Heart Disease of the Cat: Treatment Options

Therapy of heart disease in the cat is highly variable and can be controversial.  HCM, the mostHeart Disease of the Cat: Treatment Options commonly diagnosed heart problem, has some theories of therapy.  Because the main issue is the heart not having time/space to fill, there is a school of thought that gives medication to slow the heart rate (beta-blockers such as atenolol or sotolol).  The theory is to give the heart more time to stretch and fill with blood to eject more into the systemic circulation.  The more blood ejected, the less likely blood will become stagnant in the atrium to form a clot.

The counter argument to this theory is the question of how fast are cats’ heart rates at home?  Those cat owners reading this can attest that their cat likely does not spend much of his time in vigorous activity.  This author’s cat spends most of his waking hours devoted to finding the sunniest spots in the house to lay.  Some suggest that these cats do a better job keeping their heart rate low by themselves without any aid from medication.  Evaluating heart rate in a cat is a significant challenge for a veterinarian.  Consider how a cat feels when he is put into that dreaded carrier, taken for a car ride, and then carried into the exam room (click here to learn how to make the trip to the veterinarian less stressful).  Certainly, one wouldn’t be surprised if the heart rate is exceptionally high at that time.  Yet, a heart rate of 200 at the veterinarian’s office may not correlate well with what the heart rate is normally at home.

The other mainstay consideration of treatment is aimed at decreasing the clot formation that causes aortic thromboembolism.  Multiple medications have been researched and developed.  These include low dose aspirin, heparain (a blood thinning agent), and Plavix (clopidogrel) which decreases platelet binding.  As of initial publication, this author knows of no studies showing any lower rate of clot formation on any of these medications.

Therapy of DCM is much more straightforward and agreed upon.  If the diet is deficient in taurine, supplementation is simple.  If no cause is found for the disease, pimobendan or digoxin are excellent medications that aid in contractility.  Digoxin also helps control atrial fibrillation.

Any congestive heart failure is treated with medications to aid in getting fluid out of the lungs.  Diuretics like furosemide (Lasix) and ACE-inhibitors like benazepril are the mainstays of therapy.  These drugs are extremely effective in helping to manage heart failure whatever the cause.

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