[gemmaeabishop]

Hi everyone,

I'm desperately hoping someone will be able to give me some advice! I took my 7 month old sphynx boy to be castrated today and received the awful news that he has a grade 2 systolic heart murmur. His resting heart rate is 240 bpm and the vet said this is very serious. We are devastated to say the least. His Mum, Dad and Grandparents are all HCM scanned every year and all negative - all certificates seen. He is fully vaccinated and from a reputable and knowledgeable breeder. We just don’t know what this means or where to go from here. I would appreciate any thoughts on what the heart murmur and high heart rate could mean, no matter how honest. Also, where do we go from here? As far as I am aware there is no treatment for HCM. Our vet said they could refer to cardiac specialist for assessment and the cost would be 1000 pounds plus (our insurance is basic and doesn’t cover this but we will do anything necessary). Is that the only way forward? He is outwardly a really healthy and adored cat – massive appetite, super energetic, playful, lovely skin, eyes and no other health issues – he’s never been to the vets except for his vaccinations and castration. Really hoping for any advice, thanks so much in advance.

 

[havoc]

received the awful news that he has a grade 2 systolic heart murmur. His resting heart rate is 240 bpm and the vet said this is very serious

I am a little confused and I think you should take a few deep breaths. Heart murmurs are graded from 1 to 6 with 1 being the mildest and 6 the most severe. A quick look up suggests that normal resting heart rate for cats is between 160 and 240. I'd reckon on an elevated reading in the vets because a cat can't ever be properly relaxed in that environment so your kitten is on the upper end of normal. Did the vet actually do the op? I can't see they would take the risk if things were honestly as dire as they seemed to suggest.

 

[gemmaeabishop]

Hi,

Sorry seriously panicking, I need to calm down!! The vet said the heart rate was too fast to hear the murmur but when he was sedated for the op they could hear clearly and he had the murmur and his heart rate was 240 which the vet said was very serious. The vet said he has a cardiac abnormality and that he needed assessment by a specialist. He means the world to us so we were heartbroken. HCM is common in sphynx hence why we made sure all family were HCM negative. Thanks for the response, I can relax a little!

 

[havoc]

I do think you need to step back a little. The heart rate is high and a high rate combined with a murmur can be indicative of HCM. Question is, what can you do about it once you've had a specialist diagnosis? I think you need to discuss this in more detail with a vet. Diagnosis in itself isn't worth the money if it doesn't lead to worthwhile treatment - at least it wouldn't be to me.

I'm hoping someone with a bit more knowledge of the subject comes along for you. It's not something I know much about at all.

 

[jill3]

Hello Gemma. I am sorry to hear that your little one has a Murmur.
If you are not sure what to do you can always get a second opinion by another vet.
This might be the best thing to stop you from worrying.
I did loose my 3 year old British cream this year to HCM.
If we had known he was ill I would have done anything to have saved him.
The vet told me he had a murmur when I adopted him at 11 months.
He told me not to worry, if he started coughing then bring him back.
He was fine and had no warnings until that horrible night that broke our hearts.
Many cats have heart murmurs and live for many years with no problems and some kittens have them and then they heal.

So stay calm and do a bit of research. If he was mine I would get a second opinion and then go from there.
There is a guy called cuddlesmycat on here and his cat has HCM. Hopefully he will see this and give you some advice.

Keep intouch and let us know how you get on x

Harley was just unlucky.

 

[Ianthi]

I take it you didn't mean his heart rate was 240 while sedated?? I agree with Havoc above about the reasons for the increased rate being due to stress at the vets. His normal resting rate at home is a far more reliable reading, so I would suggest taking this yourself at intervals from now on.

Whether or not he has a heart murmur remains to be seen though it is important to remember that these a) can be subjective so it would be useful to get a second opinion b) murmurs can be caused by conditions other than heart disease eg anaemia c) some can actually resolve over time.

I wouldn't go so far as seeing a specialist just yet ( though would be recommend it if it if a cardiac problem was strongly suspected at a later stage ) - I'd opt for a bloodtest first called a proBNP which is used to detect heart disease in cats.

 

[gemmaeabishop]

Hi everyone,

Thanks so much for your helpful relies, really grateful you took the time. Maybe the vet was a bit ott, she really scared us, we came away thinking he was going to die. He is so healthy in every other respect it seems we should get a second opinion and go from there.

Thanks again! :001_smile:

 

[Guest]

Hello Gemma,

First thing is first calm down, take a deep breath, phone the breeder and check with the breeder to see if any of the other kittens have got heart murmurs, and what the results were and then get a diagnosis from a professional (An animal cardiologist). Yes getting a diagnosis can be expensive, but shop around, I have put a useful link on here: http://www.fabcats.org/hcm/ that tells you where you can get these tests from if you scroll to the bottom of the page. Phone around get quotes and find out who is cheapest and then get your vet to refer you to the one of your choice not their choice.

Please hang fire from doing any research as you will panic, and you don't know what the diagnosis is yet.

From what you have described on here in my personal opinion I would be inclined to have your vet refer your cat for an xray and Echocardiogram (Heart scan) and Electrocardiogram (ECG) as this will determine without a doubt if your cat has HCM (This cannot be detected through a blood test in the UK). An animal Cardiologist normally has to do this at an animal hospital. You do need to have all 3 done to be absolutely certain. I know it will cost a bit through a private vet but it would be worth the money to at least confirm or rule this out.

Cuddles as everyone knows on here was diagnosed with HCM herself in April this year (At the age of 2 years and 11 months) after a heart murmur was detected when she was 10 months old (When I adopted her). Please understand this is not the end of the world as there is treatment available and the vet or animal cardiologist should talk you through what to look out for etc. Please get expert advice first the vet has just warned you what it might be. Please take a deep breath and calm down it doesn't mean this is the end or anything like that, from the description you have put on here, they may if a positive result comes back, put your cat on medication to help slow the pace of the heart rate down. HCM can skip generations from what I understand as well and affects certain breeds of cat more as they are prone but this does not mean that your kitten/cat can become affected by HCM (Cuddles is a DSH).

The worst thing you can do at the moment is start researching as you will worry even more. Get professional advice from a specialist animal cardiologist and get a diagnosis. By the way Heart murmurs in kittens are very common and do turn out to be just that, heart murmurs and nothing comes of it.

 

[havoc]

I'd opt for a bloodtest first called a proBNP which is used to detect heart disease in cats

This is exactly the advice in Susan Little's book - The Cat, Clinical Medicine and Management. I didn't dare quote from it because I wasn't sure what was common practice here in the UK. Nice to see Ianthi suggest it.

 

[Guest]

Hello Gemma,

From what you have described on here I would be inclined to have your vet to refer your cat for an xray and Echocardiogram (Heart scan) and Electrocardiogram (ECG) as this will determine without a doubt if your cat has HCM. An animal Cardiologist normally has to do this at an animal hospital. You do need to have all 3 done to be 100% certain. I know it will cost a bit through a private vet but it would be worth the money to at least confirm or rule this out.

Cuddles as everyone knows on here was diagnosed with HCM herself in April this year after a heart murmur was detected. Please understand this is not the end of the world as there is treatment available and the vet should talk you through what to look out for etc. Please get expert advice first the vet has just warned you what it might be. Please take a deep breath and calm down it doesn't mean this is the end or anything like that, from the description you have put on here, they may if a positive result comes back, put your cat on medication to help slow the pace of the heart rate down.

It could just be a case as other members have said posting here your cat is stressed from being at the vets and heart murmurs are very common, it doesn't mean anything is wrong. But do get it checked out to put your own mind at rest. Get a second opinion if needs be.

Sorry I wanted to add as well that the Cardiologists that look after Cuddles told me when she was diagnosed that 160 to 200 bpm is the normal rate not 240 bpm. I was told anything above 200bpm would require treatment if it was steadily at this.

The main thing is here please get expert advice ask your vet to refer your cat to the animal cardiologist for the tests I mentioned.

 

[Guest]

This is exactly the advice in Susan Little's book - The Cat, Clinical Medicine and Management. I didn't dare quote from it because I wasn't sure what was common practice here in the UK. Nice to see Ianthi suggest it.

I didn't know they done this as standard practice in the UK as Cuddles had to have all the tests done mentioned above by me and no blood test was mentioned. They can't tell definitely if a cat is HCM positive in the UK from a blood test as HCM is a thickening of the muscle in the heart (Normally around the left atrium inside the heart) which is undetectable in blood tests and can only be diagnosed by an animal cardiologist with the tests I mentioned. The heart beats faster in HCM cats because the heart can't pump the blood around the body fast enough because the muscle is putting pressure on the heart valve (Normally in the left atrium). This can be calmed down with medication and there is also medication available to help relax the muscle as well. Sorry I have been doing alot of research since my cat was diagnosed and asking alot of questions to the right people (Animal Cardiologists).

Here's a link that might be helpful to back up some of what I have said and it has a list of places that do the tests mentioned so perhaps you could get your vet to refer you to one of them (Find out which is cheapest first as they all do the same tests). It goes on about two specific breeds of cats (HCM is genetic but not specific to a certain breed although certain breeds are more prone and it can skip generations and is becoming more and more common in cats of any breed and the research into Feline HCM is ongoing) but you'll get the gist of things if you read it:

Hypertrophic cardiomyopathy (HCM) in cats

I would contact the breeder and ask if any of the other kittens have been diagnosed with heart murmurs and what the results have been.

Before doing anymore research please get advice from a trained specialist (Animal Cardiologist). Otherwise you will worry yourself no end and (THIS IS IMPORTANT) please calm down and try and stay stress free otherwise your kitten will sense you are stressed and stress out as well (Your kitten/cat would have to be in a stress free environment because being stressed can also put pressure on the kitten/cat and affect their heart).

 

[havoc]

I didn't know they done this as standard practice either

Standard practice here and in the USA are likely to be different. Things tend to be 'standard' there before they are here

 

[Guest]

Standard practice here and in the USA are likely to be different. Things tend to be 'standard' there before they are here

I understand things are different on your side of the pond
Is Gemma in the US or UK? Because in the UK the tests I mentioned are standard. I apologise if she is in the US.

 

[havoc]

I'm in the UK - Dr Susan Little and her book are US based. I'd assumed the poster was UK based which is why I didn't wish to quote tests which may not have reached our shores.

 

[Guest]

I'm in the UK - Dr Susan Little and her book are US based. I'd assumed the poster was UK based which is why I didn't wish to quote tests which may not have reached our shores.

The tests I mentioned are what they do over here in the UK though as standard practice and give an accurate diagnosis. Gemma is in the UK as she quoted the price in pounds, so there's no point quoting US practices. I haven't read the book yet but I am looking to get a copy, but if the book is entirely focused on how they do things in the US I don't see how it applies if you are in the UK (I am not being single track minded but the practices are entirely different in the UK)

 

[Ianthi]

This is exactly the advice in Susan Little's book - The Cat, Clinical Medicine and Management. I didn't dare quote from it because I wasn't sure what was common practice here in the UK. Nice to see Ianthi suggest it.

It's definitely available in the UK (and Ireland) Havoc though how extensively it's used in private practice I've no idea. Idexx for one run it.

http://www.idexx.com/view/xhtml/en_...ovative-tests/cardiopet-probnp.jsf?SSOTOKEN=0

As far as I'm aware it will detect all heart problems. I was suggesting it as a first step since OP mentioned the cost implications of a referral at this point.

 

[havoc]

I haven't read the book yet but I am looking to get a copy

I have yet to read over 1300 pages of a veterinary reference book and I've had my copy for nearly a year. It isn't exactly bedtime reading

 

[havoc]

As far as I'm aware it will detect all heart problems. I was suggesting it as a first step since OP mentioned the cost implications of a referral at this point.

That's exactly what it appeared to be from my reading. I gather the chances of false positives are there but it does seem such a sensible and cost effective starting point.

 

[Guest]

I can understand what you're both saying but what I am about to put here is from experience. Cuddles had a second opinion from a private vet (No tests done, the pv assessed the information and explained it in layman terms) and the private vet explained to me that all the right tests had been done (The ones I mentioned) as HCM is a thickening of the heart muscle inside the heart.

Regarding the blood test:
1) I didn't know this existed as it was never offered,
2) I can't see it picking up HCM as it is a thickening of the heart muscle inside the heart (Normally in the left atrium) as this is only detectable through an xray (This is to check for any fluid build up), ECG (Checks heart rhythm) and echocardiogram (Checks for HCM and how bad it is. This is the only way they can diagnose HCM from this scan. This is a snap shot scan of the heart at the time of it being done). They normally repeat these tests 3 to 6 months after the initial tests to ensure that the diagnosis is correct and then every year after this. They don't normally prescribe medication after the first set of tests have been done but this entirely depends on how bad the HCM is, the heart rhythm is and if there is any fluid build up on the lungs.
3) The blood tests might pick up other heart defects, fair enough, but not HCM.

Cuddles has a grade 2 murmur and a 7mm thick wall of muscle right next the the valve of her heart in the left atrium and is coping very well and on no medication. Her heart beats were 198 bmp (In April and July 2012) but this has improved to 165 bpm, so I must be doing something right.

Sorry for the picture attached but this is how it was illustrated to me by the private vet who I got a second opinion off.

 

[Guest]

I have yet to read over 1300 pages of a veterinary reference book and I've had my copy for nearly a year. It isn't exactly bedtime reading

I haven't read any veterinary reference books myself I would hate the idea of it, but have instead asked questions to the vets and cardiologists and read things up online etc and this is where my knowledge has come from

Reading 1300 pages of veterinary reference books would terrify me as you said its not bedtime reading.