HYPERTROPHIC CARDIOMYOPATHY IN SMALL PETS. THE PROBLEM AND ITS SOLUTION
Keywords:
hypertrophic cardiomyopathy, cat breeds, echocardiography, ultrasound examination, heart failure, echocardiographic screening, cardiotonic drugs,
Abstract
Hypertrophic cardiomyopathy (HCM) is the most common form of feline cardiomyopathy, affecting approximately 15% of the domestic cat population, mostly as a subclinical disease. Hypertrophic cardiomyopathy is more common in male Maine Coon, Ragdoll, British Shorthair, Scottish, and Norwegian Forest cats. Due to the asymptomatic course of the disease, it is easy to miss the beginning of the development of heart failure or thromboembolism. Screening cats for hypertrophic cardiomyopathy should be done using echocardiography. The main areas of cardiomyopathy treatment are the use of antiplatelet and antithrombotic drugs, antiarrhythmics, angiotensin-converting enzyme inhibitors, loop diuretics, and pimobendan. In the control group, the therapeutic protocol of the Joint Committee of the American College of Cardiology and the American Heart Association was used, using the drug Vetmedin, and in the experimental group, the generic Pimopet was used off-label (outside the indications prescribed in the license). Using auxiliary methods, such as X-ray and ultrasound examination, cardiomegaly, heart failure, thickening of the wall of the left ventricle of the heart and congestion in the lungs can be detected. It was established that almost all cats from both groups belong to the "gray zone", that is, the thickness of the wall of the left ventricle is in the range between 5 and 6 mm, and have systemic hypertension, therefore they belong to stage B2. Only Bonya's cat from the control group, according to screening results, has a left ventricular wall thickness of 6.2 mm, but has a subclinical course of the disease, which allows him to be classified as stage B2 as well. As a result of the conducted research, it was established that the original drug and its generic have no significant differences, except for their difference in price. Given that this is a drug for lifelong use, the price difference for the pet owner will be significant. No side effects were observed during treatment according to both schemes. It is impossible to cure HCM, but it is possible to symptomatically alleviate the condition of a sick animal.
References
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9. Fries, R., Heaney, A. M., & Meurs, K. M. (2008). Prevalence of the myosin-binding protein C mutation in Maine Coon cats. Journal of veterinary internal medicine, 22(4), 893–896. https://doi.org/10.1111/j.1939-1676.2008.0113.x
10. Guglielmini, C., & Diana, A. (2015). Thoracic radiography in the cat: Identification of cardiomegaly and congestive heart failure. Journal of veterinary cardiology : the official journal of the European Society of Veterinary Cardiology, 17 Suppl 1, S87–S101. https://doi.org/10.1016/j.jvc.2015.03.005
11. Hogan, D. F., Fox, P. R., Jacob, K., Keene, B., Laste, N. J., Rosenthal, S., Sederquist, K., & Weng, H. Y. (2015). Secondary prevention of cardiogenic arterial thromboembolism in the cat: The double-blind, randomized, positive-controlled feline arterial thromboembolism; clopidogrel vs. aspirin trial (FAT CAT). Journal of veterinary cardiology : the official journal of the European Society of Veterinary Cardiology, 17 Suppl 1, S306–S317. https://doi.org/10.1016/j.jvc.2015.10.004
12. James, R., Guillot, E., Garelli-Paar, C., Huxley, J., Grassi, V., & Cobb, M. (2018). The SEISICAT study: a pilot study assessing efficacy and safety of spironolactone in cats with congestive heart failure secondary to cardiomyopathy. Journal of veterinary cardiology : the official journal of the European Society of Veterinary Cardiology, 20(1), 1–12. https://doi.org/10.1016/j.jvc.2017.11.001
13. Kittleson, M. D., & Côté, E. (2021). The Feline Cardiomyopathies: 2. Hypertrophic cardiomyopathy. Journal of feline medicine and surgery, 23(11), 1028–1051. https://doi.org/10.1177/1098612X211020162
14. Liu, S. K., Peterson, M. E., & Fox, P. R. (1984). Hypertropic cardiomyopathy and hyperthyroidism in the cat. Journal of the American Veterinary Medical Association, 185(1), 52–57.
15. Luis Fuentes, V., Abbott, J., Chetboul, V., Côté, E., Fox, P. R., Häggström, J., Kittleson, M. D., Schober, K., & Stern, J. A. (2020). ACVIM consensus statement guidelines for the classification, diagnosis, and management of cardiomyopathies in cats. Journal of veterinary internal medicine, 34(3), 1062–1077. https://doi.org/10.1111/jvim.15745
16. MacDonald, K. A., Wisner, E. R., Larson, R. F., Klose, T., Kass, P. H., & Kittleson, M. D. (2005). Comparison of myocardial contrast enhancement via cardiac magnetic resonance imaging in healthy cats and cats with hypertrophic cardiomyopathy. American journal of veterinary research, 66(11), 1891–1894. https://doi.org/10.2460/ajvr.2005.66.1891
17. Maron B. J. (2018). Clinical Course and Management of Hypertrophic Cardiomyopathy. The New England journal of medicine, 379(7), 655–668. https://doi.org/10.1056/NEJMra1710575
18. Meurs, K. M., Norgard, M. M., Ederer, M. M., Hendrix, K. P., & Kittleson, M. D. (2007). A substitution mutation in the myosin binding protein C gene in ragdoll hypertrophic cardiomyopathy. Genomics, 90(2), 261–264. https://doi.org/10.1016/j.ygeno.2007.04.007
19. Meurs, K. M., Sanchez, X., David, R. M., Bowles, N. E., Towbin, J. A., Reiser, P. J., Kittleson, J. A., Munro, M. J., Dryburgh, K., Macdonald, K. A., & Kittleson, M. D. (2005). A cardiac myosin binding protein C mutation in the Maine Coon cat with familial hypertrophic cardiomyopathy. Human molecular genetics, 14(23), 3587–3593. https://doi.org/10.1093/hmg/ddi386
20. Nelson, L., Reidesel, E., Ware, W. A., & Christensen, W. F. (2002). Echocardiographic and radiographic changes associated with systemic hypertension in cats. Journal of veterinary internal medicine, 16(4), 418–425. https://doi.org/10.1892/0891-6640(2002)016<0418:earcaw>2.3.co;2
21. Novo Matos J, Garcia-Canadilla P, Simcock IC, et al. (2020). Micro-computed tomography (micro-CT) for the assessment of myocardial disarray, fibrosis and ventricular mass in a feline model of hypertrophic cardiomyopathy. Sci Rep ; doi: https://doi.org/10.1101/2021.07.29.454121
22. Ommen, S. R., Mital, S., Burke, M. A., Day, S. M., Deswal, A., Elliott, P., Evanovich, L. L., Hung, J., Joglar, J. A., Kantor, P., Kimmelstiel, C., Kittleson, M., Link, M. S., Maron, M. S., Martinez, M. W., Miyake, C. Y., Schaff, H. V., Semsarian, C., & Sorajja, P. (2020). 2020 AHA/ACC Guideline for the Diagnosis and Treatment of Patients With Hypertrophic Cardiomyopathy: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. Circulation, 142(25), e558–e631. https://doi.org/10.1161/CIR.0000000000000937
23. Patata, V., Caivano, D., Porciello, F., Rishniw, M., Domenech, O., Marchesotti, F., Giorgi, M. E., Guglielmini, C., Poser, H., Spina, F., & Birettoni, F. (2020). Pulmonary vein to pulmonary artery ratio in healthy and cardiomyopathic cats. Journal of veterinary cardiology : the official journal of the European Society of Veterinary Cardiology, 27, 23–33. https://doi.org/10.1016/j.jvc.2019.12.001
24. Payne, J. R., Brodbelt, D. C., & Luis Fuentes, V. (2015). Cardiomyopathy prevalence in 780 apparently healthy cats in rehoming centres (the CatScan study). Journal of veterinary cardiology : the official journal of the European Society of Veterinary Cardiology, 17 Suppl 1, S244–S257. https://doi.org/10.1016/j.jvc.2015.03.008
25. Rush, J. E., Freeman, L. M., Fenollosa, N. K., & Brown, D. J. (2002). Population and survival characteristics of cats with hypertrophic cardiomyopathy: 260 cases (1990-1999). Journal of the American Veterinary Medical Association, 220(2), 202–207. https://doi.org/10.2460/javma.2002.220.202
26. Sangster, J. K., Panciera, D. L., Abbott, J. A., Zimmerman, K. C., & Lantis, A. C. (2014). Cardiac biomarkers in hyperthyroid cats. Journal of veterinary internal medicine, 28(2), 465–472. https://doi.org/10.1111/jvim.12259
27. Schober, K. E., & Chetboul, V. (2015). Echocardiographic evaluation of left ventricular diastolic function in cats: Hemodynamic determinants and pattern recognition. Journal of veterinary cardiology : the official journal of the European Society of Veterinary Cardiology, 17 Suppl 1, S102–S133. https://doi.org/10.1016/j.jvc.2015.02.002
28. Schober, K. E., Wetli, E., & Drost, W. T. (2014). Radiographic and echocardiographic assessment of left atrial size in 100 cats with acute left-sided congestive heart failure. Veterinary radiology & ultrasound : the official journal of the American College of Veterinary Radiology and the International Veterinary Radiology Association, 55(4), 359–367. https://doi.org/10.1111/vru.12131
29. Sent, U., Gössl, R., Elliott, J., Syme, H. M., & Zimmering, T. (2015). Comparison of Efficacy of Long-term Oral Treatment with Telmisartan and Benazepril in Cats with Chronic Kidney Disease. Journal of veterinary internal medicine, 29(6), 1479–1487. https://doi.org/10.1111/jvim.13639
30. van Haaften KA, Forsythe LRE, Stelow EA, Bain MJ. (2017). Effects of a single preappointment dose of gabapentin on signs of stress in cats during transportation and veterinary examination. Journal of the American Veterinary Medical Association. 2017 Nov;251(10):1175-1181. DOI: 10.2460/javma.251.10.1175. PMID: 29099247.
31. van Hoek, I., Hodgkiss-Geere, H., Bode, E. F., Hamilton-Elliott, J., Mõtsküla, P., Palermo, V., Pereira, Y. M., Culshaw, G. J., Laxalde, J., & Dukes-McEwan, J. (2020). Association of diet with left ventricular wall thickness, troponin I and IGF-1 in cats with subclinical hypertrophic cardiomyopathy. Journal of veterinary internal medicine, 34(6), 2197–2210. https://doi.org/10.1111/jvim.15925
32. van Hoek, I., Hodgkiss-Geere, H., Bode, E. F., Hamilton-Elliott, J., Mõtsküla, P., Palermo, V., Pereira, Y. M., Culshaw, G. J., Laxalde, J., & Dukes-McEwan, J. (2020). Association of diet with left ventricular wall thickness, troponin I and IGF-1 in cats with subclinical hypertrophic cardiomyopathy. Journal of veterinary internal medicine, 34(6), 2197–2210. https://doi.org/10.1111/jvim.15925
33. Wagner, T., Fuentes, V. L., Payne, J. R., McDermott, N., & Brodbelt, D. (2010). Comparison of auscultatory and echocardiographic findings in healthy adult cats. Journal of veterinary cardiology : the official journal of the European Society of Veterinary Cardiology, 12(3), 171–182. https://doi.org/10.1016/j.jvc.2010.05.003
34. Ward, J. L., Schober, K. E., Fuentes, V. L., & Bonagura, J. D. (2012). Effects of sedation on echocardiographic variables of left atrial and left ventricular function in healthy cats. Journal of feline medicine and surgery, 14(10), 678–685. https://doi.org/10.1177/1098612X12447729
2. Arbustini, E., Narula, N., Dec, G. W., Reddy, K. S., Greenberg, B., Kushwaha, S., Marwick, T., Pinney, S., Bellazzi, R., Favalli, V., Kramer, C., Roberts, R., Zoghbi, W. A., Bonow, R., Tavazzi, L., Fuster, V., & Narula, J. (2013). The MOGE(S) classification for a phenotype-genotype nomenclature of cardiomyopathy: endorsed by the World Heart Federation. Journal of the American College of Cardiology, 62(22), 2046–2072. https://doi.org/10.1016/j.jacc.2013.08.1644
3. Chetboul, V., Concordet, D., Pouchelon, J. L., Athanassiadis, N., Muller, C., Benigni, L., Munari, A. C., & Lefebvre, H. P. (2003). Effects of inter- and intra-observer variability on echocardiographic measurements in awake cats. Journal of veterinary medicine. A, Physiology, pathology, clinical medicine, 50(6), 326–331. https://doi.org/10.1046/j.1439-0442.2003.00546.x
4. Cirino, A. L., & Ho, C. (2008). Hypertrophic Cardiomyopathy Overview. In M. P. Adam (Eds.) et. al., GeneReviews®. University of Washington, Seattle.
5. Connolly, D. J., Cannata, J., Boswood, A., Archer, J., Groves, E. A., & Neiger, R. (2003). Cardiac troponin I in cats with hypertrophic cardiomyopathy. Journal of feline medicine and surgery, 5(4), 209–216. https://doi.org/10.1016/S1098-612X(03)00007-X
6. Elliott, P., Andersson, B., Arbustini, E., Bilinska, Z., Cecchi, F., Charron, P., Dubourg, O., Kühl, U., Maisch, B., McKenna, W. J., Monserrat, L., Pankuweit, S., Rapezzi, C., Seferovic, P., Tavazzi, L., & Keren, A. (2008). Classification of the cardiomyopathies: a position statement from the European Society Of Cardiology Working Group on Myocardial and Pericardial Diseases. European heart journal, 29(2), 270–276. https://doi.org/10.1093/eurheartj/ehm342
7. Ferasin, L., Sturgess, C. P., Cannon, M. J., Caney, S. M., Gruffydd-Jones, T. J., & Wotton, P. R. (2003). Feline idiopathic cardiomyopathy: a retrospective study of 106 cats (1994-2001). Journal of feline medicine and surgery, 5(3), 151–159. https://doi.org/10.1016/S1098-612X(02)00133-X
8. Fox, P. R., Oyama, M. A., Reynolds, C., Rush, J. E., DeFrancesco, T. C., Keene, B. W., Atkins, C. E., Macdonald, K. A., Schober, K. E., Bonagura, J. D., Stepien, R. L., Kellihan, H. B., Nguyenba, T. P., Lehmkuhl, L. B., Lefbom, B. K., Moise, N. S., & Hogan, D. F. (2009). Utility of plasma N-terminal pro-brain natriuretic peptide (NT-proBNP) to distinguish between congestive heart failure and non-cardiac causes of acute dyspnea in cats. Journal of veterinary cardiology : the official journal of the European Society of Veterinary Cardiology, 11 Suppl 1, S51–S61. https://doi.org/10.1016/j.jvc.2008.12.001
9. Fries, R., Heaney, A. M., & Meurs, K. M. (2008). Prevalence of the myosin-binding protein C mutation in Maine Coon cats. Journal of veterinary internal medicine, 22(4), 893–896. https://doi.org/10.1111/j.1939-1676.2008.0113.x
10. Guglielmini, C., & Diana, A. (2015). Thoracic radiography in the cat: Identification of cardiomegaly and congestive heart failure. Journal of veterinary cardiology : the official journal of the European Society of Veterinary Cardiology, 17 Suppl 1, S87–S101. https://doi.org/10.1016/j.jvc.2015.03.005
11. Hogan, D. F., Fox, P. R., Jacob, K., Keene, B., Laste, N. J., Rosenthal, S., Sederquist, K., & Weng, H. Y. (2015). Secondary prevention of cardiogenic arterial thromboembolism in the cat: The double-blind, randomized, positive-controlled feline arterial thromboembolism; clopidogrel vs. aspirin trial (FAT CAT). Journal of veterinary cardiology : the official journal of the European Society of Veterinary Cardiology, 17 Suppl 1, S306–S317. https://doi.org/10.1016/j.jvc.2015.10.004
12. James, R., Guillot, E., Garelli-Paar, C., Huxley, J., Grassi, V., & Cobb, M. (2018). The SEISICAT study: a pilot study assessing efficacy and safety of spironolactone in cats with congestive heart failure secondary to cardiomyopathy. Journal of veterinary cardiology : the official journal of the European Society of Veterinary Cardiology, 20(1), 1–12. https://doi.org/10.1016/j.jvc.2017.11.001
13. Kittleson, M. D., & Côté, E. (2021). The Feline Cardiomyopathies: 2. Hypertrophic cardiomyopathy. Journal of feline medicine and surgery, 23(11), 1028–1051. https://doi.org/10.1177/1098612X211020162
14. Liu, S. K., Peterson, M. E., & Fox, P. R. (1984). Hypertropic cardiomyopathy and hyperthyroidism in the cat. Journal of the American Veterinary Medical Association, 185(1), 52–57.
15. Luis Fuentes, V., Abbott, J., Chetboul, V., Côté, E., Fox, P. R., Häggström, J., Kittleson, M. D., Schober, K., & Stern, J. A. (2020). ACVIM consensus statement guidelines for the classification, diagnosis, and management of cardiomyopathies in cats. Journal of veterinary internal medicine, 34(3), 1062–1077. https://doi.org/10.1111/jvim.15745
16. MacDonald, K. A., Wisner, E. R., Larson, R. F., Klose, T., Kass, P. H., & Kittleson, M. D. (2005). Comparison of myocardial contrast enhancement via cardiac magnetic resonance imaging in healthy cats and cats with hypertrophic cardiomyopathy. American journal of veterinary research, 66(11), 1891–1894. https://doi.org/10.2460/ajvr.2005.66.1891
17. Maron B. J. (2018). Clinical Course and Management of Hypertrophic Cardiomyopathy. The New England journal of medicine, 379(7), 655–668. https://doi.org/10.1056/NEJMra1710575
18. Meurs, K. M., Norgard, M. M., Ederer, M. M., Hendrix, K. P., & Kittleson, M. D. (2007). A substitution mutation in the myosin binding protein C gene in ragdoll hypertrophic cardiomyopathy. Genomics, 90(2), 261–264. https://doi.org/10.1016/j.ygeno.2007.04.007
19. Meurs, K. M., Sanchez, X., David, R. M., Bowles, N. E., Towbin, J. A., Reiser, P. J., Kittleson, J. A., Munro, M. J., Dryburgh, K., Macdonald, K. A., & Kittleson, M. D. (2005). A cardiac myosin binding protein C mutation in the Maine Coon cat with familial hypertrophic cardiomyopathy. Human molecular genetics, 14(23), 3587–3593. https://doi.org/10.1093/hmg/ddi386
20. Nelson, L., Reidesel, E., Ware, W. A., & Christensen, W. F. (2002). Echocardiographic and radiographic changes associated with systemic hypertension in cats. Journal of veterinary internal medicine, 16(4), 418–425. https://doi.org/10.1892/0891-6640(2002)016<0418:earcaw>2.3.co;2
21. Novo Matos J, Garcia-Canadilla P, Simcock IC, et al. (2020). Micro-computed tomography (micro-CT) for the assessment of myocardial disarray, fibrosis and ventricular mass in a feline model of hypertrophic cardiomyopathy. Sci Rep ; doi: https://doi.org/10.1101/2021.07.29.454121
22. Ommen, S. R., Mital, S., Burke, M. A., Day, S. M., Deswal, A., Elliott, P., Evanovich, L. L., Hung, J., Joglar, J. A., Kantor, P., Kimmelstiel, C., Kittleson, M., Link, M. S., Maron, M. S., Martinez, M. W., Miyake, C. Y., Schaff, H. V., Semsarian, C., & Sorajja, P. (2020). 2020 AHA/ACC Guideline for the Diagnosis and Treatment of Patients With Hypertrophic Cardiomyopathy: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. Circulation, 142(25), e558–e631. https://doi.org/10.1161/CIR.0000000000000937
23. Patata, V., Caivano, D., Porciello, F., Rishniw, M., Domenech, O., Marchesotti, F., Giorgi, M. E., Guglielmini, C., Poser, H., Spina, F., & Birettoni, F. (2020). Pulmonary vein to pulmonary artery ratio in healthy and cardiomyopathic cats. Journal of veterinary cardiology : the official journal of the European Society of Veterinary Cardiology, 27, 23–33. https://doi.org/10.1016/j.jvc.2019.12.001
24. Payne, J. R., Brodbelt, D. C., & Luis Fuentes, V. (2015). Cardiomyopathy prevalence in 780 apparently healthy cats in rehoming centres (the CatScan study). Journal of veterinary cardiology : the official journal of the European Society of Veterinary Cardiology, 17 Suppl 1, S244–S257. https://doi.org/10.1016/j.jvc.2015.03.008
25. Rush, J. E., Freeman, L. M., Fenollosa, N. K., & Brown, D. J. (2002). Population and survival characteristics of cats with hypertrophic cardiomyopathy: 260 cases (1990-1999). Journal of the American Veterinary Medical Association, 220(2), 202–207. https://doi.org/10.2460/javma.2002.220.202
26. Sangster, J. K., Panciera, D. L., Abbott, J. A., Zimmerman, K. C., & Lantis, A. C. (2014). Cardiac biomarkers in hyperthyroid cats. Journal of veterinary internal medicine, 28(2), 465–472. https://doi.org/10.1111/jvim.12259
27. Schober, K. E., & Chetboul, V. (2015). Echocardiographic evaluation of left ventricular diastolic function in cats: Hemodynamic determinants and pattern recognition. Journal of veterinary cardiology : the official journal of the European Society of Veterinary Cardiology, 17 Suppl 1, S102–S133. https://doi.org/10.1016/j.jvc.2015.02.002
28. Schober, K. E., Wetli, E., & Drost, W. T. (2014). Radiographic and echocardiographic assessment of left atrial size in 100 cats with acute left-sided congestive heart failure. Veterinary radiology & ultrasound : the official journal of the American College of Veterinary Radiology and the International Veterinary Radiology Association, 55(4), 359–367. https://doi.org/10.1111/vru.12131
29. Sent, U., Gössl, R., Elliott, J., Syme, H. M., & Zimmering, T. (2015). Comparison of Efficacy of Long-term Oral Treatment with Telmisartan and Benazepril in Cats with Chronic Kidney Disease. Journal of veterinary internal medicine, 29(6), 1479–1487. https://doi.org/10.1111/jvim.13639
30. van Haaften KA, Forsythe LRE, Stelow EA, Bain MJ. (2017). Effects of a single preappointment dose of gabapentin on signs of stress in cats during transportation and veterinary examination. Journal of the American Veterinary Medical Association. 2017 Nov;251(10):1175-1181. DOI: 10.2460/javma.251.10.1175. PMID: 29099247.
31. van Hoek, I., Hodgkiss-Geere, H., Bode, E. F., Hamilton-Elliott, J., Mõtsküla, P., Palermo, V., Pereira, Y. M., Culshaw, G. J., Laxalde, J., & Dukes-McEwan, J. (2020). Association of diet with left ventricular wall thickness, troponin I and IGF-1 in cats with subclinical hypertrophic cardiomyopathy. Journal of veterinary internal medicine, 34(6), 2197–2210. https://doi.org/10.1111/jvim.15925
32. van Hoek, I., Hodgkiss-Geere, H., Bode, E. F., Hamilton-Elliott, J., Mõtsküla, P., Palermo, V., Pereira, Y. M., Culshaw, G. J., Laxalde, J., & Dukes-McEwan, J. (2020). Association of diet with left ventricular wall thickness, troponin I and IGF-1 in cats with subclinical hypertrophic cardiomyopathy. Journal of veterinary internal medicine, 34(6), 2197–2210. https://doi.org/10.1111/jvim.15925
33. Wagner, T., Fuentes, V. L., Payne, J. R., McDermott, N., & Brodbelt, D. (2010). Comparison of auscultatory and echocardiographic findings in healthy adult cats. Journal of veterinary cardiology : the official journal of the European Society of Veterinary Cardiology, 12(3), 171–182. https://doi.org/10.1016/j.jvc.2010.05.003
34. Ward, J. L., Schober, K. E., Fuentes, V. L., & Bonagura, J. D. (2012). Effects of sedation on echocardiographic variables of left atrial and left ventricular function in healthy cats. Journal of feline medicine and surgery, 14(10), 678–685. https://doi.org/10.1177/1098612X12447729
Published
2023-03-15
How to Cite
Dolbanosova, R. V., & Kolienko, K. O. (2023). HYPERTROPHIC CARDIOMYOPATHY IN SMALL PETS. THE PROBLEM AND ITS SOLUTION. Bulletin of Sumy National Agrarian University. The Series: Veterinary Medicine, (4(59), 17-23. https://doi.org/10.32845/bsnau.vet.2022.4.3
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