Abstract
Practical relevance:
Although feline hypertrophic cardiomyopathy (HCM) occurs more commonly,
dilated cardiomyopathy (DCM), restrictive cardiomyopathy (RCM),
arrhythmogenic right ventricular cardiomyopathy (ARVC), left ventricular
noncompaction (LVNC) and cardiomyopathy – nonspecific phenotype (NCM;
formerly unclassified cardiomyopathy) are all recognized in domestic
cats.
Patient group:
Any adult domestic cat, of either sex and of any breed, can be affected.
Diagnostics:
The non-HCM cardiomyopathies are rarely suspected in subclinically affected
cats, so most are first identified when a cat presents with signs of heart
failure or systemic thromboembolic disease. The definitive clinical
confirmatory test for these other feline cardiomyopathies is
echocardiography.
Key findings:
‘Cardiomyopathy – nonspecific phenotype’ is a catch-all term that groups
hearts with myocardial changes that either do not meet the criteria for any
one type of cardiomyopathy (HCM, RCM, DCM, ARVC, LVNC) or meet the
echocardiography criteria for more than one type. RCM is characterized by
diastolic dysfunction due to fibrosis that results in a restrictive
transmitral flow pattern on Doppler echocardiography and usually marked left
or biatrial enlargement. DCM is characterized by decreased myocardial
contractility and is rare in cats. When it occurs, it is seldom due to
taurine deficiency. However, since taurine-deficient DCM is usually
reversible, a diet history should be obtained, whole blood and plasma
taurine levels should be measured and taurine should be supplemented in the
diet if the diet is not commercially manufactured. ARVC should be suspected
in adult cats with severe right heart enlargement and right heart failure
(ascites and/or pleural effusion), especially if arrhythmia is present.
Feline LVNC is rare; its significance continues to be explored. Treatment of
the consequences of these cardiomyopathies (management of heart failure,
thromboprophylaxis, treatment of systemic arterial thromboembolism) is the
same as for HCM.
Conclusions:
While these other cardiomyopathies are less prevalent than HCM in cats, their
clinical and radiographic presentation is often indistinguishable from HCM.
Echocardiography is usually the only ante-mortem method to determine which
type of cardiomyopathy is present. However, since treatment and prognosis
are often similar for the feline cardiomyopathies, distinguishing among the
cardiomyopathies is often not essential for determining appropriate
therapy.
Areas of uncertainty:
The feline cardiomyopathies do not always fit into one distinct category.
Interrelationships among cardiomyopathies in cats may exist and
understanding these relationships in the future might provide critical
insights regarding treatment and prognosis.
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