How serious is a heart murmur in cats?
Original Question: I spoke on the radio some time ago about my male neutered, now 10 1/2 year old cat that has a heart murmur. We went through all the tests, gave him heart medication and the tests were inconclusive. Earl had his check-up about 3 weeks ago as well as his shots and he has been sneezing intermittently ever since (NOT coughing). Is this something we should address with our vet? Otherwise he is his normal self. He gets quite traumatized going to the vet and if I can avoid it I will. I appreciate your feedback on this. I continue to listen to your show each weekend and find you to be compassionate and informative. - Jacqui
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It’s always concerning to hear about a heart murmur in cats. However, sometimes they are completely harmless. I’ve met many clients, actual people, who have told me they have had a heart murmur all their lives and it’s never caused a problem.
In the strictest sense, a heart murmur means that ‘heart disease’ is present, but keep in mind that this really just identifies a ‘lesion’ or abnormality, which is the heart murmur. ‘Heart failure’ is when the function of the heart drops to such an insufficient level that clinical symptoms are starting to develop around the body, like coughing, lethargy, exercise intolerance, open mouth breathing, weight loss, and fluid accumulation within the body.
Many heart murmurs do not require treatment because the heart function is adequate and supportive medication would not make a difference. It sounds like this is the situation right now for you and your pet. However, it does mean that you should be monitoring the situation on a regular basis so you know if it ever starts to transition to a treatable condition. It’s especially important to be extra vigilant when it comes to cats. They do not demonstrate signs of heart disease enough to alert you that things are worsening. In fact, many cats can have severe heart disease without showing any symptoms. I have unfortunately seen many clients come home to find their cat expired without ever knowing there was a problem. A cat can have extremely subtle signs of heart disease, such as simply not wanting to jump up on high surfaces anymore.
My recommendation would be to ask your vet about a blood test called a cardiac biomarker. This is a test that evaluates the degree of stretch in the heart muscle and it is very good at finding early heart disease. It is reasonably priced compared to performing an expensive cardiac ultrasound. My suggestion is to perform this blood test every 6 months, or more frequently if you want to monitor closely. You can trend the value and once it elevates into the abnormal range, I would recommend performing the cardiac ultrasound and you would likely find that it is the right time to start treatment.
In the meantime, if you have performed a cardiac ultrasound and it is normal, then forget about the condition and treat your cat as the healthy pet it is. Don’t let an asymptomatic heart murmur scare you.
As far as the sneezing is concerned, I would try your best to see your veterinarian for a physical exam. In most cases the sneezing means there is an uncomplicated URTI, or upper respiratory tract infection. This is very common in cats. Usually, a simple treatment regime of antibiotics resolves it if it’s serious enough. I don’t like to make assumptions about a diagnosis, so I recommend you confirm this with your veterinarian. If diagnostics are suggested and your cat is doing pretty well, i.e. normal energy, appetite etc – then request a week of antibiotics before initiating expensive diagnostics, like blood work and radiographs. If it doesn’t respond to the treatment, you can always consider the diagnostics at that time. But most importantly, please have your veterinarian guide you on this decision. If there is something concerning on the physical exam, follow the recommendations you receive.
I would also encourage you to have a look at our video about preparing for the annual check-up for more information on the physical exam mentioned.
I hope this helps.
Dr. Clayton Greenway
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