Found Clot in Cats Heart, lots of Questions

I am hoping to get some people's experience with this and opinion on what to do.

I found out this week that my 15 year old cat has a large clot in his heart. He has not thrown it yet and Is not in heart failure. What I am told is that he has an enlarged heart and some fluid outside of it. With the clot I believe on the left side. He also has high blood pressure.

I am wondering if all cats eventually throw this clot to their legs? He is on a cocktail of medicine now but none of it look so like it will dissolve the clot. Is it possible the clot can get smaller or disappear?

If he is eventually going to throw it then should I put down now to avoid what seems extremely painful? My vet said no but the more I read I am not sure I'm doing the right thing.

I got a webcam to watch him while I'm working etc. My fear is that something will happen when I'm not home and he will suffer for hours. I figured if I see and hear something wrong I can run home.

He is fine otherwise, having only dialated pupils which I think is from high blood pressure. I happen to stumble on this horrible discovery bc he had been getting bad cases of diarrhea every 3 to 9 months(see other thread), so they did an ultra sound. His intestines looked fine.

When I say he said doing good I mean he is running playing eating using the litter box, resting comfortably. Quality of life seems good right now.

Also note I have been told he has had a heart murmur his whole Life but no vet ever made it sound like a urgent thing or that I should be worried.

Meds he is now on, he has not had a problem taking these at all. Putting in pill pockets and adding a treat on top. He eats right up.

-furosemide
-clopidogrel
-pimobendan
-amlodipin

Thanks so much for any helpful comments.

Have you taken your cat to a specialty hospital for evaluation by a Vet Cardiologist?  They will do a thorough workup and give you options.  No I do not think your cat will necessarily throw the clot.  Sometimes with hospitalization, the Vet can dissolve the clot with medications.  The meds he is on now are all standard, good heart meds, but I would seek a cardiology workup soon to explore further options.

I need to schedule his next appointment in 7-10 days. For a blood pressure check and radiographs which I think is another xray.

Ill make sure to make an appointment to alsospeak with the cardiologist which I'm sure will cost more money but I need to further talk this out.

After this next test they say to come back in 3 to 6 months for the echocardigram.

My anxiety is so high over this. I cannot relax. I am so terrified for what's to come it's killing me.

I have debated all day if I should just put him down now so he won't suffer. It am staring to lean towards that thinking I came across this discovery of the clot for a reason.

I am really at a lose for this whole thing and not sure how to proceed.

Do not put your cat down prior to consult with Vet Cardiologist.  I think you would be second guessing yourself from now on if you did that.

I lived with this same fear with a cat I had.  She was diagnosed at 15 with Hypertrophic Cardiomyopathy, but under the care of an excellent cardiologist, and with proper medications, she lived a good life until almost 20.  It was the kidneys that gave way, not the heart.

Call Monday morning for the earliest cardiology appointment.  Hang in there; don't stress unnecessarily.

Thank you this helps a bit.

Did your cat also have the clot? That's the thing that is so concerning. It's only a matter of time when he throws it.

I actually have an appointment just to have a cardiologist look at the results. I wasn't going to bring my cat. I have his follow up appointment on March 29th.

It's a long story but when I orignally went to the hospital I was an outpatient and just had my vet read me the results.

This is before I knew I was dealing with something so serious. I never got to talk over my results with the cardiologist and wish I would have. I have so many questions I never got to ask. I was on the Internet all day and read the most horrible things and now convinced myself putting down is the best.

My vet has been doing a great job relaying the information but she's not an expert in this area.

Lesliel76 said:

I am hoping to get some people's experience with this and opinion on what to do.

I found out this week that my 15 year old cat has a large clot in his heart. He has not thrown it yet and Is not in heart failure. What I am told is that he has an enlarged heart and some fluid outside of it. With the clot I believe on the left side. He also has high blood pressure.

I am wondering if all cats eventually throw this clot to their legs? He is on a cocktail of medicine now but none of it look so like it will dissolve the clot. Is it possible the clot can get smaller or disappear?

If he is eventually going to throw it then should I put down now to avoid what seems extremely painful? My vet said no but the more I read I am not sure I'm doing the right thing.

I got a webcam to watch him while I'm working etc. My fear is that something will happen when I'm not home and he will suffer for hours. I figured if I see and hear something wrong I can run home.

He is fine otherwise, having only dialated pupils which I think is from high blood pressure. I happen to stumble on this horrible discovery bc he had been getting bad cases of diarrhea every 3 to 9 months(see other thread), so they did an ultra sound. His intestines looked fine.

When I say he said doing good I mean he is running playing eating using the litter box, resting comfortably. Quality of life seems good right now.

Also note I have been told he has had a heart murmur his whole Life but no vet ever made it sound like a urgent thing or that I should be worried.

Meds he is now on, he has not had a problem taking these at all. Putting in pill pockets and adding a treat on top. He eats right up.

-furosemide
-clopidogrel
-pimobendan
-amlodipin

Thanks so much for any helpful comments.

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I am a semi-retired human cardiologist, not a veterinary one.  The only occasion that a cat, or a human, could have a clot of blood in one of the cardiac chambers would be if an auricle was to stop its regular beating due to a disturbance of the cardiac rhythm called 'atrial fibrillation' causing the heart to beat irregularly. 

A murmur is not a disease in itself but the noise made by blood flowing over a damaged heart valve, or in the case of cardio-myopathy, when an enlarged ventricle interferes with the flow of the blood and causes eddies. The disturbed blood flow can be heard over the heart using a stethoscope.

The treatment that has been prescribed already is for heart failure, (when the heart fails to pump the blood around the body adequately and it accumulates in the lungs and limbs.) 

A likely diagnosis, that should be checked with the vet, as I am not a veterinarian, is  that your cat has cardiomyopathy (a disease of the heart where the muscle of the heart enlarges and grows weaker). 

High blood pressure can also damage the heart muscle, but this high blood pressure can also damage the kidneys.  His kidney function should be assessed too; this is a factor that you should consider before deciding on euthanasia.  You would certainly NOT wish to put him down if his kidneys are normal.

No, I do not think that you should consider euthanasia at this stage, heart failure is not painful, and you say that your cat is still enjoying cat-life.  The main symptom that would interfere with his wellbeing is shortness of breath and this symptom would be the one that would decide you on euthanasia, assuming that he has normal kidney function. 

Incidentally as he has had time to form a large clot in his auricle without throwing a piece off so far, it is unlikely that he will ever throw off a piece of clot, (a condition known as embolisation).  With anticoagulant treatment, the clot could become more fibrotic and never be a danger for embolisation, so do not be too alarmed because of the discovery of the clot.  You should discuss all these things with your vet.

His dilated pupils could be due to a side effect of the medication, but this is unlikely to cause him any distress.

With all best wishes to you and your cat,

Geoffrey

Geoffrey, the semi-retired human cardiologist gave you some EXCELLENT advice!  I would heed it and discuss your concerns with the Vet cardiologist very soon. 

Don't make rash decisions without knowing all the facts.  While my cat did not have a clot in the heart per se, I knew a clot could form and break off at any time.  But this likelihood, was minimized by proper medication and expert care by the Vet cardiologist.  Heart disease in cats can be well managed, just as it can in humans.  Maintaining good kidney function is very important also.

I hope some of your fears have been allayed.  It sounds like your cat is enjoying life right now...and hopefully for many more years!

Geoffrey said:

I am a semi-retired human cardiologist, not a veterinary one.  The only occasion that a cat, or a human, could have a clot of blood in one of the cardiac chambers would be if an auricle was to stop its regular beating due to a disturbance of the cardiac rhythm called 'atrial fibrillation' causing the heart to beat irregularly. 

A murmur is not a disease in itself but the noise made by blood flowing over a damaged heart valve, or in the case of cardio-myopathy, when an enlarged ventricle interferes with the flow of the blood and causes eddies. The disturbed blood flow can be heard over the heart using a stethoscope.

The treatment that has been prescribed already is for heart failure, (when the heart fails to pump the blood around the body adequately and it accumulates in the lungs and limbs.) 

A likely diagnosis, that should be checked with the vet, as I am not a veterinarian, is  that your cat has cardiomyopathy (a disease of the heart where the muscle of the heart enlarges and grows weaker). 

High blood pressure can also damage the heart muscle, but this high blood pressure can also damage the kidneys.  His kidney function should be assessed too; this is a factor that you should consider before deciding on euthanasia.  You would certainly NOT wish to put him down if his kidneys are normal.

No, I do not think that you should consider euthanasia at this stage, heart failure is not painful, and you say that your cat is still enjoying cat-life.  The main symptom that would interfere with his wellbeing is shortness of breath and this symptom would be the one that would decide you on euthanasia, assuming that he has normal kidney function. 

Incidentally as he has had time to form a large clot in his auricle without throwing a piece off so far, it is unlikely that he will ever throw off a piece of clot, (a condition known as embolisation).  With anticoagulant treatment, the clot could become more fibrotic and never be a danger for embolisation, so do not be too alarmed because of the discovery of the clot.  You should discuss all these things with your vet.

His dilated pupils could be due to a side effect of the medication, but this is unlikely to cause him any distress.

With all best wishes to you and your cat,
Geoffrey

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Geoffrey thank you so much for your professional opinion. I really appreciate it. I wont be talking to the cardiologist till Wednesday next week. The appointment I had wont see me without bringing him in. It doesnt make sense to bring him in right now, it would bee too early for the test and bloodwork he needs.

I am upset that I did the intial visit as an outpaitient.

As far as I know his kidneys are ok. His bloodwork has come back good. But on the ultra sound report, its says the following. Maybe you can help translate:

"The kideys have moderate loss of corticomedullary distinction billaterally. The kidneys are upper limits of normal in length (r 4.7cm,L 4.6 cm) There is no pelvic dilation billaterally (R 1.0mm, L1.3 mm)"

He seems to be peeing fine but this all started with diarrhea. The diarrhea is gone now but I do notice he seems gasy and backedup now. He went to the bathroom yesterday but only a small amount came out.

The fact that the clot could become fibrous is a good thing. I hope that happens vs it being thrown.

Thank you again for all the helpful comments. I feel better talking this out. I emailed my vet this morning too with all the questions I had. I know she isnt the cardiologist but she can go back to them and hopefully relay some more info.

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This is some of the paperwork I got back. If there is any kidney problems I cant make sense of it.

Lesliel76 said:

 

As far as I know his kidneys are ok. His bloodwork has come back good. But on the ultra sound report, its says the following. Maybe you can help translate:

"The kideys have moderate loss of corticomedullary distinction billaterally. The kidneys are upper limits of normal in length (r 4.7cm,L 4.6 cm) There is no pelvic dilation billaterally (R 1.0mm, L1.3 mm)"

 

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The ultrasound of the kidneys does reveal a degree of kidney damage, but this is not enough to shrink the kidneys.  The cat is not apparently in kidney failure as the kidney function tests are normal.

Thank you for the echocardiograph and ECG report.  The ECG revealed atrial fibrillation and the echocardiogram  confirms atrial enlargement with clot formation.  The echocardiogram does not confirm any cardiomyopathy but there is evidence of hypertensive heart disease.  There is a degree of heart failure, but certainly NOT, in my opinion, enough to put the cat down.  Your veterinary cardiologist can advise you on the outlook.

Fresh clot formation is more likely to form emboli than old clot, and this is why anticoagulation is so effective as this treatment prevents new clot.  The risk of embolisation is also likely to be reduced as the atrium is stationary because of the atrial fibrillation.  A beating atrium is very likely to throw off clot, but there is no reason to expect the atrium to start beating while the atrial fibrillation persists - and this is usually chronic.

Things don't look so bad as they might be,

Geoffrey

Wow. I cant thank you enough for looking at these for me and giving me your thoughts. I couldnt even pay them to sit down and talk with me.

It seriously is the nicest thing!

I feel much better and right now I agree that I should at least wait till the next visit with the Cardiologist to get their opinion.

The pet cams I bought are easing my tension and anxiety for when Im away.. ill update once I hear more from the Vet.

babiesmom5 said:

 
Geoffrey, the semi-retired human cardiologist

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It sounds like it should be an official title of some kind. Semi-official.

And, while I know very little about cardiology, if I was the OP I would find this breakdown of the medical information very comforting. Thank you so much for giving Leslie peace of mind.

Wow, so I have some interesting and messed up news. So my Vet informed me that I received the wrong results!!

That he does not have heart failure or a clot in his lungs that he just has high blood pressure and some thicking of the heart wall.

Im a little in shock right now and worried I hurt him by these meds.

Lesliel76 said:

Wow, so I have some interesting and messed up news. So my Vet informed me that I received the wrong results!!

That he does not have heart failure or a clot in his lungs that he just has high blood pressure and some thicking of the heart wall.

Im a little in shock right now and worried I hurt him by these meds.

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I suggest you look for the half full glass here. He doesn't have a clot and HBP is easy to treat.

And what everyone else said..hug your baby and kiss and love!!  Sometimes we have to switch to a better quality food BUT not all cats are open to this. Exercise will also help high blood pressure. Medication is one way to help treat this. So glad your baby doesn't have a clot!!

Wow what a relief, that is really great news. My heart goes out to the kitty and the owner the results are for. I really hope it is just a   diagnosis error  not a mix up of test results 

Glad to hear that, agree with the comment about the glass being half full, but... yikes.

May be time for a new vet.

Yikes is right. I am super happy about the results but jesus thats a pretty big error. I am not going to nail her to the cross for it because I dont feel she is a bad Dr. We all make mistakes and I understand but will probably be looking for a new vet. Right now I am just happy to get some good news.

She explained to me she was anxious for Charlies results and wasnt waiting for anyone elses that day and when the hospital faxed Chalries over they included another cats from a week prior. These cat owner already new the prognosis and the vet was getting the results for her records.

She is refunded me for the medication which is great.

What an emotional rollar coaster. I hope we all learned something from this. For me it is to be patient and not get so anxiety ridden.

Lesliel76 said:

Yikes is right. I am super happy about the results but jesus thats a pretty big error. I am not going to nail her to the cross for it because I dont feel she is a bad Dr. We all make mistakes and I understand but will probably be looking for a new vet. Right now I am just happy to get some good news.

She explained to me she was anxious for Charlies results and wasnt waiting for anyone elses that day and when the hospital faxed Chalries over they included another cats from a week prior. These cat owner already new the prognosis and the vet was getting the results for her records.

She is refunded me for the medication which is great.

What an emotional rollar coaster. I hope we all learned something from this. For me it is to be patient and not get so anxiety ridden.

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she made a mistake but owned up to it and tried to make it right with you. She might be worth keeping. Bet she checks more carefully from now on.