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This cute kitty, "Buck", is a challenge and a joy to exam because of his constant purring and head rubbing. "Buck" is a domestic short-haired cat, and recently celebrated his 6th birthday. In March 2000, "Buck" was brought to the clinic due to an episode of brief but sudden crying and distress. His appetite had also decreased in the week prior. A physical exam revealed a previously undiagnosed heart murmur (Grade II out of VI) accompanied by a rapid heart rate, and normal temperature.

Because a heart murmur is unexpected in a relatively young cat, a baseline test of a general blood panel, thyroid test, and radiographs were performed. The blood tests were relatively normal except for a slight increase in the white blood cell count. Chest X-rays revealed mild to moderate pulmonary edema (fluid accumulation in the lung tissue), and the heart size appeared normal. Given these results, the differentials for "Buck's" problems included primary heart disease (infection or structural) or lung disease (from infection or parasite or something else entirely).

The next step was a cardiac ultrasound, also called an echocardiogram, which would tell if the heart muscle was thickened (X-rays cannot identify this). A specialist, Dr. Weis, a veterinary radiologist, was called-in to perform the cardiac ultrasound. In the meantime, Dr. Reid started "Buck" on antibiotics and a diuretic (Lasix) to help clear fluid from his lungs by lowering his blood pressure. Four days later, "Buck" was improving and his ultrasound did indeed show moderate to severe thickening of his heart muscle. A name could now be put on his condition - Hypertrophic Cardiomyopathy.

This disease primarily affects cats between the ages of 6 and 9 years. The cause is unknown but some breeds (Persians, Maine Coons, and Ragdolls) are genetically predisposed. Some cats may show no symptoms in the early stages, others may have nonspecific signs such as weight loss or lethargy; and still others may have a cough, fainting, or rear limb paralysis. There is no cure for this disease but treatment may be able to prolong life by years depending on the severity of the disease.

There are a variety of drug protocols for the treatment of hypertrophic cardiomyopathy. For "Buck", we chose to maintain him on the Lasix once daily and added Enalapril to further lower blood pressure as well as Diltiazem to lower the heart rate and help the heart pump more efficiently. Atenolol can also be used for this purpose.

It has now been 2 years since treatment began and, thanks to the diligence of his owners, "Buck" continues to do well. We are still keeping an eye on him and did recently added Atenolol to his treatment regimen due to a slight increase in fainting spells.