently referred to as "water tablets,"
These are intended to prevent fluid retention, which if it builds up in the chest or lungs, can make breathing difficult. Diuretics increase the amount of urine produced, which aids in the body's removal of water.
Furosemide is the diuretic that is most frequently used. Most people take furosemide twice or three times a day. Animals on diuretics will need to drink more water because they will pee more frequently. It's crucial that you don't limit your cat's water consumption because doing so could cause dehydration. Diuretic-treated animals will need to urinate more frequently and may occasionally experience urinary incontinence, which manifests as little leaks when lying down or as puddles in the home. Animals taking diuretics for an extended period of time may experience a little deficiency in some salts when the extra water is flushed out of the body along with some salts. To make sure your cat is not experiencing issues as a result of the diuretics, your veterinarian will want to test blood samples from them. However, you should not administer any additional supplements without first consulting a veterinarian. When your cat is on diuretics, you should talk to your veterinarian about any side effects you observe.
ACE blockers
This class of medications includes medicines that work by widening blood arteries, which lowers blood pressure. These medications are commonly used to treat high blood pressure in people; in cats, however, their primary purpose is to treat heart failure by preventing fluid retention and facilitating the heart's ability to pump blood. These four medications are most frequently used: ramipril, enalapril, benazepril, and lisinopril. Usually, these are administered once or twice a day.
Since these medications drop blood pressure, your cat may exhibit signs of weakness or lethargy, and very infrequently, collapse. It may take your cat some time to get acclimated to the medication when it is first administered. If these symptoms appear as soon as you begin taking the medication, speak with your veterinarian right away for more guidance. Kidney function problems are typically the most severe adverse effects observed with these medications. Because of this, if your cat is prescribed an ACE inhibitor, your veterinarian will likely advise periodic blood testing to ensure that the kidneys are functioning normally both before and during the course of medication. Certain animals may also exhibit diarrhea and vomiting.
Animals who are pregnant shouldn't be administered ACE inhibitors because they may result in birth abnormalities.
Medications that calm the heart
Beta blockers help the heart relax by lowering heart rate. They lessen the quantity of oxygen that the heart muscle requires. These medications are frequently used to treat hypertrophic cardiomyopathy in its obstructive forms. In certain cases of irregular cardiac rhythm, they can also be used to slow the heart. The two most widely used beta blockers, atenolol and propranolol, are used once or twice daily. Beta-blockers can aggravate heart failure and lower blood pressure and heart rate. There may also be diarrhea. These medications may exacerbate respiratory symptoms in certain cats that have asthma. Beta blockers are often started at a low dose and gradually increased until the desired effect is achieved in order to minimize the chance of unwanted effects. Lethargy, weakness or collapse, or a worsening of heart failure symptoms are warning indications that could point to a beta blocker overdose. Call your veterinarian for guidance if you are concerned about any symptoms in your cat.
Some cats with hypertrophic cardiomyopathy, especially those with obstructive types, may benefit from diltiazem to help relax the heart and lower heart rate. In cases of irregular cardiac rhythm, it can also be used to slow the heart. Typically, tablets are administered three times a day. In cats, the most common side effects include lethargy and vomiting. Before administering this medication, your veterinarian will want to make sure your cat's liver and kidneys are functioning appropriately.
medications that stop clots from forming
One anti-inflammatory medication that can prevent blood clots from forming is aspirin. It is administered to cats who are susceptible to thrombosis (clot formation and artery blockage). Usually, tablets are administered once every two days. Gastrointestinal discomfort and ulceration, which can result in bleeding (blood in the vomit or very dark diarrhea), are frequent side effects. You should get in touch with your veterinarian right away if you see any of these symptoms. Adverse responses to the kidneys can also happen.Before administering this medication, your veterinarian will want to make sure your cat's kidneys are functioning correctly and that there is no indication of a gastrointestinal ulcer. It is not advised to give your cat any additional anti-inflammatory medications, such as corticosteroids (prednisone, prednisolone), while they are taking aspirin. If for any reason your cat does require these medications at any stage, please consult your veterinarian.
Another medication that prevents thrombosis by preventing clot formation is clopicatrel. One tablet is administered each day. Bleeding may result from an overdose. Before providing this medication, your veterinarian will want to make sure that there is no sign of gastrointestinal ulcers.
