"Larry," a 10 year old, male cat was presented
to the hospital for a one month recheck of a previously detected heart arrhythmia. That day Larry was less active than usual and was breathing hard, although he had been doing well before that day. Since Larry’s breathing indicated fluid in his chest an x-ray was taken to check for fluid. The x-rays confirmed that there was fluid in Larry’s chest.

Nearly 350ml of fluid (about as much as a can of soda) was removed from Larry’s chest. Larry was able to breathe much easier without the fluid compressing his lungs. Another x-ray was taken after the fluid was removed, which showed much better lung expansion.

An ultrasound exam, called an echocardiogram, was done to look inside Larry’s heart and determine if it was functioning normally. It was also possible that Larry had cancer in his chest, and the ultrasound could help us determine what was causing the fluid. The ultrasound exam is non-invasive and painless. Normally, no sedation is required. An EKG was also done to look for other arrhythmias or abnormalities.

The ultrasound exam showed that Larry’s heart was very weak and that the chambers (left ventricle=LV, left atrium=LA, right ventricle=RV, and right atrium=RA) were enlarged. On the right side of the ultrasound image above, you should see large wavelike contractions of the heart. Instead you see very small waves (arrows), which indicates weak contractions. Larry’s heart was not pumping well, and fluid was backing up into his lungs. Larry had dilated cardiomyopathy (DCM) and congestive heart failure. He needed medications to help his heart beat stronger and easier.

Many people are surprised to learn that the medications used to treat heart failure in animals are the same as those used in people. Larry was given digoxin (Cardoxin) to strengthen the contractions of his heart, furosemide (Lasix) to help reduce the fluid buildup, and enalapril (Vasotec or Enacard) to reduce his blood pressure and make it easier for the heart to pump. In some cases, DCM is due to an amino acid deficiency and can be reversed or greatly improved by supplementing taurine in the diet. He responded well and no further fluid has accumulated in his chest.

Larry has been doing well at home since his treatment. However, his condition is serious, and unless related to a taurine deficiency, it will progress over time until we are unable to help with medication. As long as Larry is happy, we are happy.

Larry’s story illustrates the importance of yearly physical exams for all pets. It is also an example of the value of ultrasound exams in evaluating heart problems. Previously, due to cost of the equipment and the expertise needed to interpret the images, ultrasound has been available only at universities, large referral hospitals, or by traveling specialists. We are pleased to now be able to offer these exams here at Springfield Animal Hospital.