Heart murmur

I took my cat Pudden in for a uti and the vet said she heard a murmur. She decribed it as a galopping sound. That same day she was diagnosed with diabetes as well as the uti I suspected. Pudden also suffers from asthma and is on inhaled flovent.

When i first took her in for asthma in july the ER vet said he heard a slight murmur. He did an xray and her heart looked fine. Her regular vet saw her multiple times after that and said her heart was perfect. Her regular vet is the best one in the clinic and the one I trust the most as far as skill goes.

The appt. I made for Pudden's uti was scheduled with this current new vet and she is now hearing this gallop murmur. I don't understand why sometimes it is there and others not.

I am disabled and am dipping into savings to pay for everything. I have spent over 3000 dollars in 4 months and don't have anything left. I am so worried she has heart disease, but an echo for $500 is not an option for me.

The vet wanted to do an xray but because of the bloodwork, urinaysis and insulin the bill was $400 and I couldn't afford the $200 xray too.

Can a vet prescribe heart medication with only an xray if I save up for it? Her other xray was normal, but that was in July and I worry it might have changed since then.

I don't know Puddin's background, but I do know I have had a couple of cats who contracted heartworm (only 2 in 40+ years) and the symptoms are not unlike asthma, and the galloping heart rhythm was also a clear sign according to my vet. 

From the American Heartworm Society:  "Heartworm disease in cats is very different from heartworm disease in dogs. The cat is an atypical host for heartworms, and most worms in cats do not survive to the adult stage. Cats with adult heartworms typically have just one to three worms, and many cats affected by heartworms have no adult worms. While this means heartworm disease often goes undiagnosed in cats, it’s important to understand that even immature worms cause real damage in the form of a condition known as heartworm associated respiratory disease (HARD). Moreover, the medication used to treat heartworm infections in dogs cannot be used in cats, so prevention is the only means of protecting cats from the effects of heartworm disease."  https://www.heartwormsociety.org/pet-owner-resources/heartworm-basics

With the asthma and the gallop rhythm, I would definitely ask your vet to do a heartworm test (not expensive) and if positive, then use ultrasound to find the worm.  (Unlike dogs, cats rarely have more than one or two worms, often just one.)  Chances are that your cat's symptoms are NOT caused by a heartworm, but if they are, you will know what you are up against and have a choice in how you want to handle it.

Signs of heartworm disease in cats can be very subtle or very dramatic. Symptoms may include coughing, asthma-like attacks, periodic vomiting, lack of appetite, or weight loss. Occasionally an affected cat may have difficulty walking, experience fainting or seizures, or suffer from fluid accumulation in the abdomen. Unfortunately, the first sign in some cases is sudden collapse of the cat, or sudden death.  One of  mine had been to the vet in the afternoon, and the vet commented on her gallop heart rhythm but did not connect it to heartworms since that is rare in cats.  She got worse in the evening and I called the vet back and even though she was officially ON CALL she would not come back in because she said she didn't know what to do.  The poor cat later died in my arms, unable to breathe, and I have never forgotten that.  It would have been kinder to put her to sleep, but of course I didn't know what was wrong with her.  They never tested her for heartworm or did an ultrasound, which would show a live worm, or even a dead worm if it had not yet dissolved and broken into pieces.  (I don't think an x-ray would show a worm but ultrasound does.) The second cat that got heartworm years later was in the same state, but my vet here did come in and we did put him to sleep.  It was too late to remove the worm.

In cats, often the heartworms are not at all symptomatic while the worm is alive, but when they die, they get flushed into the lungs by the blood flowing through the heart, and in the lungs they cause an inflammatory reaction which can lead to fluid in the chest and difficulty breathing.  Symptomatic treatment consists of fluids and steroids.  If you do a heartoworm test and it is positive, that is diagnostic.  Cats cannot be treated like dogs can.  The only successful treatments I know of consisted of surgically removing a heartworm BEFORE it died and caused problems.

There was n article being worked on for this last year.  I will include it in the next message.

Here is a copy of the article still in draft form.

“Heartworm? I thought only dogs got that?”

That’s a common response, but not true. Cats can get heartworm as well as dogs, but it’s harder to diagnose and often more serious for that reason.

Heartworm comes from the bite of an infected mosquito. Microscopic larvae then travel through the cat’s system, at first in body tissue. After three or four months, they migrate to the arteries and blood vessels in the lungs. This is where the females grow into mature worms, ready to produce offspring. It takes about eight months - that is one month longer than in dogs.

If a mosquito bites Kitty during this period, it can draw the offspring into its system. Then the mosquito can infect other cats or dogs and perpetuate the cycle.

Cats are somewhat resistant to heartworms and sometimes, if they have a strong immune system, can spontaneously rid themselves of the worms. It appears the heartworms die because they fail to thrive in the body. However, this is not common, so treatment is needed, as heartworm can be fatal.

One difference is that cats develop fewer and smaller heartworms than dogs do. Those worms live two to three years, compared to five to seven years in dogs. While that news is good, the worms can still cause a lot of damage to Kitty’s lungs in the meantime. If the female heartworm produces offspring, the cycle continues.

Even though the worms are small by human standards, cats can show symptoms with as few as one to three heartworms living in the heart. What are the symptoms?

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  Difficulty breathing
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  Coughing
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  Vomiting
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  Lethargy
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  Loss of appetite
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  Weight loss

Severe reactions include shock and respiratory distress, a diagnosed heart murmur or sudden death. Dr. Cathy Alinovi, a veterinarian with a rural practice in Pine Village, Indiana, says heartworms live between the right and left side of the heart. If the worms crowd the opening that allows for blood flow, the results mimic a heart attack - the cat will fall over and die, even mid-step. This can occur in cats of any age.

One of the problems with heartworm in cats is that the test that works well for dogs doesn’t do as well for cats, since cats tend to have fewer worms to detect. “Other helpful diagnostics include radiographs (x-rays), an echocardiogram (an ultrasound of the heart), complete blood count (CBC), internal organ function testing (chemistry), and fecal exam (to rule out parasites that can live in the lungs and cause coughing),” says Dr. Laura Theobald of Lap of Love Veterinary Hospice.

A common misconception is that indoor cats cannot get bitten by mosquitoes. Think how often you’ve swatted a mosquito indoors or been kept awake by the whining buzz of one trying to attack you in your sleep. Kitty can be a victim, too. If you live in an area where mosquitoes are a common problem, use a monthly preventative designed just for cats. NEVER use a heartworm drug designed for dogs or for cats of a higher or lower weight.

There is no treatment for heartworm in cats. The use of the monthly preventative will make sure no offspring grow into worms and will weaken the existing worms and shorten their life span. In severe cases, cage confinement, IV fluids, or oxygen therapy may be needed. If the lungs are inflamed, a small dose of prednisone can help, but be aware it also increases a cat’s need for fresh drinking water and can cause a larger than usual appetite—which also means more trips to the litter box.

If Kitty is showing any of the symptoms and there’s no other diagnosis to explain them, it’s time to test for heartworms. It could save her life.

I took her to her regular vet today. She listened for a long time and said there was no murmur. She believes if one was heard it was most likely caused by stress. Pudden has no symptoms and this vet is very skilled so I trust her judgment. I am so relieved!