Case of the month: 11 months old European Shorthair cat with sudden onset of respiratory distress
Signalment and anamnesis
- 11 months old European shorthair cat with sudden onset of respiratory distress
For further clarification the following radiographs were taken:
Radiographic description
- The pleural space and mediastinum are unremarkable
- A moderate to severe, disorganized, multifocal interstitial to alveolar lung pattern is evident throughout the lung parenchyma, but most pronounced in the perihilar and perivascular areas
- There is also moderate to severe generalized cardiomegaly with a renal heart shape on lateral view and a "Valentine heart" character on ventrodorsal projection
- Both pulmonary arteries and veins are mildly enlarged and asymmetric with the veins larger than the arteries
- Thin radiopaque fissure lines are evident between the pulmonary lobes, indicative of mild pleural effusion
- The trachea is normal in location and position
- The liver in the cranial abdomen is enlarged and shows rounded margins and caudodorsal displacement of the stomach.
Diagnosis
- The radiographs show moderate, generalized cardiomegaly. Various subtypes of cardiomyopathy are the most common cause of cardiomegaly in this species. In this case hypertrophic cardiomyopathy seems most likely due to the shape of the heart
- The vasodilatation is indicative of the development of heart failure
- Given the cardiomegaly and vascular changes, it is relatively likely that the lung pattern is reflecting cardiogenic edema due to left heart failure
- Mild hepatomegaly is suspected; given the cardiac disease, this is most likely due to cardiac-related congestion; metabolic or vacuolar hepatopathies are also possible. Diffuse inflammatory or neoplastic infiltration is possible but less likely
Outcome
- Echocardiography could confirm hypertrophic cardiomyopathy
Discussion
- Primary or secondary hypertrophic cardiomyopathy in the cat is characterized by abnormal thickening of the myocardium, papillary muscles, and ventricular septum
- As a result, the ventricular lumen is reduced, and diastolic dysfunction occurs
- The disease can occur from 3 months to 17 years of age but tends to affect middle-aged to older cats
Many thanks to Dr. ECVDI Thorsten Rick for this case report!
Special thanks to the 
Vetklinikum Vienna for making the case available!
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