Enlarged Heart in Cats

Enlarged Heart in Cats - Symptoms, Causes, Diagnosis, Treatment, Recovery, Management, Cost

What is Enlarged Heart?

Your veterinarian may use the term dilated cardiomyopathy (DCM) to describe the condition of enlarged heart, specifically the loss or weakening of cardiac muscle, leading to decreased function and possibly to congestive heart failure.

An enlarged heart is a condition in cats in which the muscle of the heart increases in size due to many different possible causes. This increase causes the heart to work harder to pump the same amount of blood, resulting in decreased efficiency and possibly heart failure. Though it used to be more common, a link between taurine deficiency and enlarged heart has been established, leading cat food companies to include taurine in their food, and a subsequent significant drop-off of enlarged hearts in cats. It's worth noting that outdoor cats or those fed diets not based on commercial cat food may still be at risk for taurine deficiency.

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Symptoms of Enlarged Heart in Cats

Cats with enlarged hearts will often have a broad range of symptoms, and depending on the age of the cat, these could be mistaken for simply a sign of being elderly. Only veterinary examination can pinpoint dilated cardiomyopathy for certain. The primary symptoms include:

  • Listlessness (depression)
  • Lack of appetite
  • Weakness/sluggishness
  • Partial paralysis as blood clots become more common
  • Abnormal heart rhythm
  • Difficulty breathing, possibly with a cough

Causes of Enlarged Heart in Cats

It is widely believed now that taurine deficiency was the primary cause of enlarged hearts in cats, but with the addition of taurine to cat food, this has been largely resolved. Modern cases have no single cause that can be pinpointed, but instead there are several possible known culprits, including:

  • Parasites
  • Viruses
  • Genetic predisposition to enlarged heart

Assuming taurine deficiency is not the cause of your cat's enlarged heart, a more in-depth examination will be needed.

Diagnosis of Enlarged Heart in Cats

Your veterinarian will need to examine your cat, particularly the sounds of the heart and the ability of your cat to breathe on their own. 

If your cat suddenly stops eating, shows signs of general disinterest or extreme fatigue, has difficulty breathing, or behaves in a way that indicates partial paralysis or pain in one specific region, it is a good idea to have them examined as soon as possible. 

On examination, a veterinarian will be listening for a galloping heartbeat, a heart murmur, weak pulse and other abnormal heart rhythms. In addition, the cat's breathing will potentially be labored as fluid builds up around the heart and lungs, a condition called effusion. Further examination through blood drawing can indicate heart damage by evaluating levels of creatinine, a chemical marker of muscle breakdown, an increase of which can suggest cardiac damage. Ultimately, an echocardiogram is the best test for diagnosing enlarged heart, and will be the next procedure if the initial examination suggests cardiac enlargement.

Your vet may ask you about your cat's eating habits lately compared to normal. In addition, they will likely ask about onset of a cough, decreased energy and playfulness, if they have lost interest in toys or novelties that used to get their attention. Being clear about your cat's normal behavior versus what they have experienced since you've noticed the change can be essential in helping your veterinarian determine what they need to evaluate. 

Treatment of Enlarged Heart in Cats

Treatment for cats with enlarged hearts involves reducing swelling of the heart as well as reducing the amount of fluid accumulating in the chest. This will improve breathing and allow the doctor more time to establish a cause. If it is determined that taurine deficiency is the underlying cause of the DCM, taurine will be administered, but even in these cases, the prognosis is not good. Once cats begin to exhibit symptoms of enlarged heart, it can be too late to treat effectively. Unless your cat is not eating prepared cat food, lack of taurine is not the primary cause, so identifying the culprit takes precious time. For the most part, treatment is focused on improving heart function while a cause can be established.

Diuretics

Diuretics work by helping your cat expel excess fluids that their body might be retaining. Diuretics are usually administered orally, but depending on the condition of your pet, may be given intravenously. There is little risk here but they do not offer a permanent solution.

Antiarrhythmic Drugs

AADs work by inhibiting the impulses that cause irregular heartbeats. They are not useful if the enlarged heart has progressed to congestive heart failure, though.

Administered Oxygen

This is another stopgap, designed to give your cat's doctor more time to find an underlying cause. 

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Recovery of Enlarged Heart in Cats

If caught quickly enough, the prognosis can be about 50% for survival in cats with enlarged hearts, assuming taurine deficiency is the cause. For examples without a readily apparent trigger, expected recovery rates are very low. Even for those with taurine problems, the chance at survival is not high. Long-term management of the condition depends on the initial trigger, but once a cat has survived and the condition causing the enlarged heart is identified, it can be addressed accordingly.

Enlarged Heart Average Cost

From 570 quotes ranging from $1,000 - $5,000

Average Cost

$2,000

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Enlarged Heart Questions and Advice from Veterinary Professionals

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American Shorthair

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Ashe

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1 Year

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My pet has the following symptoms:
Pumonary Edema
Dialated Cardiomyopathy
My downstairs neighbor's cat has been diagnosed with DCM and pulmonary edema. I have a cat myself, and while they don't interact, I'm worried about it affecting her. Is it likely, or even possible?

May 16, 2018

0 Recommendations

Dilated cardiomyopathy isn’t a contagious or infectious disease; however it may develop due to a variety of reasons which may include some infections. I wouldn’t worry since as I mentioned it isn’t something which is contagious. Regards Dr Callum Turner DVM

May 17, 2018

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Domestic shorthair

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Misou

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9 Years

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My pet has the following symptoms:
Healthy.
Hi, I have a 9 year old cat who had a back issue in Oct. 2017 and was treated with some pain pills and fully recovered within a week. On the X-ray taken of her back the radiologist noted a concerning large heart that was 3 spaces wide. The vet made us more concerned about the enlarged heart than anything else, although my cat had no symptoms of heart disease whatsoever. And at that time strongly recommended an ultrasound. I did not have the funds to get the ultrasound but took my cat back to the vet in Feb. 2017 for her annual exam and shots. My cat was perfectly healthy but yet again I was strongly encouraged to get an ultrasound for my cats enlarged heart. I was told not to wait any longer and that it’s a silent killer, etc. and that they really needed to see what the inside of her large heart looked like. So today I took my cat to a specialist and paid $450 for an ultrasound which the specialist essentially said she didn’t even need - her heart wasn’t even large! It wasn’t even on the large side of normal. And needless to say, everything in side her regular sized heart was normal. I was shocked. I called her vet and they took zero responsibility for what the specialist suggested was a poor X-ray or less likely possibly an error by the radiologist who read it. The vet was so rude to me and insisted that my cat had a large heart because the radiologist’s report said so. I suggested there was an error on their part in taking the X-ray and instead of admitting any error on their part I was told that I should be grateful that my cat’s $450 test came back favorable. The vet was so rude and I am so frustrated that I was told as a fact that my cat’s heart was enlarged and pressured to get a test to see what the inside looked like and then I find out the heart isn’t large at all. I was sent to get a test that wasn’t needed because there was no large heart anyway. The vet refuses to admit anything could’ve been amiss with their X-ray. I’m supposed to speak with the owner tomorrow and would love your thoughts. Clearly something went wrong in the large heart diagnosis as it isn’t a large heart. Now I’m stuck with a $450 bill that was unnecessary to begin with and the vet takes zero accountability for their incorrect diagnosis of a large heart. It seems the likely error is in the X-ray? Additionally at my cat’s annual exam done 4 months after the incidental enlarged heart finding and absolutely no symptoms, wouldn’t it have been appropriate for the doctor to do another X-ray instead of pressure me to get an ultrasound?

April 11, 2018

0 Recommendations

The x-ray was most likely done correctly as anything which would have falsely increased the size of the heart would have affected the image quality to the point where it would have needed to be retaken; without seeing the x-ray I cannot comment, the responsibility falls on the Radiologist if they are the one which made the diagnosis. Whilst you (and I) are relieved that the enlarged heart was a misdiagnosis, it does raise some questions; if you have concerns about how this case was handled you should contact your local State Veterinary Board especially if you are disputing the cost of the ultrasound. Regards Dr Callum Turner DVM

April 11, 2018

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From 570 quotes ranging from $1,000 - $5,000

Average Cost

$2,000

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