A cat can present with many symptoms early in life or be asymptomatic for years until an older cat. A cat will begin to change their activity level and not be as active as usual. They may begin to hang out in quiet places or hide in places away from the family more often than usual. They might look as if in pain or discomfort. They may continue to eat and use the litter box or may begin to avoid both. If not a lap cat, they may suddenly be one and come to you for comfort. Cats will begin to have difficulty breathing as congestion forms. Some cats might pant, some might seem to wheeze or cough but mostly, a cat will have rapid chest heaving as it breathes. An owner can count the breathing rate for a cat at rest by counting how many up and down chest movements occur within 15 seconds. One up and down is one count. If a cat breathes six times in 15 seconds, then the breathing rate is 6x4=24 per minute, a normal rate. Cats’ breathing rates vary when sleeping and when they walk, run, or even as they look out of the window. That is why the rate should be counted a couple of different times as the cat sleeps to see what is normal or to see if it is high. A cat that presents with a breathing rate nearing 30 when at rest and over 30 when awake will need to see the vet or animal emergency as soon as possible as that is a sign of CHF. Other signs that a cat is sick are if a cat is suddenly lame, screaming in pain, fainting or falling over, or is acting dazed and confused. Immediate treatment is necessary.
Depending on the strength of the medication or the form which will be used (pill, liquid, gel, etc.) these medications can be purchased at the local pharmacy with a script from the vet and do not need to be purchased at the vet’s office where prices are often higher. Most are available as generics. Locally, Kroger offers many as part of their $4.00 generic drug program. And if pilling a cat is difficult, a liquid oral or cream transdermal version might be possible. Ask your vet about what is possible to use with your pet. Putting pills into pill pockets works with some cats, while we simply dip a pill into wet cat food to coat it and place it into Myrna's mouth. For medications that are in liquid or gel form, a compounding pharmacy such as the online Road Runner or the local Clark Pharmacy on Washtenaw can mix these medications.
Taking care of cat with heart disease requires many meds, supplements, and other supplies. In order to feel that the house is not overloaded with cat things, and in order to better organize Myrna's medications, I use many organizing tools. Cat supplies such as wipes, brushes, nail clippers, etc. go in stackable containers that fit neatly into the cupboard. Her medications and supplements go into lidded boxes and stackable trays in the kitchen cupboard for easy daily access. Once a week, I prepare her medications by using a good pill cutter and a pill organizer that has four daily compartments in individual trays for all seven days. I cut the prescribed dose and place it in the correct pill compartment. Then each day, I set out that day's tray of pills and we dose as scheduled. There is also a tray for refrigerated supplements and medications that prevents those from getting lost in the frig. Being organized decreases the stress of and speeds up the care of taking care of a cat with heart disease.
A word on other medications: steroids should be avoided unless needed for cancer or other disease treatment and always with the coordination of the cardiologist. Many pain meds cannot be given but Buprenex or buprenorphine can be tolerated. It might be needed to relieve pain or inflammation, and can be used as an anxiety medication. If a cat is taking Plavix, per the FDA warning, a cat (or human) cannot take Prozac or other psychotropics or Prilosec and other stomach medications because Plavix needs an enzyme that is inhibited by these other medications. A cat or human is at risk of clots or heart attacks because Plavix cannot work as prescribed. If a cat has upset stomachs from the heart medications (and Myrna has recently), the use of club soda in wet food will reduce the stomach acid. It works for Myrna. The only safe psychotropic in this case is Valium. While Valium may cause liver disease in cats, if a cat is highly anxious or going out of the box, it might be necessary to use. Myrna has been on it for over two years and so far, is tolerating it very well. Blood tests are needed to monitor liver values. And surgery must be avoided because cats cannot receive anesthesia. But again, coordination of care must be made with the cardiologist if surgery is warranted.
Care must be taken to decrease stress in a cat’s environment as stress can lead to congestion. A cat with HCM needs to be kept warm in winter and cool and free from humidity in summer because the diseased heart cannot work keep a body warm or cool effectively. Hot, humid or even cold weather coming in through windows can lead to congestion. Avoid loud noises in and outside of the house, make sure other pets do not fight with the sick cat, make sure children do not play too roughly with the cat, and even be wary of stress that visitors might cause. If work is being done inside the house, try moving the cat to the opposite side of the house and close the doors. If noise is outside of the house, close the windows. When it storms, close the shades and maybe take the cat to the basement or give it food or treats to distract it. And if the cat is an outdoor cat, begin keeping it in for longer periods of time. A cat with heart disease will need medications at different times of the day and if it goes outside, it might miss a dose. An outdoor cat is also prone to injury, disease, even things like bee stings for which it cannot receive steroid medication because steroids retain fluid.