Spot heart disease in cats by recognizing breathing problems, lethargy, heart murmurs, and other warning signs. Read about causes, testing, and treatment options.

Heart disease in cats is more common than many realize, especially as our kitties age. Some cats show obvious symptoms such as breathing difficulties or lethargy. But others may show no signs at all until the condition becomes serious.

From cardiomyopathy to taurine deficiency, several factors can affect feline heart health. Knowing what to watch for, and getting an early diagnosis, helps improve your cat’s quality of life and long-term outlook.

Main causes of heart disease in cats

Three kinds of cardiomyopathy cause most heart disease in cats.

HCM (hypertrophic cardiomyopathy) causes about 60% of cases. This condition thickens the walls of the heart, leading to less space inside the heart. HCM generally affects older male cats and often causes a loud systolic murmur. Most cats with HCM don’t show signs of heart disease.
DCM (dilated cardiomyopathy) thins and weakens the heart walls. Low dietary taurine causes this condition. Most cat foods offer enough taurine, but grain-free diets do not always meet recommended levels.
RCM (restricted cardiomyopathy) occurs when the heart muscle gets too stiff and is unable to beat as strongly

In all three types of cardiomyopathy, the heart pumps less blood when it beats. Heart disease can also arise as a secondary effect of hyperthyroidism, high blood pressure, and lymphoma invading the heart muscle.

HCM and RCM occur more often in some purebred cat families, showing an inherited link. But so far, veterinarians can’t predict which cats will develop these conditions or how severe they will become.

The average survival time for cats with symptomatic HCM is about five to six years. For cats with heart failure, the prognosis is three to 18 months. Not all cats with heart disease will experience heart failure.

What are the symptoms of feline heart disease?

Your veterinarian may first detect the first sign while listening to your cat’s heart. Many of these problems (though now always) can cause a heart murmur or gallop rhythm. Many cats live most or all of their lives with a heart murmur, without showing any signs.
When heart disease strongly affects a cat, signs of CHF (congestive heart failure) occur. The most common signs involve breathing problems, including coughing, rapid breathing, panting, or open-mouth breathing.

Normally, a cat breathes less than 30 times a minute. To check your cat’s breathing rate, wait until they are resting. Then count how many times their chest rises in one minute. Apps such as Breaths Per Minute (Apple) or Pet Breath Counter (Android) help track your cat’s respiratory rate and show trends and values over time.

Cats with heart disease may also become lethargic. They may hide more, sleep more, or play less. Their abdomen might get larger from fluid buildup. As their heart gets worse, they may vomit food and have a decreased appetite. Their gums may be pale or even a slight lavender color. Their feet might feel cold.
Emergency signs include sudden collapse or weakness in the hind legs. Some cats may become partially paralyzed and cry out in pain. A clot has suddenly blocked circulation to the hind legs. The faster you get your cat to a veterinarian, the better their chances of being helped.
Unfortunately, for some cats, the only symptom is sudden death.

Treating feline heart disease

Cats with severe symptoms may need oxygen therapy and anti-anxiety medication. These treatments help breathing and reduce stress, especially during veterinary exams. Giving a cat Rescue Remedy before the car ride, and just before you enter the veterinary clinic, will also help.

Some breathing problems can arise from fluid in the chest. The veterinarian may need to remove the fluid so the lungs can expand normally.

Conventional therapies

In the hospital, and when going home, a veterinarian might prescribe the following:

Diuretics, to remove fluid from the system and stop its accumulation in the chest or abdomen
Ace inhibitors and beta blockers to decrease blood pressure
Drugs to prevent clotting or reduce the size of clots
Other drugs, depending on the severity of the disease.

Natural therapies

Lifestyle changes:

- If the cat is overweight, feed fewer calories but more protein.
- If your cat shows signs of stress, such as increased respiration, behavior changes, and decreased appetite, try Rescue Remedy and provide more hiding places.

2. Supplements (work with a holistic or integrative vet before starting your cat on anything new):

- Taurine: 250 to 500 mg per day
- Vitamin E: 25 to 50 IU per day (if the cat is not on digoxin)
- CoQ10: 30 mg once or twice a day
- Omega-3 fatty acids: about 25 mg combined EPA and DHA per pound of bodyweight
- B vitamins: especially B1, B6, B12, and folate
- Increased potassium in the diet: unless the cat also has kidney disease

Although heart disease in cats is serious, proper care and monitoring help many affected kitties live comfortable lives. Watch for subtle changes in breathing, energy, appetite, and behavior. Early detection can improve treatment outcomes.

Feline heart disease: more common than you think

About 15% of cats develop heart disease. In cats over 12, the rate rises to 29%. The good news is that many live long lives and show few to no signs of a problem.

Congenital heart problems affect between 1% and 2% of cats from birth. This usually manifests as a hole in the heart between the ventricles. Smaller holes are less likely to cause problems. Less common is PDA (patent ductus arteriosus). In this case, the connection between the aorta and the artery to the lungs doesn’t close at birth.

Tests that diagnose heart disease in cats

An echocardiogram (heart ultrasound) is the only test that can differentiate the causes of heart disease. It shows ventricle wall thickness, blood clots, valve structure, and pressure inside the heart.
A BNP blood test (also called ProBNP or NT-ProBNP) shows whether the cat’s heart muscle is under stress. It helps decide if there is a problem associated with a heart murmur, and whether your cat needs treatment.
Chest x-rays show whether the heart is enlarged and fluid has accumulated in the lungs. It is useful for showing how well some drugs are working.
Taurine level testing shows if there’s a measurable taurine deficiency. It also shows whether your cat is getting enough taurine.
Blood pressure and thyroid blood tests help show other causes of heart disease that might also need treatment.

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