Congestive Heart Failure (CHF) in Cats

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Overview of Heart Failure in Cats

Heart failure is a condition, caused by an abnormality in the structure or the function of the heart, in which it is unable to pump normal quantities of blood to the tissues of the body. The heart is a pump, and when it fails, it often leads to fluid retention in the lung and the body cavities leading to congestive heart failure.  Congestive heart failure is commonly abbreviated and referred to as “CHF”. 

Below is an overview about Congestive Heart Failure in Cats followed by In-depth detailed information about the diagnosis and treatment of this condition. 

There are many causes of heart failure in cats, including:

  • Birth (congenital) defects of the heart
  • Degeneration of the heart valves
  • Heart muscle disease (cardiomyopathy)
  • Heartworm disease
  • Diseases of the pericardium (the lining around the heart)
  • Irregular electrical rhythms of the heart (arrhythmia)

    Cats of any age and any breed can develop heart failure. The most common cause of congestive heart failure in cats is heart muscle disease (cardiomyopathy), though anemia and uncontrolled hyperthyroidism can also lead to this problem.

    Heart failure affects your cat by reducing the amount of blood that is pumped to the muscles, leading to fatigue. In addition, most cases of heart failure are associated with accumulation of fluid (edema) in the lungs, the chest cavity (pleural effusion), or the abdominal cavity (ascites). This fluid accumulation can lead to shortness of breath and other problems such as coughing and difficult breathing.

    Some of the symptoms of heart failure, and the progression of heart failure, are related to increased activity of the nervous system and to increased concentrations of circulating hormones (and related chemicals).

    What to Watch For

  • Coughing
  • Shortness of breath
  • Difficult breathing (dyspnea)
  • Weight loss
  • Fatigue

    Diagnosis of Congestive Heart Failure in Cats

    Your veterinarian may suspect CHF after examining your pet, but he will probably run several diagnostic tests to confirm the diagnosis and underlying cause. Tests may include:

  • General physical examination with emphasis on stethoscope examination (auscultation) of the heart and lungs
  • A chest radiograph (X-ray)
  • Measurement of blood pressure
  • An electrocardiogram (EKG)
  • Ultrasound examination of the heart (echocardiogram)
  • Treatment of Congestive Heart Failure in Cats

    Treatment for congestive heart failure will vary depending on the underlying cause. This may include one or more of the following:

  • Initial treatment may require hospitalization with a diuretic, oxygen, and other drugs such nitroglycerine paste.
  • A diuretic (“water-pill”) such as the drug furosemide (Lasix®)
  • Pleural effusion (fluid around the lungs) may require thoracocentesis, which is insertion of a small needle in order to drainsome of the fluid. This often improves breathing and makes your cat more comfortable.
  • Nitroglycerine, which comes in the form of a paste, is often used topically (spread on the ear or abdomen or other relatively hairless area).
  • Other diuretics, such as spironolactone.
  • Angiotensin converting enzyme inhibitor such as enalapril (Enacard) or benazepril. These drugs block some of the harmful hormones that circulate in heart failure and prevent salt retention.
  • A diet limiting sodium intake and preventing fluid retention.
  • Use of digoxin (Lanoxin; Cardoxin)
  • Dietary supplements
  • Home Care

    At home, administer all veterinary prescribed medications on a regular basis. Be aware of your cat’s general activity, exercise capacity and interest in the family activities. Keep a record of his appetite and ability to breathe comfortably (or not), and note the presence of any symptoms such as coughing or severe tiring.

    Do not stop medication or change the dosage without checking with your veterinarian. Most medications are for the life of your cat. And never withhold water, even if your pet urinates more than normal, unless specifically instructed to do so.

    Difficult breathing is usually an emergency. See your veterinarian immediately.

    Preventive Care

    In general, heart failure cannot be prevented, although early diagnosis of the underlying cause can provide an improved quality of life. Once diagnosed, you should prevent excessive physical activity or excitement, avoid high heat/humidity and avoid high salt (sodium) foods or treats.

    In-depth Information on Congestive Heart Failure in Cats

    Congestive heart failure leads to inadequate blood flow to the tissues of the body, resulting in depression and fatigue. Accumulation of fluid often impairs breathing. When the fluid accumulates in the lungs (pulmonary edema) or around the lungs (pleural effusion), the condition can become life threatening. Though dramatic, the symptoms of congestive heart failure are not specific for only that condition. As there are dozens of reasons for coughing, difficult breathing and fatigue; therefore, your veterinarian must formulate a diagnostic plan to make a correct diagnosis.

    The conditions most often confused with heart failure are diseases of the airways, the lung and the chest cavity (pleural space) including:

  • Pneumonia or infection of the lung can lead to symptoms that are similar to those of heart failure.
  • Asthma is a condition that can result in coughing and difficulty breathing.
  • Heartworm disease, a parasitic infection of the blood vessels of the lungs, must be excluded as a possible diagnosis. This infection can also lead to heart failure as well as lung injury.
  • Tumors of chest can cause symptoms that resemble those of heart failure.
  • Fluid accumulation within the chest cavity that surrounds the lungs (pleural effusion) can cause shortness of breath. Some cases are caused by heart failure, but others are not. Pleural effusion is a common problem in cats.
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