Delilah's heart murmur

Delilah finished the last of her kitten shots today. The vet noticed a heart murmur last month when Delilah was there. It has been the same since. The vet recommended she see a cardiologist and get an echo to completely diagnosis it. I would have to take her to NC State to do that and it would be expensive.

I have never had a cat or kitten with a heart murmur so I don't know if I should try and come up with the money to take her to the cardiologist or if I should wait and see if it gets better as she gets a little older. I don't even really know what questions to even ask. I didn't think about this today but I will ask when I have a chance to talk to the vet, but will having a heart murmur be something I should worry about when she gets spayed. We are planning on doing it about mid September as long as everything is good.

My biggest fear already is losing Delilah for some reason. It may be irrationally as she is doing really well, the heart murmur is the only possible concern. I love all my babies, but there is just something special about Delilah. I have never had such a bond with any other animal.

Any wisdom or experience of what I should do or know is greatly appreciated.

Look at it this way.  Maybe 20 years ago, you would have had no clue about the heart murmer.  Heck, I had a heart murmer when I was young, too.  She may outgrow it.  It may shorten her life.  But there's not much you can do about it.  The cost of additional test would only serve to use up money that you could put to use for regular vet visits, etc.  If I were in your shoes, I'd save the money, enjoy Delilah every day, and hope ever day becomes many years.
 

Was the vet surprised to hear a murmer? I assume it just started recently. If Delilah was near the end of her life instead of the beginning, I would say it is probably an age-related disease. Considering she is still a tiny kitten, I can't imagine the problem would be any of those conditions.

If a heart murmer interferes with spaying in any way and is still present next month, the vet will cancel the surgery. There may not be a problem with it. If your vet is not worried about the spay surgery, I'm not either.

Did the vet give you an idea of how severe it is?

In some cases you can get the vet to do the scan, and send them off to someone certified for reading. I wouldn't risk getting her spayed without knowing more about how severe things are.

She didn't say how sever it was, just that it is stable. It has sounded the same the last 3 times we have been there. I can call on Monday when she is there, unless the severity is listed in her chart then I could just call and ask tomorrow.

I'm agreeing with Mr Blanche on this one

3 years ago my new vet found a murmer in Jack who's now 5 years old. He said it was very faint and if he had to put it on a scale of 1-5 he would say 1

I panicked naturally and asked if he should have  a cardiogram or medication?, but he said no. I asked if l should stop him running around as much because Jack goes full pelt when he plays, especially when he has his night time crazies, but again he said no and to just let him carry on as normal.

If it hasn't changed in the last three visits l wouldn't worry, but find out what grade it is. But as someones said, if the vet wasn't happy about spaying they would have said something to you

When Flowerbelle developed a murmur (detected for the first time in November of last year, she just turned nine), the vet said it's a grade 2. Given the way it sounds, they think it's a valve, not deterioration of her heart muscle. In a kitten Delilah's age, I suspect it's a valve, not heart disease per se.

I have a murmur, it's "mitral valve prolapse." What that means is that sometimes the mitral valve in my heart doesn't close all the way. It creates a little backflow. The only thing it affects is dentals. I need to take antibiotics before I have work done on my teeth. My heart can beat fast and weird for really short periods of time if I'm really physically active or really stressed. But I just feel it rushing and fluttery, and it goes away quickly. It doesn't hurt or anything.

The vets went back and forth on whether we should get an echocardiogram done, or a cardiac ultrasound. They settled on cardiac ultrasound. burretje just went through something similar with her kitty, Zeya: http://www.thecatsite.com/t/246718/possible-hip-dysplasia-and-heart-problem

You might want to ask the vet if you could consider a cardiac ultrasound for Delilah instead of an ECG. :dk: That you may be able to do closer to home? :dk:

At some point you probably will want an ECG, just to get a baseline, so you can compare in the future to see if there are any changes. But given what's involved, for now perhaps an image of her heart would be more helpful to see what the issue is? :dk:

Just yesterday, we had to euthanize our precious 4-year-old male (domestic shorthair) cat, Yuki. He had been a robust, active cat up until about 2 months ago, when we noticed a decrease in his appetite. Thinking that maybe a tooth was bothering him, we took him to our vet. She immediately informed us that Yuki's heart rate was in the 300s when it should be like 160-180. She then took an Xray which showed clearly that his heart was thickened and mis-shapen. She said he had hydrotropic cardiomyopathy and said we needed to rush him to the emergency vet clinic who had a cardiologist on hand. Long story short, after an ultrasound was done and medication given to lower his heart rate, we basically got the diagnosis that our young cat had only months, not years to live and that he would need to be medicated for the remainder of his life. Our precious boy was dying. To say that my husband and I were devastate by this news is an understatement. Since his diagnosis in the middle of June, I have been doing a ton of research on this insidious disease. It is the #1 killer of kittens and cats under six-years-old. Our vet has seen a kitten as young as 10 months old die suddenly from HCM. The reason why I felt compelled to reply as regards your precious Delilah was that heart murmurs are many times a precursor to HCM...a disease that is sort of a hidden killer as what generally happens is there are no outward signs of it except sudden death or symtoms like coughing, gagging, labored breathing...and by then, it's generally too late. What we also discovered is that even the best kitty cardiologists don't know how to treat a cat with heart disease. Much more research needs to be done. Right now, they just use human heart meds...Our cardiologist prescribed like 6 different meds...which we administered to Yuki for a week (1 was an injection) until we just said NO MORE! We only cared about giving him a quality of life for the little time he had left. Both our vet and cardiologist were informed that we stopped meds and were fine with it...as Yuki's HCM was so advanced and his prognosis so poor. It is hard enough to say goodbye to our older furried buddies, but to lose a cat this young has been the biggest heartbreak of all. Because of our experience with HCM, I hope that I can help at least one cat guardian and their precious cat. I think a baseline ultrasound might be a good idea. If caught early enough, many cats do very well on medication and can live normal lives...if you catch it early. So please do ask your vet about HCM. I hope this helps and I wish you and Delilah the very best.

I'm so so sorry about your Yuki. :heart2:

CatNamedPanda, a heart murmur does not necessarily mean heart disease and does not necessarily mean hypertrophic cardiomyopathy (HCM).

A heart murmur is an abnormal heart sound caused by the vibration of turbulent blood flow. Normally, blood flow is laminar and very quiet. Having a heart murmur is not itself an illness or disease. It is a characterization given to an abnormal sound heard upon auscultation over the region of the heart. Cats of any age, breed or gender can be born with or later develop heart murmurs.

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From: http://www.petwave.com/Cats/Health/Heart-Blood/Murmurs.aspx


More information on murmurs vs heart disease: http://www.petmd.com/cat/conditions/cardiovascular/c_ct_heart_murmur#.UCV1OaMsHwM


Yes, it needs to be determined what is causing Delilah's heart murmur. :nod: Hopefully it is just a structural problem that doesn't need correction, like I and many people have. :nod:

One of my babies was diagnosed with a heart murmur when he was approx 5 months old. The vet strongly suggested that I wait to have Gabe neutered because she was unsure if there was a problem with his heart and did not want to be responsible for something happening to him.. She gave me the option of waiting a month, have him come back in so that she could listen to see if it was still there. If it was wait another month recheck and keep doing that until he reached 7 months to see if it went away or get an ultrasound then. Some kitten outgrow it. We waited the month, she rechecked him. During that time I was so upset over it, waiting was hard. After the one month checkup and it was still there I decided to take him to get the ultrasound because I wanted to know definitely. He is a 1 on the scale. The cardiologist found that the left side of his heart wall had a slight deformity and told me to bring him back in 1 year, if all was ok no changes, bring him back a year after that. If no changes it would be safe to say he was fine. Today was his one year checkup and they found that the right side is now showing an ever so slight change. There is no way of knowing if it will progress and he will have to be put on meds at this point. So it is a waiting game. I am upset over it, being told my 18 month old baby has the heart of a 70 year old human, but am trying to look at it this way... If it gets worse at least they will have caught it early enough that he will be put on meds and have a longer life than if they didn't know and he ended up going into congestive heart failure. His normal vet treats him as though he has cardiac disease, being very cautious in how they handle him. They did neuter him but used a sedative that they would use on a older cat or one that has health issues. I believe I made the right decision with the ultrasound. I hope it works out for you and Delilah.

I wasn't going to reply, but I can't not, when I lived it, and know, exactly, what to do, and, you can't do nothing, and you can't wait and see, and you can't blow it off.

He was diagnosed at 10 months old, his was genetic, Maine Coon.

Bear with me, this is very very difficult.

HCM is hypertropic cardiomyopathy. It means the left ventrical does not work properly. It should open and shut, like your front door, instead, it swings like a saloon door.  It lets in too much blood, or not enough. Grades are 1-6, with 1 being moderate and 6 being severe. He was a grade 3.  

When vets detect a heart murmur, they can estimate the grade, in most cases, they are right. The next step is to do an x-ray, to see if there is fluid on the heart or lungs, this, is not good.  Then they do a CBC and Wellness blood panel, you want it sent to Antech or Idexx, you want, them involved, to see if any values are not normal, and if there are any other issues that need to be dealt with, which, is also not good, you want the values in the normal ranges.  Then they need to take his blood pressure. The next step is the cardiologist, and you take the x-ray and blood panel with you. They do an ultrasound. This is the only way to properly determine, the grade, exactly what they are dealing with, and what is the appropiate treatment.

2 Cardiologists said he would not live past 1 yr old. I said, find me another cardiologist, he was sent to UC Davis, that man, Dr Mark Littleton, saved his life.

He was put on a med, to slow the heart rate, Atenenol, which I can't spell, they started at a very low dose. He was also put on a blood thiner, baby aspirin, 81 mgs, one every 3 days. He had no fluid, so he did not have to be put on Lasix. His blood pressure was within the normal range, so he did not need to be put on blood pressure meds.  

Besides the meds, depending on what they find, the following is the most important, if your not willing to do it, then might as well, not do the above. Its not an automatic death sentence, it is very manageable, but, there are no guarantees.

The kitty needs to be put on a grain free, by product free, gluten free, soy free, and LOW IN SALT food.  The low in salt, is imperative. Dr Littleton beyond, stressed the low in salt. 

You need to feed wet, mixed with water, so its soupy, you have, to keep them flushed out.   If kitty won't eat wet, which he wouldn't, then you mix 1 teaspoon Gerber baby food, chicken or turkey ONLY, with water, so its like a broth, twice a day.

You have to only use purified drinking water, not spring water, not distilled water, but purified drinking water, I use the store gal jug, its like $1.00, some use Brita, some use PURR.  Tap water has too many minerals in it, you need, to avoid, crystals, bladder issues, urinary issues.

You have to, keep the household stress free, have to, no yelling, fighting, lot of people over, loud big parties, no picking on by other family members, frends or other pets. You can let them play normal, you just have to avoid the stress, have to.

You have to be very diligent in what meds he is given. You have to ask the vet, is this safe, for a HCM kitty, never accept,  I don't know or probably, make, them look it up. Never never never give any over the counter meds, without checking with the vet first, never never never try to treat him yourself. Some meds that can be safely given to a normal cat, will kill a HCM kitty, Centrine is one, it will kill a HCM kitty. Its an antispazmodic, for upset tummys.  Any change in medical condition, he has, to go to the vet, you cannot wait.

You now have a cat that has a weakened immune system, similiar to a young child or elderly person.  All the above, is preventative, because his immune system is weakened, you have to take special care, like you would with a young child or elderly person.  You want to give L-Lysine, its an immune booster. you can get it in the human vitamin section. Get a good brand, one that does not have any fillers in it, it will say so on the bottle. The capsules are easier to break open, you mix the powder with the wet food, use at least 1/2 3.0 oz can, some won't eat it, he wouldn't. If you can't find the capsules, you can get the pills, just smush them up into a powder.   The usual dose is if the kitty is under 9 lbs, you give 250 mgs once a day, if kitty is over 9 lbs, you give 250 mgs, twice a day. Kittens would get 250 mgs once a day, it also depends on how the kitten is, your vet would know, and you need to run this by your vet too.

What you need to watch for, is if they have trouble breathing, if they are limping/not using one paw/leg, if they are coughing, and its not hairballs, this one, is tough to tell, call the vet and ask, the very worst one, is if they are dragging their hind legs, as in, they cannot use them, that one, means they threw a clot, its lodged in the V of where the back legs come together, this one, is, its pretty much over.  Any of these, is take them to the vet or the ER, like right now.

He was diagnosed at 10 months old. He threw a clot, could not use his back legs. The ER called in a Critical Care Specialist and ICU Specialist, just for him, they were waiting for him.  My vets husband also works there, sadly, he was not on duty that day, I could have used the support. There was just nothing more they could do for him. He was put down on Friday April 13 at 11 am.  He was only 5 yrs old.  The specialsts talked to my vet, then I talked to her. I pretty much already knew.  She said its time.   My very sweet baby boy, the love of my life, was gone, taken from me, so very young.

Until that morning, you would never have known, there was anything wrong with him. He was very happy, he loved his mommy, he ran and played.  It can come on, that quickly.  

His was genetic, he was fighting a battle that could not be won. But, he lived 4 yrs longer, than he was supposed to, and he loved his mommy, I got him when he was only 8 weeks old.   

When he was diagnosed, I did extensive research on HCM, I talked to about a zillion breeders and vets, anybody who could give me any information. If you do a search for Maine Coon HCM, you will find a plethera of information.  

Hope this helps, and please don't hesitate, if you have any questions. If you want to talk, email me, [email protected]

(((((((((((((((BIG HUGS)))))))))))))              

FlintMcCullough said:

I wasn't going to reply, but I can't not, when I lived it, and know, exactly, what to do, and, you can't do nothing, and you can't wait and see, and you can't blow it off.

He was diagnosed at 10 months old, his was genetic, Maine Coon.

Bear with me, this is very very difficult.

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And I'm sure the OP will be very appreciative that you shared this. I'm so sorry about your kitty. :heart2:

FlintMcCullough said:

HCM is hypertropic cardiomyopathy. It means the left ventrical does not work properly. It should open and shut, like your front door, instead, it swings like a saloon door.  It lets in too much blood, or not enough. Grades are 1-6, with 1 being moderate and 6 being severe. He was a grade 3.  

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...but not all heart murmurs are caused by HCM, and in your kitty, it was the left ventricle, but it can be either. Heart murmurs can also be structural in nature, as discussed in the links I provided earlier.

Here is an easy to understand overview of HCM: http://heartdisease.about.com/cs/cardiomyopathy/a/HCM.htm

In fact, there is now a blood test for HCM. It detects the enzymes released during the process. This is the test: http://www.idexx.dk/animalhealth/laboratory/probnp/

Thanks.     Had to go in Wed for a booster shot.  He has to be pretreated and I waited a good 30 min in the waiting room afterwards, just in case. It was the first time, I had been in a vets office, since he was put down in the ER. Then a couple brought in a very old dog, she couldn't even walk, large dog, they were carrying her.  The lady was crying. I knew why they were there. I started to cry uncontrolable, it brought it all back. No one asked why, just as well, didn't want to talk about it any how.

Any kitty can have HCM or a heart murmur or heart issues, doesn't have to be a breed/registered cat.  Maine Coons and Ragdolls are prone to it, as are some other breeds, including Persians.  It can affect only one kitten in the litter, boys are more prone, but girls can get it too. It can also skip a generation.  His was genetic, traced it back to his grandmother, on his mothers side, his mother was spayed and taken out of the breeding program, his grandmother, thats a very long story, not owned by the breeder.  

But your right, each situation is different, the grade different, the treatment different, I only related his story.  But the principals are the same, you have a kitty that has a weakened immune system and you have to take preventative measures.

Back in the 60's, when I was a kid, we had a show horse farm, one was diagnosed with a heart murmur.  The vet said, most would just put him down, but you have so much pasture, just turn him out and leave him alone. We did for years. One day, my father said, to the vet, as long as you are hear, check him. The vet said, his heart murmur is gone, go ahead and ride him, and yes, you can show him. We did, he did real well, and lived to be an old horse, one day he died in his stall. Might have been the heart murmur came back, might have been something else.  Who knows, didn't have the medical knowledge back then, we have today.  Each horse is different, each cat is different. 

The Winn Foundation has been doing testing on Ragdolls. They identified one gene, but they still don't know, what causes HCM in MC's and RD's. Haven't checked the site in awhile.   Earlier in the year, they were looking for Maine Coon's to volunteer test, something about linking diet or something, forget now what, it was alot of months ago. My vet said he could go, the test was I believe in June, too late for him.  

Wish they could of traced it back, like they did with Impressive and HYPP.   Now AQHA, ApHC, PHBA has mandated DNA tests, ya got it, ya can't register the foal, made the breeders police theirselves, wish CFA would.  If CFA would follow what AQHA does, it would eliminate, half their issues.  My first CFA show, I went to the check in desk, with registration papers and health papers in hand, and asked, where is vet check?  They looked at me, like I had 2 heads. First show they asked, ah ya. We don't have vet check, they said. That floored me.  Most horse shows, your not getting your number or your stall, without them, and some shows, your not even getting on the grounds, without going thru vet check.  And, if the vet sees something that don't look right, he can pull your horse off the trailer.  If you refuse, have a good trip home.    

Saw where this post was headed, had to share his story.   I still cry about him.        

FlintMcCullough said:

Thanks.     Had to go in Wed for a booster shot.  He has to be pretreated and I waited a good 30 min in the waiting room afterwards, just in case. It was the first time, I had been in a vets office, since he was put down in the ER. Then a couple brought in a very old dog, she couldn't even walk, large dog, they were carrying her.  The lady was crying. I knew why they were there. I started to cry uncontrolable, it brought it all back. No one asked why, just as well, didn't want to talk about it any how.

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My heart hurts for you!

FlintMcCullough said:

Any kitty can have HCM or a heart murmur or heart issues, doesn't have to be a breed/registered cat... But your right, each situation is different, the grade different, the treatment different, I only related his story.  But the principals are the same, you have a kitty that has a weakened immune system and you have to take preventative measures.

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Exactly. I just didn't want poor CatNamedPanda freaking out, when it may not be HCM, and if it is, it may be treatable. :heart2: :cross:

FlintMcCullough said:

Saw where this post was headed, had to share his story.   I still cry about him.        :high5:

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LDG said:

Exactly. I just didn't want poor CatNamedPanda freaking out, when it may not be HCM, and if it is, it may be treatable.

 

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I agree, a heart murmur doesn't mean HCM and without further testing there's no point in worrying the OP. A low grade murmur can also clear up all on it's own

Good breeders are screening for HCM, unfortunately it also shows in moggies. I'm unaware of Persians having it, Ragdoll, Maine Coon and Bengal breeders screen here, it's quite prolific in some Bengal lines and some negative cats are producing HCM kittens. A lot more research is needed.

Hope had a heart murmur detected twice by a vet, and she has gone twice to another vet afterwards, and he couldn't detect anything.
Both vets however, said to watch her. To not worry too much about it - if she is acting healthy, playing, eating, acting completely normal, she is fine for now - we keep monitoring, and seeing if they can listen to the murmur.
I did ask about HCM - they said the majority of murmurs is not HCM. It would be completely my choice to test her..... But he didn't feel it was necessary..... Not at this point.
On her last consult, he couldn't detect anything..... Hope is a DLH, I might do the test next year, but for now, I am not too concerned.....
To he OP: Try to not draw conclusions too early.... I know it is hard, especially with a little one, Delilah, who you have gone through so much with already :heart3: But lots of kitties have murmurs and are just fine :cross:
Hopefully that will be the case too :cross:
You should ask for the grade though - knowing the severity will really help

I still feel, a heart murmur, or any medical issue, should be investigated, and the tests done, to see what one is dealing with.  As most on here feel, yes, it could be nothing.   But, what if it is something, and testing and taking the appropiate steps/medication/care, could manage it, help it.  What if one chose not to do anything, and down the road, find out, it was something, and could have been treated, per say, all this time. 

My horse vet used to tell me all the time. I would rather have you call and ask me, and I tell you its nothing, or keep an eye on her, than to have to tell you, gee, ya should have called sooner, now, its too late. 

Granted, his was genetic and his was serious, but, we didn't know exactly what we were dealing with, until we did the tests. His too, started, as a heart mumur, during a wellness exam. 

This is just my opinion, lol, doesn't mean I am right, doesn't mean I am wrong.  The other posters are giving their opinions too, doesn't mean they are right, doesn't mean they are wrong, lol, each cat is different, each situation is different.  

At least get an x-ray, that is ballpark $85, it will show if, the heart is enlarged, and will show, if, there is fluid around the heart and lungs.  If its not enlarged, then great, and take the wait and see route, but, if it is enlarged, then you have some decisions to make.  At least get a CBC and Wellness blood panel, that is ballpark $45, that will show, if any values are not normal, and if they are, then you can decide weather to pursue that or not.  

I look at it, like, what if your doctor, told you, you had a heart murmur, what would you do?  Wait and see, or, do some tests?

And yes, lol, I am overly pickey about my babies, lol, very well known for it on the circuit, and, very proud of it, lol.  

Best of luck with the kitty, I hope it is nothing, but if ya ever need help, I and the others, are always here for you.  (((((((((hugs))))))))))

        

FlintMcCullough said:

I still feel, a heart murmur, or any medical issue, should be investigated, and the tests done, to see what one is dealing with.

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And I don't think anyone is recommending otherwise.

We were just trying to make it clear that it isn't necessarily a life-threatening condition, which is how several posts sounded. :rub:

Thank you everyone for your thoughtful responses.

Yuki and Flint I am sorry for your losses.

Before I let myself freak out too much I am going to call my vet on Monday and find out the grade is and talk about maybe doing an ultrasound for starters and go from there. Don't worry I will do whatever I can for Delilah. I will have to save up to be able to afford to take her to State. Luckily it is only a little over an hour away and where I grew up so I could stay with my parents. I will of course make sure that she would be safe to spay before I do it as well.

I will let you all know what I find out on Monday and just take this one step at a time.

LDG said:

In fact, there is now a blood test for HCM. It detects the enzymes released during the process. This is the test: http://www.idexx.dk/animalhealth/laboratory/probnp/

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This is VERY interesting. I would ask the vet about doing this. Seems like this diagnostic is very new, so your vet may not know about it.

LDG:

I'd be ver curious to know how effective this is compared an ultrasound in diagnosing hcm. Also, how well does it work in a very early stage - since Delilah is a kitten? Do you know?