Grade 3 heart murmur

[Mollycat]

Oh no my heart sank when I saw a new problem with your name on it, this really is such a rough time for you!!

I know untreated hyperthyroidism eventually causes heart problems. HT raises metabolism, part of this is heart rate, the heart beating faster and harder raises blood pressure and eventually thickens heart muscle leading eventually to heart failure. This is why HT can't be left untreated (as well as potential blindness), but there are options for that including strict diet management and the expensive but curative radioiodine. The other 2 options with HT are daily tablets, and surgery, but surgery has a 70% chance of needing a second surgery and then 30% chance of ending up on tablets for life anyway. If Jasmine is HT you have lots of experienced friends on here to help.

Molly is unpillable and hers was diet controlled while we waited for her radioactive iodine, I think there's a little hint in the paragraph above as to why I don't like the surgery option. Molly's heart and one eye showed early signs of minor damage, and she now has very mild CKD which was masked by the high blood pressure of HT, she's 14 and not on any special diet or treatment, she's fine.

I can't help much with the heart murmur, they can get white coat heart murmurs but maybe not grade 3. My Boo had a heart rate over 200 every time we saw the vet but bloods showed nothing abnormal, just white coat syndrome. Dog had a heart murmur - the time we took him for a 2 hour walk and swim on the way to the vets. If scans show what's really going on with Jasmine, take it from there.

[Mollycat]

How old is Jasmine? I don't think they can really be accurate about the severity of a heart murmur without scans, as far as I'm aware. But it does sound like it might be interfering with her quality of life as it is, if she is having any kind of difficulty with her breathing.

Primary HCM is genetic and although it's a cat disease it has a higher rate in Raggies, Persians and Maine Coons. Secondary HCM is usually due to hyperthyroidism but sometimes other causes of hypertension. If it's secondary to hyperthyroidism, I believe but don't quote me on this, that cure ie surgery with fingers crossed or I131 should let the heart slowly improve, whereas drug control or diet will slow it down but not allow for any repair. I don't know if grade 3 will rule out surgery. I'm never satisfied with high blood pressure as a diagnosis, it always has a cause, and merits investigation before giving up as "idiopathic" and resorting to tablets.

So, did the bloods show up hyperthyroid, or is that just the weight loss and not backed up by test results?

[Mollycat]

I forget sometimes that all vets don't have the same facilities. Mine have basic blood testing that gives us things like thyroid, kidney, liver, diabetes and some other things in-house in 20 minutes.

As for treating what you're not sure of, my guess is the drugs given would be harmless if it's not hcm but effective if it is, a bit like a broad spectrum antibiotic given when they know there is infection before identifying it.

[fjm]

Pippin had high blood pressure and a very rapid heart rate as a result of hyperthyroidism - curing that brought everything else back to normal. He was on medication for it for a while, though, because of the risk of blindness and further damage to the heart muscle. Hyperthyroidism would explain the weight loss. Hope you get more information soon, and it proves readily treatable.

[Mollycat]

Having a nose around (as I do) I found these two related and nicely written articles from VCA

https://vcahospitals.com/know-your-pet/ ... rs-in-cats
https://vcahospitals.com/know-your-pet/ ... hy-in-cats

What led me there was a comment about anaemia as a root cause, which I can't see in the text now, but is a good point.

[Mollycat]

Get some Pill Pockets there are lots of different versions but the one I get is a putty from the vets. Not that it did us much good as we still had to get that down Boo's throat with the pill inside as he would lick the stuff off and leave the pill, but he resisted a lot less because the taste was ok. Dogs are so much easier because they are stupid and greedy and will happily watch you put the pill in the sausage and eat it.

Sounds like it's an ounce of prevention being better than a pound of cure. Chin up x

[fjm]

Good to get firm answers, either way, and in one trip rather than several. Hyperthyroidism can be odd - some cats have symptoms quite the opposite of the "norm".

[Mollycat]

Oh, no that's not the best news, but still could be very manageable. What's the next step?

Yes fjm like mine, always fat until the HT was treated and now a decent normal weight

[fjm]

I am sorry - yet more anxiety. I hope whatever is causing the symptoms proves treatable, and the heart issue stays stable.

[Mollycat]

So, she has hypertrophic obstructive cardiomyopathy, no sign of heart failure CHF. the specialist has said this is probably the cause of heart murmur but the hocm is mild so is not actually causing her symptoms. Rescan heart 6 months and no meds needed. However She has to go for chest xray/scan to look at lungs and chest, possibly tummy too. Jasmine has been referred to the internal medicine specialist who is looking after honey.
So overall , depressing and i’m lost for words.

I'm really sorry, I'm struggling to understand. It's not heart failure? It's HOCM which is thickening of the wall between L&R ventricles, leading to obstruction of blood flow out? No meds, is that because meds won't help, or not needed? Sorry for the questions.

[Mollycat]

A bit, yes, but I'm not very clued up with heart stuff in detail.

Heart muscle thickening is usually due to beating harder and faster as far as I'm aware and that pumping raises blood pressure, is Jasmine's BP being checked? or do they think the thickening isn't due to raised BP? They put the cuff on the tail apparently, yes I asked when they checked Molly's!

So the bit I really don't get is, if Jasmine's HCM isn't causing her too much of a problem, and hasn't developed into heart failure, isn't that slightly better news? But disappointing that there isn't an obvious underlying cause to work on?