# Hypertrophic Cardiomyopathy



## M_lissa (Jul 19, 2005)

Hello,

Has anyone experienced the above disease? the vet found a heart murmor back in Jan when he was 1 yr and said to bring him back in 6mths for a re check. Well he still had it and we had the ultrasound and that is what she found. The put him on diltiazem 3 times a day. She said that hbe wasn't showing any symptoms so that is good, but they can't be sure how long he will live. I guess it is a disease where the heart muscle walls thicken and have a hard time pumping the blood correctly. Any advice?


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## Meowmie (Jun 4, 2005)

A little bit of information:
http://members.aol.com/jchinitz/hcm/

Since you already have a diagnosis, I urge you to find an excellent holistic vet without delay and follow the advice you'll find in the article below. Hopefully with early treatment you will be able to slow down the disease.
I know of more than one person who was actually able to reverse the disease with very aggressive natural treatment, so please make natural treatment a top priority. 

To find a holistic vet in your area:
http://www.ahvma.org/referral/index.html

Also, please get this book for additional information:
Shawn Messonnier DVM: Natural Health Bible for Dogs and Cats

*Cardiomyopathy = Heartbreak?*

_Maybe not...a combination of natural remedies can help._

By Fran Pennock Shaw

It's scary diagnosis - cardiomyopathy. It isn't necessarily a death sentence, although it does require prompt treatment. Deciding how to best help your cat with heart muscle disease can be heart-wrenching, and sometimes you may have to consider trying multiple approaches.

The first symptom of this most-common heart condition in cats is often a heart murmur, however not all heart murmurs develop into cardiomyopathies. Most at risk are cats with a taurine deficiency or genetic predisposition, but the actual cause of most cases is unknown. If diagnosed early, it is controllable and sometimes even reversible. Left untreated, the condition usually progresses to fatal congestive heart failure.

Many owners and veterinarians believe they can extend the lives of cats with even late-stage cardiomyopathy through homeopathy, diet, Chinese and western herbs and nutritional supplements, including amino acids, antioxidants and Coenzyme Q10. Diuretics are essential for cats suffering congestion in the lungs or chest, although opinion differs over whether pharmaceuticals or nutraceuticals are better in the long-term.

"If not treated fully, the cat with cardiomyopathy is going to die," warns Shawn Messonnier, DVM, a holistic veterinarian in Plano, Texas, who uses supplements and Chinese herbs along with traditional heart medicines. "When the cat's already in heart failure, you have to stabilize the patient first. Then you can reduce drugs and replace them with natural diuretics, but it should be done very carefully. You shouldn't just go out and pick any herb and think it's going to work."

Use of Herbs

Many vets say herbal diuretics such as dandelion or sarsaparilla tea or asparagus or carrot juice are too weak to effectively reduce the fluid from congestive heart disease. Dr. Messonnier also warns that all botanicals should be used in consultation with veterinarians because "some of these herbs can be very, very potent, even dangerous" for cats - especially ill cats - who metabolize substances differently than humans.

Owners can give cats hawthorn berry and bilberry to help heart function. Jeff Levy, DVM, a homeopathic veterinarian in Williamsburg, MA., says, however, "it's essentially enhanced nutrition and not likely to have enough of an impact on this serious a pathology. Basically, without intervention, cardiomyopathy will result in death. I don't want people to think it's simple enough to do anything on their own and have a prayer of succeeding."

He says he's successful using homeopathic remedies for the cardiomyopathy and common secondary symptoms such as difficulty breathing, fluid buildup and blood clots. "To see observable improvement in heart muscle takes at least six months," he says. "You're looking at years on a single remedy or sequence of remedies. While that's getting better, though, the cat should be doing relatively okay. You should expect to see significant clinical improvement within weeks to a month or two. Obviously, it varies from case to case."

Gary Wood, DVM, of Cardiology Northwest heart specialists in Portland, Ore., similarly believes "there are a lot of cats with cardiomyopathy who live a long time. There's a tendency to over-emphasize how bad it is. The sooner it's diagnosed and treated, the better cats do." Even cats with congestive heart disease can benefit, he adds, "If we get that under control and the underlying heart disease is moderate, a fairly large number go on to live many years." (Dr. Wood gets referrals from holistic vets but he relies mostly on conventional drugs - diuretics, blood thinners, antiarrhythmics, calcium channel blockers and beta-blockers - along with "sometimes controversial drugs" such as ACE-inhibitors to combat heart enlargement.) 

Even mainstream vets emphasize good nutrition and reduced stress for cardiomyopathy. Cats are often prescribed low-salt therapeutic or homemade diets and supplements of taurine, antioxidant vitamins and minerals, plus fish oils to improve appetite. Potassium is commonly given to cats on diuretics.

Cardiomyopathy Basics

There are three known types of cardiomyopathy, In hypertrophic cardiomyopathy (HCM), the left ventricle muscle thickens so the heart does not relax and fill properly. The left side of the heart bulges, creating a valentine shape. HCM mostly affects male cats, 1 to 8 years old, especially domestic shorthairs and longhairs, Ragdoll, Maine **** and Persian breeds. It's idiopathic (of unknown cause) and represents about 80 percent of the cats with heart disease, according to John Carl Goodwin, DVM, of the Veterinary Heart Institute, Gainsville, Fla., who sees about 700 animals a month with heart conditions. 

The heart muscle also in thickens in restrictive cardiomyopathy (RCM), which is similar to HCM, but considered harder to treat, possibly because it is much less common. Viral infections are one suspected cause.

In dilated cardiomyopthy (DCM), heart walls thin as the heart enlarges like a balloon. Incidence has dropped 90 percent since manufacturers began adding taurine to commercial cat food. The primary cure for DCM remains taurine supplementation; however, cats without a taurine deficiency still get DCM for unknown causes. 

Vets diagnose a heart murmur through a simple physical exam. A diagnosis of cardiomyopathy requires X-rays and an echocardiogram (ultrasound). A veterinary cardiologist may take additional tests.

Symptoms To Watch For

Cats typically hide their symptoms and the severity of cardiomyopathy can vary greatly anyway. Watch for panting or abnormal breathing, exercise intolerance, loss of appetite, weight loss, fainting. Most dangerous are abdominal swelling, coughing up blood, visual impairment or paralysis of the hind legs. A heart murmur (turbulent blood flow) is "always a red flag," but it could also mean feline anemia, thyroid disease or just a mechanical abnormality, Dr. Wood notes. 

Blood clots are a real threat from cardiomyopathy, especially from HCM. Potentially fatal clots, which form in the heart, travel through arteries and block essential blood flow. Cats with HCM most often get clots in the hind legs (saddle thrombus), resulting in full or partial paralysis. All cardiomyopathies can lead to congestive heart disease because whenever the heart pumps improperly, fluid can accumulate in the lungs (pulmonary edema) or chest cavity (pleural effusion). Both clots and congestion require emergency treatment. 

Other disorders can cause heart enlargement, "which mimics the effects and symptoms of cardiomyopathy," says Dr. Wood, including hypertension, hyperthyroidism, congenital disorders and pituitary gland and kidney diseases. Sometimes cats develop these diseases along with their cardiomyopathy. Treating kidney disease and heart disease "is always a real balancing act," he adds, and cats with late-stage dual diseases typically survive only three to six months.

Hopeful Alternatives

Dr. Levy reports "substantial success" treating cardiomyopathy with homeopathy, however, even when combined with kidney disease. Most difficult is cardiomyopathy with hyperthyroidism, he believes, yet overall, "in the vast majority of cases, I expect to beat the prognosis of the cardiologists."

He won't discuss specific homeopathic remedies, warning against developing "a cookbook way of thinking. We who know homeopathy still find cardiomyopathy very challenging. Anyone familiar with homeopathy should know they shouldn't be fooling around with this serious disease. Like cancer, you have to know how to find the remedies and follow the case. It takes a real long time to develop that expertise and even if you have the expertise, it's very difficult to be objective enough to see the pattern of symptoms clearly with your own pets."

He advises long-distance clients to get a diagnosis from their vet, then send him the cat's lifetime medical records, owner's observations and listing of all the pet's symptoms before beginning homeopathy, which he explains is based not only on symptoms but "on the cat's preferences, personality, behaviors." He also requires that traditional drugs and "medicinal herbs" be stopped. (That's not a prerequisite of all homeopaths.)

Additionally, the following nutritional supplements have been studied for cardiovascular disease:

Amino Acids

Taurine is a proven treatment for DCM, and some vets also supplements with carnitine. Although no one is sure if taurine helps with HCM or RCM, it is commonly prescribed.

Amino acids do many things, including the transport of other important substances like oxygen and nitrogen to the heart, explains Randall Thomason, director of research for Pet Health Pharmacy. In part, he analyzes a cat's blood "to determine what damage is being done to the heart," he says, and then develops a customized formula of natural substances, using amino acid transporters "to get them where they should go without breaking down. With advanced heart cases, often we cannot reverse but we can stabilize the disease so 90 percent of the time, the cat can still live a comfortable life."

Using amino acids plus antioxidants and other naturally occurring chemical substances "is an alternative treatment to create pharmacological effects," he says, but in serious cases, regular drugs may also be given. Owners can consult Thomason but vets must supply the blood samples and write the prescriptions for Pet Essentials individualized nutraceuticals.

Antioxidants

Oxygen is crucial to proper heart function, but oxidation harms cells and hastens decay. Antioxidants reduce this cellular damage by trapping and neutralizing free radicals - roaming molecules that break through membranes and create unwanted bridges between cells. Vitamins C, E, A, super oxide dismutase, selenium and zinc are typical antioxidants. 

Bioflavonoids (extracted from grape seeds, pine bark and cranberries) are "the most potent free radical scavengers in the plant kingdom," maintains John Mulnix, DVM, consultant to Animal Health Options Inc., which markets Proanthozone antioxidant through veterinarians. "Bioflavonoids also can help reverse the plaquing from cholesterol deposits on artery walls and help create a stronger collagen bond in the artery lining," he adds. "This has a role in slowing the progression of heart disease."

In his own veterinary practice, he treats cardiomyopathy with traditional drugs and antioxidants. There are no studies of bioflavinols for feline cardiomyopathy, but Dr. Mulnix notes a recent Colorado State University study testing Proanthozone on cats with measurable red blood cell injury, saying the research proved the product safe "and indicated that Proanthozone appears to protect red blood cells from oxidative damage."

Europeans more readily accept the benefits of proanthocyanidins (which includes bioflavinols) for cardiovascular and congestive heart diseases, adds nutritional consultant Mark Timmons. "In France, they are sold over-the-counter to improve circulation, take pressure off the heart and stop leakage of fluids for capillaries. Studies in England show that antioxidants reactivate white blood cells that become engorged with cholesterol and also help make the blood less prone to clotting," he says.

Coenzyme Q10

Present throughout the body but concentrated especially in heart muscle cells, Coenzyme Q10 (CoQ10) is essential for enzyme activity and energy transfer. It also inhibits oxidative damage. Studies link low levels of CoQ10 to congestive heart failure and other diseases in humans and animals. Supplementation with this vitamin-like substance may remedy diastolic heart problems like feline HCM/RCM.

"With HCM, the heart works too hard. It can't relax," Dr. Goodwin explains. "CoQ10 increases oxygen levels in the heart and may help it relax." He commonly prescribes it in his own practice "with good results - cats have more energy and the heart failure doesn't progress. We don't have a cure for HCM but it helps to treat them with Coenzyme Q10."

Dr. Goodwin is scientifically studying his feline patients on CoQ10 to see if they do better than cats given a placebo. He ultimately plans to track 200 cats with cardiomyopathy, all of who will continue receiving conventional drugs. CoQ10 will not aid DCM, most heart murmurs or valve disorders, he notes. He also advises using only oil-based gelatin capsules not powders or tablets, which degrade. His study involves only the use of Co-Mal-Q10 by Nutramax Laboratories Inc., which is sold through veterinarians.

A major problem treating cardiomyopathy, Dr. Goodwin concludes, is owners who resist drugs, like diuretics, even for short-term use. "To treat a cat in heart failure without diuretics would be very irresponsible. It would be like refusing antibiotics," he says. "Cardiac therapy is often a combination of traditional medicine and holistic therapies. To practice good medicine, you have to avoid a bias against either one of them."


_Fran Pennock Shaw is an award-winning freelancer and journalist from Lancaster, PA_


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## emma_pen (Nov 2, 2004)

Your right, HCM is the thickening of the muscle of the heart, namely in the left ventricle. It is a hereditary condition, and fairly common in young cats. The best way to diagnose HCM is with an ultrasound scan, is this what your vet has done? 
Thickened cardiac muscle can also be caused by hypertension & hyperthyroidism, so it would be a good idea to rule out both of these conditions if not already done.
Learn how to check your own cats heart & respiratory rates, and be watchful for changes. If he seems unwell, get vet attention immediately. And please do some research on the symptoms of Thromboembelism, so you know what to watch for, particularly hindlimb paralysis.
There is no cure for HCM, though medication may help for quite a long time, simply by improving heart function. It's a good thing that he seems to have been diagnosed early, as it increases his chances of living a full life. Some cats only suffer mildly, others develop in serious heart failure. It can gradually worsen over months, or years, there really is no way of guaranteeing how long a cat will live with the condition, as each individual is different. Cherish and enjoy your baby boy as much as you can. I've known young cats to live years before succumbing to this terrible disease.

Ems


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## emma_pen (Nov 2, 2004)

Oops, posted at the same time as Meowmie :wink:


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## Meowmie (Jun 4, 2005)

> And please do some research on the symptoms of Thromboembelism, so you know what to watch for, particularly hindlimb paralysis.


This is extremely important, invaluable advice. When help comes in time, cats can be pulled back literally from the brink of death.


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## Deedee (Jul 15, 2005)

Ok first I will stress - I am not a medical person! But this topic hits home and I can give my personal experiences with this as I have Hypertrophic Cardiomyopathy myself. My dad and my grandfather did too. The track record for shorter life expectancies is there, but we've all played sports and lived our lives to the fullest. My affected heart walls are 3x thicker than normal and the individual cells themselves are in a disarray. The only way to diagnose and monitor HCM is with echocardiograms and your vet will want to recheck the measurements every year or two to monitor the growth and check for obstructions.

Anyway, there's a couple factors involved in human HCM.  One is the wall thickness and one is the cell disarray.  Both cause their own problems.  The thickness causes the heart to work extra hard and the increased pressure can cause a sand-blasting type internal damage or the deformed shape can cause obstruction... it can be a bit of a mess or get infected or break off bits that get into the blood stream and get caught on something and you can guess that's never good. But I won't go into massive medical jargon on you because I'm writing this personal account to you to counteract the cold, sterile and scary diagnosis fear I know you're feeling right now. TONS of people live full and normal lives with HCM and this is just my perspective and my experience.

Anyway if things don't get obstructed, it can go pretty smooth believe it or not! And even be a pretty strong muscle too!  A fun and interesting sporting example of something similar to this would be the great race horse legend Secretariat, who had an enlarged heart (3x but not deformed) and you can certainly see how he used it's strength in his life.  Now the cellular disarray is where the electrical compromises come in.  If you look microscopically at my heart tissue you would see the cells are not all lined up and orderly but in a chaotic mess. That's why we need defibrillation paddles instead of CPR... because the nature of our cardio cell structure doesn't lend itself to stable rhythmic pulses once it looses the beat.  (Think Jim Carrey dancing... it just doesn't synch up with the music!)  That, in a nutshell, is why often a young HCM athlete can collapse on the sports field and not be saved with CPR.  That's why HCMers push school districts to get portable defibrillation paddles at every sports event too. If any kids at your school have murmurs, I'd push for this HARD and for murmur screening if it hasn't been done too... but I digress...

Okay, so some kids with obstructive HCM are not up to and/or discouraged/not allowed to play sports or do normal kid stuff, but the vast majority of human HCMers can do whatever they want.  I have always done as I pleased and have often been a total sports fanatic (playing not watching!) so even with 3x stats on my wall measurements, I get away with it because I'm not obstructed.  Does my heart's strength due to me not giving up on it and using it all these years help me not lose my electrical beat during fluttery tachycardia episodes which I get daily?  I'm not sure anybody can really say for sure, but given an informed choice the entire time, I would have still chosen to live my life and have fun how I have done.

I am out of breath a lot compared to other people at my fitness level, but I'll gladly take that in exchange for enjoying my life.  I don't think living your life with HCM instead of sitting on the sidelines is at all similar to playing Russian Roulette.  I think it's taking what you've got and making the most of it.  This is not meant to make the parents of OHCM children feel judged tho... this is just my personal choice that I made for me and my heart and my particular (some say peculiar, LOL!) situation.

A cat is just a little bit of a thing but since I started life as a 3 pound little bit of a thing myself, and I did okay - I just hope you're not too frightened by this very scary sounding diagnosis.  I'd be very interested to know the reasons your cat was put on a drug if it's not having symptoms? And murmur doesn't count... evidence of obstruction or inability to keep a beat would count. So why the drug I wonder?

Please PM me anytime the fear or hopelessness grips your heart or mind. I have had many years to deal with the fear and head game a bad heart diagnosis can put on you and would be happy to calm you and talk about the bottom line (the HCMer enjoying their life just like anyone else has a right to do) any time at all.  If you're like me, you'd rather have something than have your child or pet have it because at least then you understand more what is going on.  I can't even IMAGINE being an HCM parent, honestly.  To a child or to a pet.

Well I hope these words calmed you a little. Listen, I might play 2 hours of tennis, go on a 2 hour kayak trip in the ocean and then return for another 2 hours of tennis and all a lot of cats mostly do is nap in the sun, right? As long as he's asymptomatic I would not worry too much. How human HCM and feline HCM differ is something I know nothing about, so maybe someone will come along and say all my words were a waste of uninformative and misleading time, but I hope you just receive them in the manner they're intended... to calm down a very frightened kitty mom from someone with HCM insider's feelings.


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## Meowmie (Jun 4, 2005)

Deedee, just a couple of quick comments.

Heart disease in cats is a killer, and it can be a horrible, unsuspected, silent killer. A cat can look perfectly healthy, it can look and act like the healthiest cat in the whole wide world and it can be dead from one moment to the next without any warning whatsoever.

The heart disease can be so silent that no vet will discover it in time during a routine office visit. A cat can even survive a procedure (a dental appointment for instance) that requires anesthesia shortly before it dies without the slightest warning sign that anything is wrong with the heart. 

An early diagnosis can be a blessing because it gives the owner a chance to do something for the cat.

An important sentence from the article I posted for the original poster:
_"If not treated fully, the cat with cardiomyopathy is going to die," warns Shawn Messonnier, DVM, a holistic veterinarian in Plano, Texas_

Information about sudden death, the most shocking, heartbreaking thing that can happen:
http://www.vetinfo.com/csuddeath.html


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## M_lissa (Jul 19, 2005)

Wow, thanks for all of the information. 
They put Frankie on diltiazem which is a calcium blocker and is supposed to slow the disease and help his heart pump blood more efficiently. The vet had said it was a good thing that we caught it before he was symptom matic because then the medicine could start to slow the progression of the disease.

I haven't had much luck trying to understand homeopathy. Is there a link or links which could better explain what this kind of vet could do for Frankie as opposed to my regular vet?

The thought of thromboemblism is frightning. If he isn't symptamatic is he still at high risk of this?


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## Meowmie (Jun 4, 2005)

> I haven't had much luck trying to understand homeopathy. Is there a link or links which could better explain what this kind of vet could do for Frankie as opposed to my regular vet?


Very simply holistic vets and homeopaths work with herbs, nutritional supplements and homeopathic remedies instead of medications. The pet benefits because natural treatment allows your conventional vet to cut down on the amount of toxic medication he/she has to prescribe and together the vets can control the disease with less harmful substances. Heart medications are especially toxic, so natural treatment is very, very important. 

In addition to all the natural treatment options described in the article, you get excellent information from the 
Natural Health Bible for Dogs and Cats by Shawn Messonnier DVM
The Nature of Animal Healing by Martin Goldstein DVM
Complementary and Alternative Veterinary Medicine Principles and Practice by Allen M. Schoen DVM and Susan G. Wynn DVM
Prescription for Nutritional Healing by Balch (MD)

Using blood thinners from very early on and relying on natural blood thinners as much as possible is the most important thing you can do to try to prevent blood clots. If you reread the article a few more times and then go on to read the books you'll understand everything and it will be very easy for you to work with a holistic vet.

The most important thing when you treat heart disease: never, ever try to rely on self-treatment. Always work with knowledgeable, highly trained veterinarians (holistic and conventional). 
Your holistic vet will give you additional helpful information about homeopathy and explain things to you about the remedies.


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