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Articles by Dr. Tesluk

HEARTWORM: NOT JUST FOR DOGS ANYMORE
 

Dr. Stephen Tesluk, DVM

 

            “You might want to check on Sassy in Room One,” said Libby; “she seems to be breathing hard.” Our technician, Libby, had just come from Room One, where she had administered fluids to Sassy Lewis, a 10-year-old cat we diagnosed with chronic renal failure only a few days earlier.

            A report of “trouble breathing” gets me moving faster than a triple-shot latte with double sugar, so I dropped what I was doing and in a few seconds I was standing in front of Sassy and Mrs. Lewis.

            Libby was right; Sassy sat on the table, her back up and head slightly extended, and it was easy to see the exaggerated movement of her chest and flanks that occurred with every breath.

            “How long has Sassy been breathing like this?” I asked.

            “She was fine two days ago, when she got her last fluid treatment,” Mrs. Lewis replied, “but yesterday she didn’t move around much, and this morning she was breathing funny.”

            I listened to Sassy with my stethoscope, and found that her breath sounds grew faint as I moved from high to low on the side of her chest.  “We need to take an X-ray,” I told Mrs. Lewis, “it sounds like she has fluid in her chest cavity.”

            We gave Sassy some oxygen for several minutes, and then took the X-rays.  The films showed Sassy’s lungs floating in a sea of fluid that completely obscured the view of her heart.  The fluid was compressing her lungs so she could not take a full breath no matter how hard she tried.

            We placed Sassy in an oxygen cage and I went back to Room One to explain the situation to Mrs. Lewis.

            “Sassy has another problem besides chronic renal failure,” I began.  “Cats with chronic renal failure need increased fluid intake because they cannot concentrate their urine.  But the additional fluids we have been giving Sassy under her skin have caused fluid to build up in her chest.  The most likely explanation for this is Sassy must have heart disease as well.”

            Mrs. Lewis looked as if she had heard enough bad news for one day.

            “We need to pull some of that fluid out of her chest so she can breathe easier.  We will start her on diuretics to help remove additional fluid.  She will stay in the oxygen cage tonight, and tomorrow we will ultrasound her heart to get a better understanding of the nature of her heart disease.”

            Mrs. Lewis hugged Sassy and said a say goodbye.  We were able to remove a large amount of fluid from Sassy’s chest, and she was visibly breathing easier when we placed her into the oxygen cage for the night.

            By the next day, Sassy had made additional improvement and was able to breathe normally outside of the oxygen cage.  As soon as I began the cardiac ultrasound, I could see the heart was clearly abnormal.  The right chambers of the heart were enlarged, and within those chambers were distinctive, bright parallel lines that flashed into view and then disappeared with each contraction of the heart.  The cause of Sassy’s heart disease had been discovered – Sassy had heartworm disease.

            “I knew my dog could get heartworms, but I didn’t realize that cats can get them too,” Mrs. Lewis said when I told her the news.

            “Cats can get heartworms, but they are not as susceptible as dogs, so that in any given area, it is estimated that there is only one cat with heartworm for every five to 20 dogs with heartworm,” I replied.  “Cats may show signs such as coughing, trouble breathing or vomiting when they are infected with heartworms.  Sudden death may occur in a small number of cases.”

            Can cats be treated to remove the worms like dogs?” she asked.

            “Unfortunately, treating cats to get rid of the worms is very risky, and 20 to 30 percent of cats treated this way die from complications.  But there is some good news: Cats generally have only a few worms, and with supportive treatment and a little luck, many can outlast the worms, which only live one to two years.  Like dogs, cats can be given medication once a month to prevent heartworms, but the use of heartworm preventatives in cats is not as common as it is in dogs because far fewer cases are seen in cats.”

            Sassy responded well to the supportive treatment, and she was put on monthly medication to prevent infection with new worms.  It seems likely that, as with heartworm disease in dogs, the number of cases seen in cats will increase with time, making the use of preventative medication in cats more common as well.




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