Appropriate next steps for sr. cat with heart murmur

[Suzanne_TO]

Hello, everyone!

I've been lurking here for eons, stealing great advice, and finally registered so I could ask my own question... (and I did search the archive but none of the 21 q's I found matched mine! )

First, I'll give a bit of background on Chewy. He's 12 years old with no pre-existing health conditions aside from VERY bad teeth. He seems to get plaque buildup immediately after cleanings and it's an ongoing battle. At this point, he has only four teeth, two of which hang down outside his mouth. All other tests are regularly normal. He is an indoor cat for the most part, but we allow him to chase butterflies in our enclosed backyard every day under supervision. He has always been very healthy.

A week ago, he had an "episode" of about 5 seconds where he was coughing. He had just come from outside, and it was almost like he was catching his breath. The cough was much like when he has a hairball, but more shallow.. and no hairball produced. Next day, same thing happened. This was new and I didn't like it, so I took him to the vet.

The vet examined him and noted he had a "pronounced" heart murmur. This was the first time I'd heard of a heart murmur with him. She reviewed his file and found that the other consulting vet had noted a "grade 1" murmur 4 months ago at his teeth cleaning. She then recommended an ecg as follow up.

Fast forward a week. The vet called to tell me that his ecg was completely normal. In fact, textbook normal. No trace of a murmur. And his thyroid was "borderline" at 36, requiring no treatment at this time. She recommended we do nothing and check back in 6 months. I wanted to get him a chest x-ray to see if he indeed has heart disease but the vet said with his ecg results, it was not recommended.

Chewy has had no further episodes. His appetite is normal, toilet habits normal, and is as peppy as the day is long. But I am still worried.

I know this is a very specific case, but if anyone has some advice, I would really appreciate it. Chewy means everything to me. I can't stop worrying about him and want to do the right thing for him.

Is it really the right thing to wait and see or should I push for further testing.. and if so, which tests?

Thanks very much in advance for sharing your expertise..
Suzanne

[sugarcatmom]

Originally Posted by Suzanne_TO

Hello, everyone!

Welcome Suzanne and Chewy!

Originally Posted by Suzanne_TO

He's 12 years old with no pre-existing health conditions aside from VERY bad teeth.

Some cats are genetically predisposed to have bad teeth, unfortunately. What does Chewy eat?

Originally Posted by Suzanne_TO

The vet called to tell me that his ecg was completely normal.

There are some situations where a cat will have a normal ECG but still have a heart condition, so I wouldn't rule it out based on this one test. A much better diagnostic tool for cardiac issues is an echocardiogram. This can also be extremely expensive, unfortunately (I paid $650 for the most recent one for my cat, although somewhere around $500 is more typical). You might have to ask your vet for a referral as not all clinics have the equipment, nor the skill to interpret the results.

Originally Posted by Suzanne_TO

Is it really the right thing to wait and see or should I push for further testing.. and if so, which tests?

Honestly, if it were me, I'd push for further testing, specifically an echocardiogram. I wouldn't waste the money on an x-ray. If Chewy does turn out to have a specific heart condition, there are a number of medications that can help improve cardiac functioning. My own cat was diagnosed with a mild, non-symptomatic variation of HCM after a galloping heart murmur showed up on a routine pre-dental ECG. Follow-up echo narrowed down the specifics, and he was put on daily Atenolol (a beta blocker). He's been doing great since then (many years later) and his last echo in March showed significant improvement in heart function (he was even given the go-ahead for a dental at the ripe age of 17).

Here is some more info for you:
http://www.fabcats.org/owners/heart/article.html
http://www.vin.com/proceedings/Proce...U2002&PID=2990

Good luck! Let us know how Chewy does (he sure is cute).