Treatment of chronic heart failure in dogs and cats. Heart medications for cats

Causes
CHF can develop against the background of almost any disease of the cardiovascular system, but three main etiological factors are:
- cardiomyopathy (CM),
- arterial hypertension,
- heart defects.
Establishing its cause is necessary to choose treatment tactics for each specific case.

Cardiomyopathies
CMP and subsequent progression of CHF due to changes in the geometry and local contractility of the myocardium are called left ventricular (LV) remodeling. decrease in total myocardial contractility during CMP - hibernation (sleep) of the myocardium.

Arterial hypertension
Regardless of their etiology, a structural restructuring of the myocardium develops, which is called hypertensive heart. Mechanism of chronic heart failure
V in this case caused by the development of LV diastolic dysfunction.

Heart defects
Characteristic development of CHF due to acquired and uncorrected congenital defects.

It is necessary to remind about idiopathic dilated cardiomyopathy (DCM) - enough rare disease unspecified etiology, which develops in relatively at a young age and quickly leads to cardiac decompensation.

Forecast
Using the New York Heart Association (NYHA) classification adapted for animals, the annual mortality of patients with functional class I (FC) CHF is about 10%, FC II is about 20%, FC III is about 40%, and FC IV is more than 60%. Despite the introduction of new treatment methods, the mortality rate of patients with CHF does not decrease.

Goals of therapy
1. Elimination or minimization of clinical symptoms of CHF ( increased fatigue, tachycardia/increased heart sounds, shortness of breath, edema).
2. Protection of target organs (vessels, heart, kidneys, brain, by analogy with the treatment of arterial hypertension) and prevention of wasting of striated muscles.
3. Improving quality of life.
4. Increased life expectancy.

Treatment of chronic heart failure

Non-drug
Diet - the main principle is to limit salt intake and, to a lesser extent, liquid intake.
Physical rehabilitation - mandatory walks with the animal for 20-30 minutes. per day with monitoring of the animal’s condition, in particular its pulse. A load at which reaching 75-80% of the maximum permissible heart rate for the patient does not depress hemodynamics is considered effective.

Drug treatment
Ideally, any treatment algorithms should be based on “evidence based medicine,” i.e., effectiveness medicines must be proven by international multicenter, randomized studies. Unfortunately, the specifics of veterinary medicine do not allow conducting full-fledged studies of this scale.

The entire list of medicines used for treatment of CHF, are divided into three groups:
- main,
- additional,
- auxiliary. The main group of drugs fully meet the criteria of “medicine evidence” and are recommended for use in all countries of the world (ACE inhibitors - ACE inhibitors, diuretics, cardiac glycosides, beta-blockers as an addition to the prescription of ACE inhibitors). According to indications, it is possible to prescribe additional group drugs whose effectiveness and safety have been proven by large studies, but require clarification or meta-analysis (aldosterone antagonists, angiotensin-P receptor antagonists, calcium channel blockers of the latest generation).

The effectiveness of auxiliary group drugs, as a rule, has not been proven. However, their use is dictated by certain clinical situations (peripheral vasodilators, antiarrhythmic drugs, antiplatelet agents, direct anticoagulants, non-glycoside positive inotropes, corticosteroids, statins).

Despite big choice medications, polypharmacy is unacceptable in treatment (unjustified prescription large quantity groups of drugs). At the same time, representatives of the main group in the treatment of CHF do not always occupy leading positions, and preference may be given to additional and auxiliary drugs.

Let's look at the characteristics of the main group of drugs.

ACE inhibitors
Currently, in the treatment of CHF, the effectiveness and safety of captopril, enalapril, ramipril, fosinopril and trandolapril are beyond doubt.

The prescription of ACE inhibitors is indicated for all patients with CHF, regardless of the stage, functional class, etiology and nature of the process. As clinical practice shows, doctors not only in Russia, but also in developed countries These drugs are not always prescribed, which leads to increased mortality. The main reasons for this situation are the lack of awareness of doctors, the relatively high price of some ACE inhibitors, the fears of the doctor and the patient about the occurrence of adverse reactions. However, the inability of a doctor to prescribe a drug due to the risk of adverse reactions is more likely to indicate his lack of qualifications than to the presence of absolute contraindications to the prescription. It was revealed that the earliest prescription of an ACE inhibitor, already in NYHA class I, can significantly slow down the progression of CHF.

Common adverse reactions:
- dry cough caused by blockade of the destruction of bradykinin in the bronchi. Possibility of prescribing ACE inhibitors against the background chronic bronchitis or bronchial asthma without increasing cough - a serious argument in favor of prescribing the drug. The lowest risk here is associated with fosinopril;
- increase in the degree of proteinuria, azotemia - a rather rare complication, occurring mainly in patients with concomitant chronic renal failure. In such cases, it is also advisable to prescribe fosinopril, since it has two routes of elimination from the body (renal and hepatic);
- arterial hypotension, the occurrence of which is possible immediately after the start of the use of ACE inhibitors due to the rapid effect on circulating neurohormones. When treated in titrating doses, this effect either does not occur or decreases within 2 weeks. The long-term effect is realized through the blockade of tissue neurohormones.
- Minimization arterial hypotension achieved:
- refusal to simultaneously prescribe ACE inhibitors and vasodilators (P-blockers, calcium channel blockers, nitrates) - after stabilization of blood pressure levels, you can return to the previous treatment regimen;
- refusal of previous active diuretic therapy, especially on the eve of the appointment of ACE inhibitors, in order to prevent the implementation of the potentiating effect of the drugs;
- in patients with initial hypotension, short-term use of small doses of GCS (prednisolone, 10-15 mg/day) is possible, however, if the initial systolic blood pressure is less than 80-90 mm Hg, then ACE inhibitor therapy is not indicated;
- the initiation of therapy with any ACE inhibitor should begin with minimal (starting) doses.

Basic principles of ACE inhibitor dosing: starting and maximum (target) doses are determined for each specific drug. If necessary, titration is carried out no more than once a week under conditions wellness patient, absence of adverse reactions and mean arterial pressure of at least 90 mm Hg. Art.

Diuretics (diuretics)
A paradoxical situation arises with regard to diuretics. No one doubts the need for their use in decompensated CHF. However, neither in humanitarian nor in veterinary medicine there is not a single study that has confirmed their effectiveness from the standpoint of evidence-based medicine.

The main indication for prescribing diuretics is Clinical signs excessive fluid retention in the body of a patient with CHF. However, it should be remembered that diuretics cause hyperactivation of neurohormones of the renin-angiotensin-aldosterone system and electrolyte disturbances.

Principles of therapy using diuretics:
- combination with ACE inhibitors allows you to reduce the dose of diuretics with the same clinical effect,
- the weakest person is appointed effective drugs in order to prevent the development of addiction,
- it is necessary to have a backup diuretic in type and dose during the period of CHF decompensation.
- daily administration in a minimum dose to achieve a positive fluid balance in terms of diuresis.
- Characteristics of the most commonly used diuretics. Basically, two groups of diuretics are currently used - thiazide and loop.

From the group of thiazide diuretics, preference is given to hydrochlorothiazide, which is prescribed for moderate CHF (NYHA class II-III). In minimal doses it causes almost no adverse reactions, but in maximum doses it provokes electrolyte disorders. The maximum effect is observed 1 hour after administration, the duration of action is 12 hours. Recommended to take in the morning.

One of the most powerful representatives of the group loop diuretics is furosemide. It shows its effect within 15-30 minutes. after administration, the maximum effect is observed after 1-2 hours, duration of action is 6 hours. The dosage varies depending on the severity of CHF symptoms. It is recommended to take it in the morning on an empty stomach. The diuretic effect persists even with reduced renal function.

Ethacrynic acid- a drug similar in its effect to furosemide, but acting on other enzymatic systems of the loop of Henle. It can be used in case of development of refractoriness to furosemide or combined with it in case of persistent edema. It is recommended to take it in the morning on an empty stomach.

Cardiac glycosides
Currently the most common cardiac glycoside in Russia, digoxin is the only drug from the group of positive inotropic agents that remains widely used clinical practice at long-term treatment chronic heart failure. Non-glycoside drugs that increase myocardial contractility have a negative effect on the prognosis and life expectancy of patients and can be used in short courses for decompensated chronic heart failure
.

Currently, the effect of glycosides is associated not so much with their positive inotropic effect, but with a negative chronotropic effect on the myocardium, the level of circulating and tissue neurohormones, and with modulation of the baroreflex.

Digoxin is a first-line drug in patients with CHF in the presence of a constant tachysystolic form atrial fibrillation. In sinus rhythm, the negative chronotropic effect of digoxin is weak, and myocardial oxygen consumption increases significantly due to the positive inotropic effect, which leads to tissue hypoxia. Thus, the use of the drug may provoke various disorders rhythm, especially in patients with ischemic etiology of chronic heart failure
.

Optimal indications for prescribing cardiac glycosides:
- constant tachysystolic form of atrial fibrillation,
- severe CHF (NYHA FC III-IV),
- ejection fraction less than 25%,
- cardiothoracic index more than 60%,
- non-ischemic etiology of chronic heart failure
(DCM, etc.).

Modern principles of treatment
Glycosides are prescribed in small doses. It is necessary to control their concentration in blood plasma, which is problematic in Russian practice; for digoxin it should not exceed 1.2 ng/ml. The pharmacodynamics of the drug are taken into account: the concentration increases exponentially by the 8th day from the start of therapy, therefore patients are advised daily monitoring ECG to monitor rhythm disturbances.

p-blockers
In 1999, doctors in the USA and Europe recommended beta-blockers for use as the main means of treating CHF. So, the postulate about the impossibility of prescribing drugs with a negative inotropic effect to patients with this pathology was refuted. A number of studies have proven that beta-blockers for CHF have a hemodynamic profile of action similar to that when taking cardiac glycosides, i.e. Long-term administration of β-blockers leads to an increase in the pumping function of the heart and a decrease in heart rate. But among the latter, not all means have positive effect with CHF. Currently, only three drugs have been proven effective:
- carvedilol (has blocking activity, antiproliferative and antioxidant properties),
- bisoprolol (the most selective agent for p-1 receptors),
- metoprolol (retarded form of a selective lipophilic compound).

Principles of β-blocker therapy. Before prescribing the drug:
- the patient must be on a stable dose of ACE inhibitor that does not cause arterial hypotension;
- it is necessary to intensify diuretic therapy, because due to a short-term decrease in pumping function, an exacerbation of CHF symptoms is possible;
- if possible, discontinue vasodilators and nitrates; for hypotension, a short course of corticosteroids is advisable;
- the starting dose of any drug should be 1/8 of the average therapeutic dose;
- subsequent doubling of dosages is carried out no more than once every 2 weeks, provided the patient’s condition is stable, there is no bradycardia and hypotension;
- select the optimal dose.

Principles of combined use of basic drugs for the treatment of chronic heart failure

Monotherapy in the treatment of chronic heart failure
rarely used. In this capacity, only ACE inhibitors can be used, and only in the initial stages.

Dual therapy with ACE inhibitor + diuretic is optimal for patients with CHF IMII NYHA class with sinus rhythm. The use of a diuretic + glycoside regimen, which was extremely popular in the past, is not currently used.

Triple therapy of ACE inhibitor + diuretic + glycoside remains an effective regimen in the treatment of chronic heart failure, but in patients with sinus rhythm it is recommended to replace the glycoside with a beta-blocker.

The gold standard is the combination of ACE inhibitor + diuretic + glycoside + beta-blocker.

For animals, as for people, the heart is most important organ, without which it is impossible to live. This is the “engine” of the body, but, unfortunately, sometimes it can fail. Pets suffer from heart disease no less than their owners (not in terms of the number of diseases, but in terms of physical condition). If for some reason an illness strikes your mustachioed friend, believe me, he, like a person, is in pain and hard. And very dangerous for life.

Symptoms and how they manifest themselves

Failure in the functioning of the heart muscle in an animal inevitably leads to complex violations all systems of the body. If you miss the moment when a problem occurs and do not take action, then over time your pet will develop a disease called heart failure. Already from the name it is clear that the activity of the heart is not enough for a normal life.

But the illness does not fall on the ward for no apparent reason. It accumulates, gaining its crushing power, starting small and gradually turning into a terrible beast.

Not every owner of a purr knows the symptoms indicating the development of heart failure. First, the heart muscle begins to contract in the “wrong” rhythm. This leads to disruption of the circulatory system. Paroxysmal rhythmic disruptions literally suck the energy out of the patient. It becomes so small that there is not enough strength to distribute oxygen and nutrition to the animal’s organs and tissues. And this is when he is physically inactive! Now imagine what will happen when your pet starts running or playing? A sharp lack of oxygen causes asphyxia, the pussy begins to suffocate, as if it were being strangled.

That is, usually:

Shortness of breath for no reason
Constant barking cough
Cyanosis - blue discoloration of mucous membranes and tongue
Ascites is the accumulation of fluid in abdominal cavity
Increased fatigue, fainting.

Often the first symptom the owner notices is pulmonary edema (severe respiratory failure). Another symptom of severe heart failure is paralysis hind legs. It is associated with thromboembolism of the abdominal aorta.

The disease most often affects cats past their sixth birthday. More often, but not always. Heart failure is quite capable of developing in six month old baby. So it's not "senile" cat disease, as many mistakenly believe. Fortunately, the disease is not as common among cats as it is among people. Still, the diet and biochemical reactions in animals are somewhat different.

Types of disease

Like almost any disease, this too can have acute or chronic form. There are several manifestations of pathology by type:

Congenital.
Acquired.
Primary.
Secondary.

The last one on the list may develop against the background past infection. In addition, there are some cat breeds that have a tendency to develop heart and vascular diseases. Basically, these are large animals, Maine Coons, for example.

Causes

Congenital heart pathologies. In cats they are quite rare, occurring in approximately 2% of all cases.
Heart muscle diseases caused by infectious diseases.
Cardiomyopathy, which is caused by an inadequate diet of cats. They, as a rule, do not receive enough taurine, which is part of raw fish and meat. During cooking, it is destroyed.
Heartworms, their larvae are found in mosquitoes. They are microscopic in size. When a mosquito bites, their larvae enter the animal’s bloodstream and settle in pulmonary artery. Heartworms can grow up to 30 centimeters in size. With his presence in circulatory system they interfere with the outflow of blood and cause enormous damage to the arteries. Adults entangle the heart, thereby interfering with its full functioning. Heartworms can be detected using a blood test.
Age hormonal changes . Heart failure is thought to occur in cats over 6 years of age.
Metabolic disease. Sometimes it is caused by improperly structured nutrition.

Cats should be periodically screened for heartworms to help prevent heart disease. If a taurine deficiency is noticed in a timely manner, it must be introduced into the cat’s food, due to which the vital activity of the heart muscle is restored.

Congenital heart disease is quite rare in cats. According to some data, they occupy no more than 1-2% of cardiac pathologies. Most often these are valve insufficiency, cardiac septal defects and patent ductus botellus.

Predisposition

Most often, the disease is found in animals of the following breeds:

Regdoll.
Maine Coon.
British.
Scottish fold, Scottish straight.
Norwegian forest.
Sphinx.
Persian.

Diagnostics

Blood and urine tests.
X-ray examination chest .
Ultrasound.
ECG.

If a cat is diagnosed with heart failure, it is recommended to protect it from breeding offspring, since the disease is often inherited.

Among other things, the development of this anomaly in an animal is determined using the following methods:

Taking a complete medical history(data about the pet from the owner). It is important to prepare and provide the veterinarian with detailed, comprehensive information; it is best to bring it to the appointment in writing, so as not to miss important details about the health and vital functions of your pet.
Listening, palpation and other methods of visual and physical examination. Even by measuring an animal’s blood pressure, you can come across a sign of a disease: decreased performance usually indicate serious heart problems.

Treatment

First emergency aid:

lay the pet's head to one side;
remove tongue from mouth;
Apply a cool compress prepared in advance to the cat’s head;
try to bring the animal to its senses by holding a cotton ball soaked in ammonia to its nose;
The paws must be held above the head to increase blood flow to it.

For recovery you need:

Complete rest of the animal. The pet must be limited from any stress - this could be a working vacuum cleaner, a trip to public transport or the arrival of guests.
Treatment with diuretics removes excess fluid from the body. During illness, fluid can accumulate near the lungs, thereby causing swelling. In the chest, causing pleurisy. In the abdominal cavity, causing ascites. Reducing the amount of fluid in the body helps reduce the load on the heart.
Treatment ACE inhibitors , which reduce the load on the heart by increasing blood flow.
Positive inotropes make the heart pump more blood, control the heartbeat, and slow it down so it pumps more blood into the body.
When the fluid content in a cat’s body is greatly increased, the veterinarian will pump it out and thereby remove it from the body. The cat will feel relief for a while, but this will not last long, as the fluid will return. Pumping is carried out by inserting a sterile needle into the required place.
Balanced diet.

Cardiac glycosides - aimed at improving myocardial trophism. Digoxin is used for treatment, but its use is contraindicated in the presence of arrhythmias. Prescribed in minimal doses, gradually increasing to the optimal amount over the course of a week.

To improve pumping function, beta-blockers are used - bisoprolol, metaprolol. The starting dose should be an eighth of the expected dose, and increased every 2 weeks.

Standard drug therapy regimens:

ACEI only - used in treatment initial stages illness.
ACE inhibitor and diuretic - with the development of insufficiency of 2 or 3 degrees.
ACE inhibitor, diuretic, cardiac glycoside and beta-blocker are the most common and “gold standard” therapy in veterinary medicine.

Diuretics (diuretics). A paradoxical situation arises with regard to diuretics. No one doubts the need for their use in decompensated CHF. However, neither in humanitarian nor in veterinary medicine there is not a single study that has confirmed their effectiveness from the standpoint of evidence-based medicine.

Main indication for prescribing diuretics- clinical signs of excessive fluid retention in the body of a patient with CHF. However, it should be remembered that diuretics cause hyperactivation of neurohormones of the renin-angiotensin-aldosterone system and electrolyte disturbances.

Ethacrynic acid- a drug similar in its effect to furosemide, but acting on other enzymatic systems of the loop of Henle. It can be used in case of development of refractoriness to furosemide or combined with it in case of persistent edema. It is recommended to take it in the morning on an empty stomach.

Cardiac glycosides.Currently, the most common cardiac glycoside in Russia, digoxin, is the only drug from the group of positive inotropic agents that remains in wide clinical practice for the long-term treatment of chronic heart failure. Non-glycoside drugs that increase myocardial contractility have a negative effect on the prognosis and life expectancy of patients and can be used in short courses for decompensated chronic heart failure

Treatment is often lifelong and includes:

A therapeutic diet.
Normalizing body weight, minimizing situations that can cause stress.
Prescribing medications to thin the blood, normalize blood pressure, increase heart contractility, diuretics, potassium and magnesium supplements, and vitamins.

Prevention

It is impossible to completely eliminate the risk of developing the disease. Significantly reduce the likelihood of its occurrence:

Proper feeding.
Absence of factors that cause stress in the cat.
Examination by a veterinarian every year, if the breed of the animal predisposes to the disease - every 6 months.
Exclusion from breeding of animals with a history of congenital heart pathologies.

Pet owners need to be aware that a number of heart pathologies, such as feline hypertrophic cardiomyopathy and some others, can long time don't show yourself in any way. But if the animal’s body is subjected to stress, including anesthesia, cardiac pathology can become threatening to the normal existence and even life of the cat.

Therefore, before carrying out planned surgical interventions, it is very important to undergo a cardiac examination (Ultrasound of the heart), during which hidden cardiac pathologies of cats, if any, will be identified.

In heart failure, such disturbances in the “pumping” function of the heart are observed when the blood supply to the whole organism deteriorates significantly. That is, tissues and organs do not receive oxygen and other nutrients. Moreover, the higher the activity of the animal, the stronger this shortage appears. The pathology is quite uncommon in cats, but this does not mean that it does not deserve due attention.

Changes that occur during cardiac dysfunction, their causes.

Heart failure in a cat can be acute, manifesting itself in minutes or hours, or chronic, occurring over months or years. Pathology is not a separate disease; it is rather a complex of symptoms that accompanies many infectious and heart diseases.

An acute course is not typical for cats. This is explained by the peculiarities of metabolism and anatomical structure of cardio-vascular system. Chronic course occurs more often, although cats have a lot of different compensatory functions of the body.

In cats, there are 4 types of heart failure, which appear due to:

heart overload with an unnaturally large volume of pumped blood;
deterioration of the contractility of the heart muscle;
high pressure on the inner walls of the heart, which is exerted by the blood flow during contraction;
lack of blood flow from the veins.

There are many reasons for the development of cardiac pathologies, and they are not always caused by the condition of the heart:

heart defects (from birth or that appear during life);
chronic arterial hypertension;
inflammatory processes in the heart muscle;
dystrophic changes in the tissues and vessels of the heart;
hyperthyroidism, causing chronic tachycardia;
pulmonary stenosis;
infectious and inflammatory diseases of the respiratory and cardiac systems;
general poisoning of the body (for example, intoxication of the kidneys or hepatobiliary system, pyometritis);
diabetes.

What does heart failure look like in cats?

Symptoms depend on the causes that contributed to the development of problems in cardiovascular system cats, on the form of the flow, on the age of the animal.

The acute form of heart failure in cats manifests itself:

a thread-like pulse that may disappear altogether;
sudden loss of strength;
apathy with shortness of breath;
pale bluish mucous membranes;
cold extremities and ears;
the pet lies down, rarely gets up or doesn’t get up at all;
there may be fainting.

Chronic heart failure in cats is more common than in cats and manifests itself:

systematic shortness of breath, especially after running or active games;
almost constantly increased but heavy heart rate;
accumulation of fluid in the peritoneum, chest cavity;
cardiac edema;
partial failure hind limbs(rarely).

If the cat has heart attack(symptoms):

the animal rushes and fusses, tries to find a secluded place;
difficulty wheezing;
loss of consciousness is possible.

Manifestations of heart failure in kittens:

usually develops against the background congenital problems with heart;
unnaturally rapid fatigue;
heavy breathing after increased physical activity;
blue discoloration of visible mucous membranes and tongue;
worsening in the afternoon.

Diagnosis of insufficient functioning of the cardiovascular system.

Cats by nature have tremendous compensatory properties, so owners of mustachioed pets often turn to veterinary clinics for help when the disease lasts for a very long time. No one other than a veterinarian can accurately determine heart failure in a pet. To do this you need to do:

Detailed collection and analysis of anamnesis.
Physical examination with mandatory listening to heart sounds.
Cardiogram (reflects the work of the heart with all deviations).
Radiography.

How can I help my cat?

Treatment of heart failure in cats should only be prescribed by a veterinarian - only after the cause of its development has been established. Therapy is only medicinal, because Heart surgery is not performed in cats, and it depends on the cause of the failure. At acute course Treatment will be aimed at relieving the attack; in case of a chronic attack, lifelong maintenance therapy will be used.

It is necessary to prescribe diuretics for elimination excess liquid from the body. This action relieves stress on the heart.
Drugs that increase blood supply to the myocardium.
In the presence of infectious diseases or any inflammatory processes, antibiotics can be used.
Inotropic agents - increase blood flow into the body, balancing the heartbeat.
Means that normalize arterial pressure and depressing ACEs, relieve the heart due to the outflow of blood from it.
Antithrombic agents may be needed if blood clots are identified that interfere with the nutrition of the hind limbs.
If one of the causes is hyperthyroidism, therapy will be prescribed that affects the functioning of the thyroid gland.
Be sure to use general strengthening agents for the heart.
Rest and balanced nutrition are provided to the sick animal.

Cats, like other mammals, suffer from heart disease. However, in cats, these diseases are difficult to detect at an early stage. Their relatively low mobility and ability to conduct b O Most of the time, sleep hides symptoms that are more pronounced in animals that are more active. active image life. Another difficulty is that the symptoms heart disease similar to symptoms characteristic of diseases of the respiratory tract and lungs. Therefore, it is important to closely monitor your cat’s health, and if the first symptoms of the disease appear, immediately contact veterinarian.

Steps

Part 1

Recognizing Early Symptoms

Pay attention to the cat's lethargic behavior. When the heart finds it difficult to cope with its functions, the animal becomes lethargic.

This is explained by the fact that even a slight physical activity, for example, walking or climbing stairs, increases the load on the circulatory system.
If blood circulation is insufficient, the cat will feel dizzy and weak. Therefore, the animal prefers to move as little as possible, avoiding physical activity.

Notice the increased breathing rate. Another sign of a cat's heart disease is rapid breathing, even if she is at rest. This phenomenon is called increased breathing intensity.
- If you suspect your cat is hyperventilating, monitor her by counting her breaths per minute. Do this several times to be sure of the result. This information will be useful to the veterinarian, since many cats find themselves in an unfamiliar environment veterinary clinic, breathe quickly, which makes it difficult correct definition respiratory rate of an animal at rest.
- Normal frequency A cat's breathing rate is 20-30 inhalations and exhalations per minute. More than 35-40 breaths per minute at rest is considered high frequency, and a frequency above 40 is a clear deviation from the norm.
- An animal's rapid breathing can be caused by the accumulation of fluid in its lungs, which reduces the efficiency of oxygen exchange in the animal's lungs. lung tissue. To obtain a sufficient amount of oxygen, the cat is forced to breathe more often, thereby compensating for the reduced oxygen exchange.
Take a closer look to see if your pet is having difficulty breathing. One more a worrying sign is mouth breathing, or difficulty breathing. Mouth breathing is not typical for cats (unless the animal is in a state of severe stress, or has not yet moved away after vigorous play).
- By breathing through its mouth, the cat tries to increase the flow of oxygen to the lungs, which indicates difficulty in oxygen exchange.
Observe if the cat is posturing oxygen starvation. If an animal is experiencing a lack of oxygen, it can adopt an “oxygen starvation” pose. In this case, the cat falls to the ground with its stomach, stretching its head and neck forward. At the same time, she places her elbows to the sides of her chest, trying to expand her chest as much as possible with each breath.

Poor appetite is also a cause for concern. Many cats with heart disease have a decreased appetite. While swallowing, the animal holds its breath. When experiencing a lack of oxygen due to heart disease, a cat will be reluctant to hold its already labored breath in order to swallow food.

Part 2
Recognition late symptoms
Part 3
Visiting a veterinarian
1. Take your pet to a veterinarian for a checkup. If you notice any of the symptoms listed above, visit your veterinarian. During the examination, the doctor will listen to the animal’s heart using a stethoscope and, based on the results of the preliminary examination, will prescribe the necessary tests.
2. Observing the breathing of an animal. To assess the severity of the disease, your veterinarian may observe your cat's breathing while she lies quietly in a basket or box.
  - This will help assess the animal's breathing in its most relaxed state before it experiences stress during a medical examination.
  - The doctor will count your breathing rate and determine the degree of difficulty.
3. Signs of abnormal breathing. As a rule, it is difficult to detect the movements of the chest of a healthy animal during breathing. In the case of difficulty breathing (caused by problems with the heart or lungs), the cat's chest noticeably expands and contracts, and its movements are easy to see.
  - Another sign of difficulty breathing is the noticeable rise and fall of your cat's abdomen with each inhalation and exhalation. This type of breathing is called " abdominal breathing"and indicates that the animal is trying to increase the amount of air entering the lungs.
  - It should be noted that cats rarely cough as a result of heart disease, unlike dogs, in which coughing is a common symptom of heart disease. This is explained by the fact that in respiratory tract cats have fewer receptors that initiate coughing when there is a lack of oxygen.
4. Tell your veterinarian about your cat's history of heart murmurs previously diagnosed. The doctor will want to know if your pet has had a heart murmur in the past.
  - The presence of a heart murmur at a young age indicates congenital defect heart disease, which can develop over time.
  - However, the absence of heart murmurs at a young age does not mean that they cannot appear in the future. If a cat has problems with the heart and breathing, it is important to listen to the work of its heart and determine whether there are murmurs in it.
5. Have the vet listen for heart murmurs. The doctor will listen to the animal's heart and determine whether there are murmurs, how intense they are, and also check the heart rhythm and frequency.
  - Most cats with heart disease have a heart murmur. They are caused by turbulent blood flow in the chambers of the heart. Heart pathologies such as thickening of the valve leaflets or thickening of the walls lead to the appearance of heart murmurs.
  - Although heart disease often causes heart murmurs, the converse is not always true, meaning that just because a cat has a heart murmur does not necessarily mean it has heart disease. Many murmurs are "harmless" and are not associated with serious circulatory problems.
6. Ask your doctor about your heart rate. By the frequency of heart contractions, you can judge whether its work is difficult. The normal rate for cats is approximately 120-140 beats per minute.
  - However, an error cannot be ruled out because a cat's heart beats faster when under stress. Most veterinarians believe that clinical settings The heart rate is within normal limits if it does not exceed approximately 180 beats per minute. B O Larger values are considered abnormal. This is important because diseased heart has a lower stroke volume (pumps less blood with each beat compared to a healthy heart).
  - To compensate and maintain blood pressure at the proper level, the heart is forced to beat faster ( larger number blows at lower shock pressure allows you to maintain blood circulation).
7. Ask your veterinarian about your cat's heart rate. Irregular heartbeats indicate difficulty in the heart. A healthy heart rhythm is characterized by two features.
  - First, the heart beats at regular intervals. Secondly, the cat has " sinus arrhythmia". This concept means the normal acceleration and deceleration of heart contractions, synchronously with the animal's inhalations and exhalations.
  - For the abnormal heart rate characterized by irregularity. This rhythm may consist of a series of normal contractions followed by irregular heartbeats. This occurs when the heart muscle is damaged and scar tissue interacts with electrical signals in the heart wall, affecting the interval between beats.
8. Have your veterinarian check the color of your pet's mucous membranes. Gums healthy cat must have pink color, just like your own. The doctor should examine the gums, the color of which can indicate problems with blood circulation.
  - In the case of a diseased heart and insufficient blood circulation, the gums become pale and sometimes even turn white. However, this sign does not clearly indicate a diseased heart, since the gums can also turn pale due to anemia or disease of the gums themselves.
9. Observe as your veterinarian checks for distension of the jugular vein. Some of the doctor’s manipulations may look quite strange: for example, he may wet medical alcohol fur on a cat's neck. This is done in order to identify the outlines of the jugular veins, through which blood returns to the heart.
  - The jugular veins run through the neck, and if the heart is obstructed, blood accumulates in them, causing them to swell.
Part 4
Animal examination
1. Please note that for accurate diagnosis As a rule, additional examination is necessary. Such an examination will most likely be needed to confirm the initial suspicion of heart disease, to determine the causes of the disease and its severity.
  - When diagnosing heart murmurs in cats, a special blood test (BNP test), chest x-ray, and echocardiography are usually used.
2. Your veterinarian may order a BNP test. This blood test is designed to measure the levels of "biological cardiac markers" in the blood. Cardiac biomarkers are proteins released by diseased heart muscle cells.
  - The analysis results are divided into three groups: low concentration indicates that clinical symptoms not caused by heart disease; normal level means heart disease is possible but unlikely; high concentration indicates serious damage to the animal's heart muscle.
  - The BNP test is used to exclude the possibility of heart disease (in the case of low biomarker levels), as well as to monitor the progress of treatment in cats suffering from heart disease (if successful treatment originally high level should decrease).
3. Your veterinarian may order a chest x-ray of the animal. Pictures are taken in two directions - from above and from the side. This allows you to judge the size and shape of the heart.
  - Sometimes x-rays are inconclusive because in the case of one of the common heart diseases in cats, hypertrophic cardiomyopathy, the heart muscle thickens in the middle of the organ. Because the X-rays They allow you to see only the external outlines of the heart, and not what is inside it; this disease is difficult to identify with radiography alone.
  - However, x-rays are useful in identifying the path of blood in the lungs and detecting pulmonary edema, which may indicate heart disease, and in detecting diseases such as asthma or lung tumors in a cat.
4. - Left ventricular wall thickness. In hypertrophic cardiomyopathy, the thickness of the walls of the left ventricle increases significantly, which leads to a decrease in the volume filled with blood.
  - Left ventricle, aortic proportion. Using an ultrasound map, the doctor will be able to measure the width of the left ventricle - the main chamber from which blood begins its journey through the body. The width of the aorta is also determined, after which the ratio between these two values is calculated. The result of the calculation shows whether the left ventricle is dilated. This parameter is important because in some heart diseases the heart muscle weakens and becomes sluggish, resulting in increased blood pressure inside the heart, which leads to stretching and weakening of the walls of the ventricle.
  - Contractility measurement. This is another useful parameter calculated based on the results ultrasound examination. The width of the ventricle is measured in the fully relaxed and maximally compressed positions. As a result, the percentage relationship between these values is determined, which is compared with the table values corresponding to the norm. Deviations from the table values, both smaller and larger, indicate heart disease.
- Symptoms such as heavy or rapid breathing, decreased appetite, and weakness indicate problems with the heart or lungs. To find out the exact cause, the veterinarian needs to examine the animal, and then general examination, most likely, further, more thorough examination will be needed.

Coping with problems that arise due to the presence renal failure in cats, cats and kittens, the matter is not at all easy and here you need to pay attention to the first symptoms and have time to contact a veterinarian as soon as signs of such a serious health problem are detected in your pet.

There are nutritional requirements for cats with this problem and general recommendations that must be followed to get the desired result from proper treatment prescribed by a qualified veterinarian.

Heart failure in cats, cats and kittens, early symptoms, can CHF be treated in cats, diagnosis and diet

Heart failure in cats, unlike in humans, develops quite rarely. First alarming symptom the disease is shortness of breath in case of the slightest physical activity, attacks of suffocation, cough, fainting, weakness. In old animals, CHF can cause asphyxia and ascites.

Chronic heart failure develops as a consequence of a sedentary, “bedside” lifestyle and poor nutrition leading to obesity.

The disease can be treated and even inhibited at an early stage, which, however, does not negate annual observation by a doctor. When diagnosed with CHF, sick animals are given protein and taurine-rich food.

Is it possible to treat CHF in cats with Corvalol and iodine at home?

For heart failure, cats can be given such “human” medications as Corvalol, Valocordin and valerian, but in tiny amount and strictly as prescribed by the attending physician. The same applies to iodine. Usually, as a general tonic, it is not iodine that is prescribed, but blue iodine, iodine active or iodomarin.

Acute heart failure in cats pulmonary edema

A cat suffering from acute heart failure will have to be treated for life. She constantly needs medications that prevent blood from clotting, and diuretics that remove excess fluid and reduce swelling.

If the doses of drugs are incorrectly calculated, the cat may develop pulmonary edema, and if heart failure is added to this ailment, the animal may not be saved.

Heart failure in cats treatment. How to treat

In the treatment of heart failure, drugs are prescribed that increase blood supply to the heart muscles (Mexicor, trimetazidine). The myocardium is nourished by adenosine triphosphoric acid and asparkam. Sometimes an additional course of antibiotics is prescribed. The doctor selects the treatment regimen individually, taking into account the stage and severity of the disease, as well as the condition of the animal.

Heart failure in cats: causes, prognosis

The causes of heart failure in cats can be hypertension, ischemia, myocarditis, myocardial infarction, and heart defects.

It is clear that it is impossible to give definitive recommendations for the treatment of heart failure and any prognosis for such different diagnoses. Statistics show that death from heart failure occurs in 70% of cases.

The death of animals occurs from suffocation or pulmonary edema due to the fact that the owners of the animals do not consult a veterinarian in a timely manner and self-medicate.

Chronic heart failure in a cat, what to do, what to feed after surgery

Chronic heart failure is a disease that is not typical for cats, so clinics that will treat this heart disease surgical method, too few.

And yet, if the operation is performed, then the cat is not fed at all for the first 24 hours after it. In the future, use a special concentrated feed or give products recommended by a doctor,

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