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Hypertrophic Cardiomyopathy in Cats

Hypertrophic Cardiomyopathy in Cats

Hypertrophic cardiomyopathy, HCM, HOCM

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Updated on September 26, 2024
SUMMARY OF CONTENT
Hypertrophic cardiomyopathy (HCM) is the most common heart disease in cats. With this disease, the heart muscle becomes abnormally thickened, resulting in poor contraction of the heart. Congestive heart failure and aortic thromboembolism (serious blood clots) are serious conditions commonly associated with HCM.
SEVERITY:
Severity is moderate to severe
  • Time to Cure
    Resolution is not possible, as lifelong treatment is needed
  • Treatment Icon
    Manageable by a veterinarian, by the pet parent
  • Prevention Icon
    Prevention is not possible
  • Spread Icon
    Transmission is not possible between animals or animals to people
  • Lab Icon
    Diagnosis requires physical exam, lab tests, x-rays, echocardiogram, electrocardiogram (EKG, ECG)
VERY COMMON IN
Common in middle aged to older cats of either gender. Maine Coon and Ragdoll breeds are predisposed.

Symptoms & Signs

Most cats with hypertrophic cardiomyopathy (HCM) do not show any overt clinical signs that there is a problem. Some cats may develop a heart murmur that a veterinarian can detect during a physical exam. Since most cats do not show signs of disease until it has progressed to [congestive heart failure](https://www.petcoach.co/cat/condition/congestive-heart-failure-1/) , many cats presenting with HCM have difficulty breathing, a more rapid respiratory rate, lethargy, weakness and a loss of appetite. Coughing can occur in cats with HCM, but it is not very common. In some cases, sudden death is the only apparent sign of disease.

Diagnosis

As with many health conditions, diagnosis begins with a physical exam by a veterinarian. Although most cats with hypertrophic cardiomyopathy (HCM) are asymptomatic, a heart murmur or arrhythmia (abnormal heart rhythm) may be noted in some cats. For cats that present in congestive heart failure or blood clots due to HCM, a veterinarian may also detect other abnormalities, such as abnormal lung sounds, cold limbs or changes in their pulses. Additional diagnostic testing is needed to definitively diagnose HCM. Chest x-rays are useful in evaluating the size of a cat’s heart, as well as the presence of congestive heart failure. However, x-rays alone are insufficient to diagnose HCM. An echocardiogram (ultrasound of the heart) is required to evaluate the thickness of the heart muscle, as well as the heart’s function. Other tests, such as an electrocardiogram (ECG) may be recommended if an arrhythmia is present and blood tests may be useful to evaluate a cat’s overall organ function, particularly if certain medications are needed. The feline Pro-BNP test is a newer test that can be run in the hospital setting and can help identify congestive heart failure. This test measures the most stable cardiac biomarker NT-Pro BNP. This test can be run on cats where heart failure is suspected or as an early detector tool.

Causation

Hypertrophic cardiomyopathy (HCM) is the most common type of heart disease in cats. The heart is divided into four chambers (two atria and two ventricles), which pump blood through the lungs so that it can be oxygenated, as well as then pumping this oxygenated blood throughout the body. With HCM, the heart muscle, notably the left ventricle, becomes abnormally thickened, resulting in a decreased ability for the heart to contract and pump blood efficiently. The left ventricle’s poor contraction results in a backup of blood in the heart and lungs. This leads to congestive heart failure as fluid accumulates in and around the lungs. While a genetic mutation has been identified in Maine Coon cats as the culprit of HCM, the precise cause of HCM in other breeds has not been directly identified.

Treatments

icon AT-HOME CARE
Hypertrophic cardiomyopathy is predominantly managed with medication and monitoring at home.
icon SUPPORTIVE CARE
Severe cases of HCM, including cats that are secondarily experiencing congestive heart failure or aortic thromboembolism, may require hospitalization for supportive care. Such treatments may include oxygen therapy and IV medications.
icon MEDICATIONS
Medication is the mainstay of HCM management. However, the specific medication(s) for an individual cat varies depending on the severity and complications with the disease. Medications used can include [atenolol](https://www.petcoach.co/pet-medication/atenolol), [furosemide](https://www.petcoach.co/pet-medication/furosemide), [spironolactone](https://www.petcoach.co/pet-medication/spironolactone), [pimobendan](https://www.petcoach.co/pet-medication/pimobendan), [enalapril](https://www.petcoach.co/pet-medication/enalapril), clopidogrel or heparin.
icon DEVICES
None
icon SURGERY
None
icon SPECIALISTS
A consultation with a specialist in veterinary cardiology is needed for the vast majority of cats with HCM both from a diagnostic and therapeutic standpoint.

Cost Of Treatment

The cost to diagnose HCM in cats is greater than the treatment. In most cases, diagnosis may cost up to $1500. Medications used in treatment may cost up to $300 each month.

Recovery

Recovery from HCM is not possible, as this is a progressive disease. Treatment is a lifelong commitment. Cats with HCM that are not in congestive heart failure can survive for months to years with proper management, whereas the survival time is much lower for cats that are also in congestive heart failure or with an aortic thromboembolism.

Monitoring

The frequency of an individual cat’s veterinary recheck exams and testing vary based on their response to treatment and the severity of disease. Typically, most cats require evaluation every few months.

Prevention

Cat breeders may have genetic screening tests or echocardiograms performed on their breeding animals in an attempt to decrease the incidence of HCM in future generations. However, since so many cases of HCM in cats do not appear to have a genetic association, it is impossible to definitively prevent this disease.

Questions about Hypertrophic Cardiomyopathy in Cats

I have a cat that as a kitten was very ill. We got him from 7 months old. We knew he’d had cat flu prior to him coming here. He is now nearly 5 yrs old. He picks huge fights with our other cat. He keeps urinating and scratching at doors and windows around the house. We allow him to go out via the cat flap unlimited. What is happening to him

I'm glad to see that Pippin has been neutered because this eliminates that possibility of hormone-fueled behavioral changes and aggression. Behavioral changes in cats can occur at any point in time, and could be related to anxiety or stressful situations (even rearranging furniture or introducing new people to the home can be stressful to cats). Without a lot more information and observing Pippin's behaviors, I can't precisely tell you why these changes are occurring. It may be best to consult a veterinary behaviorist in your home so that they can observe everything firsthand. You can also try using calming pheromone collars or diffusers (Feliway is one example), and discussing the use of anxiety medication with Pippin's vet. I hope that all goes well!

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Hi! My cat was recently diagnosed with diabetes. He’s taking insulin and taking antibiotics for a Uti. It’s been 4 weeks and he wobles when he’s walking. He can’t jump up on the bed like he used to.He’s blood sugar is 250 it’s better than it used to. I don’t understand why he’s so wobbly.

Cats can develop what's called diabetic neuropathy, where their hindlegs become progressively weak. The best thing to do is try to get his diabetes under control as quickly as possible. Here is a link describing the conditon: http://www.diabeticcatcare.com/DCCCOK/Neuropathy.htm

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My senior cat has metastized cancer.17 yrs old. My vet gave her predizone1 and one half tabs a day.i wanted to know if i can just stop the meds.

Is there a reason you want to stop the prednisone? I would recommend not stopping it and if you feel it is better to stop the prednisone then I would recommend weaning off of the prednisone. I would discuss how to wean the prednisone with your veterinarian. Thank you for using Boop by Petco.

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My 3 year old long haired tuxedo female pees just fine in the litter box, but she preferred to poop on the bathroom rug or on the carpet behind the sofa. Then, she will go weeks and everything is fine only start pooping outside the box again. I have 4 litter boxes and 3 cats. I clean all several times a day. She is the youngest. I've put wee wee pads down and she lifts them up and poops under them. Any ideas to help? Thanks!

A good first step, if you haven't already, is to rule out any health issues with your vet such as arthritis that may be causing the accidents. Secondly, making sure none of the other cats are bullying her away from the litter box may also alert you to any issues. Thirdly, a good enzymatic cleaner may help reduce the smell/discourage use of these areas in the future. That said, if you've done the above and the issue is still happening, it's probably time to call in a veterinary or animal behaviorist that can visit in person to see what may be going on. They may be able to check for stressors that could be causing the accidents where they are, look for issues with refusal to defecate in the box, or see if there is a cycle that is happening that is triggering this reaction. From there they may be able to set up a more tailored plan to help reduce the accidents and encourage use of the litter box at all times. If you're in the US, you can use this website to help find someone available in your area: https://www.dacvb.org/page/about

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There seems to be two wounds underneath my cat’s ear. There is not one on the other side. Does it look like ringworm or caused by fleas? What can I use to help her? It was smaller a week ago.

Thank you for contacting Boop by Petco with your question about Tor and for providing pictures, they are very helpful. Yes, I see the two wounds, and they could be caused by her scratching at her ear. While that could be due to fleas, it may be she has an ear infection causing her to scratch at her ears. Continually scratching at them would cause the wounds to get bigger. This does need to be checked out by a vet, as if she does have an ear infection, it could be caused by ear mites, yeast, or bacteria. In addition, the ear drum needs to be visualized through an otoscope to make sure it's still intact before any medication is given. Ear problems can be considered an emergency as leaving them untreated can lead to hearing loss. Given that these wounds are getting bigger, I'd see if you can get her into her vet asap. I hope this helps!

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My cat is having trouble passing a turd... He keeps producing small amounts of this brown mucous on the pee pad I have in front of the litter box, but hasn't been able to completely eliminate the actual piece. He's eating normally & drinking plenty of water, & he's at a healthy weight. I realize that I'm going to have to take him to the vet if this doesn't clear up, but in the meantime, is there anything I can do to help him?

Seeing your vet ASAP is definitely a good idea to make sure there isn't an impaction causing the severe constipation that may need an enema or stool softeners to resolve. In the meantime, you can try offering a little bland yogurt to try and help the soften the stool, as well as make sure he's drinking plenty of water by mixing some into his food, but if Booboo is in severe distress, hasn't passed any stool at all, or is having other symptoms such as abdominal pain or stops eating, you should seek out veterinary care from your vet or a local ER clinic immediately.

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Disclaimer

The information contained on this page is for educational purposes only. This medication should only be given under the advice of a veterinarian who has examined your pet under the laws applicable to your state of residence.