Archive for August, 2016

Heart murmurs in Cats

Tuesday, August 30th, 2016

murmurDuring an examination we sometimes detect a heart murmur in a cat, but this finding is not always cause for immediate concern. During an exam we have two primary goals:

  • > identify any issues
  • > educate you as a pet caretaker

We want to make certain that you understand what having a heart murmur, or any of your pet’s medical conditions, mean.  Having and understanding this information will then help you to make educated decisions about your cat’s care.

Scoring a cat’s heart murmur

Scoring a heart murmur’s volume

cat heart murmur

Dr. Swindell listening to a patient’s heart.

You have seen us use our stethoscope every time you have brought your pet in for a check-up or visit. When we listen with our stethoscope to a cat’s heart we can pick up subtleties in the sounds. So when we hear a heart murmur in a cat we are assessing loudness, pitch, and in which stage of the heart beat the murmur is occurring.

Veterinarians always grade a heart murmur. We use a 1-6 scale to grade the loudness of a murmur, therefore we have something objective we can track over time. Grade 1 is hardly audible with a stethoscope, while grade 6 is not only audible with our stethoscope, but is also palpable with a hand on the outside of the chest. There is no defined rule that a heart murmur will get louder as the disease affecting the heart progresses, but it often will.

The goal is to identify the cause of the cat’s heart murmur

A heart murmur in a cat is not a diagnosis in itself.

It is a manifestation of a disorder of the heart or the blood vessels.  We make the diagnosis through further investigation into the cause of the murmur.  The simple definition of a heart murmur is turbulence of blood flow through the valves of the heart. There are 4 main valves in the heart. The blood flows at high speeds through these valves in one direction only. Anytime there is some regurgitation of blood through a valve in the opposite direction we can hear the turbulence of the blood flow as a slight “wooshing” sound, called a murmur.

The ‘lub’ and “dub’ sounds of a cat’s heart

The physiology of the heart is very similar across many species of mammals; a cat’s heart is very similar to our own human heart. There are two main heart sounds in a heartbeat. A ‘lub’-when the blood is ejected from the heart into either the lungs or the aorta before being delivered all over the body.  And a ‘dub’- when the heart fills with blood and the valves to the ‘exits’ of the heart are closed.

Dopper to analyze a pet's heart murmur

Doppler image of blood flow in a pet’s heart.

While there are many causes of heart murmurs in cats there are some more common causes in the species.  High blood pressure (or hypertension) is common, especially in older cats. Also, an overactive thyroid (Hyperthyroidism) can affect the heart in a few ways; it can increase the heart rate, thus the flow and velocity of blood through the heart, and it can cause a high blood pressure, and change the heart muscle by making it do more work. Hyperthyroidism tends to also affect older cats (9 years old or older).  Disorders of the heart itself include enlargement of the heart chamber muscles (hypertrophic cardiomyopathy), degeneration of the heart valves as a cat ages, and a systemic (whole body) infection that can subsequently infect the heart valves themselves (endocarditis). Heartworm disease

(Blog post on heartworm disease), of course can also cause heart murmurs.

Simple blood test

Simple blood test

So you see, there are diseases that originate elsewhere in the body that affect the heart in various ways. Because of this, one of the most important tools we have for diagnosing the cause of a heart murmur in a cat is general blood-work. Of course we’ll recommend x-rays and blood pressure to help us diagnose heart problems as needed.

A Veterinary Cardiologist often makes the final diagnosis about a cat’s heart murmur

echo-cardiogram of a pet's heart with a murmur

Echocardiogram of a pet’s heart with valves labeled.

We have the benefit of having a Board Certified Veterinary Cardiologist as a part of our team at Carlson Animal Hospital, so often the final step to a final diagnosis is a visit with her for an ultrasound of the heart.

This is called an Echocardiogram, and will provide just about everything we need to know about the inside of the heart and its full functionality.

With the diagnostic information complete, we can then provide you and your pet with a diagnosis, prognosis, and treatment options. We can also use this information to make patient-specific anesthesia plans that are as safe as possible for surgeries or dental cleanings. Often, no matter the diagnosis, cats can live happy years with heart disease with your good care and ours.

Always our goal is to provide the best and most comprehensive medical care possible for your pet and the best education for you.

JP and Chloe

Inappropriate Elimination Disorders in Cats

Wednesday, August 10th, 2016
cat inappropriate eliminiaton

Cat not using her litter box

One of the most common behavioral problems we see in our feline patients are “elimination disorders.” Your heart drops when you discover that your beloved kitty is using locations other than their litter box to urinate and/or defecate. This can cause a great deal of stress for both the you and pets in the household. We know how hard this can be and want to help you deal with the problem as quickly as possible. Tell us about this as soon as you know or suspect anything is amiss.

Carlson Animal Hospital, Oak Park, IL

Carlson Animal Hospital, Oak Park, IL

Our job as your veterinarian is to determine if the disorders is due to a medical or behavioral problem – or both.

Behavioral or Medical problem

Before deciding that the problem is behavioral, we must first rule out a medical problem.  We recommend a thorough physical examination and some tests. These are  what we call ‘a minimum diagnostic database.’ We’ll get a complete blood count, serum chemistry profile, total T4, fecal analysis, and urinalysis. These tests tell us a lot and my preclude, or indicate, additional diagnostics.

If we identify a medical disorder,  we’ll recommend the therapy based on our knowledge and experience. We’ll confer with you as to what to expect from the treatment.

Behavioral causes

If  we don’t see any signs of a medical condition causing the inappropriate elimination, we can begin determining the likelihood of a behavioral disorder. Behavioral causes of inappropriate elimination fall into two general categories: 1) a dislike of the litter box, and 2) stress-related misbehavior.

Inappropriate Elimination

Cats and their litter box habits

A cat may avoid the box if it has become objectionable to them. Cats can be fastidious so they may avoid a box if it is not cleaned frequently enough or sometimes a cat dislikes type of litter used.  The location of the litter-box may also play a factor in avoidance.

Here is a list of some possible related causes leading to feline inappropriate elimination disorder

  • >  A new person (especially a baby) in the house

    moving to a new home can stress a cat

    A new home can cause cats stress

  • >  A person that has recently left the house (permanently or temporarily)
  • >  Several new pieces of furniture or rearrangement of existing furniture
  • >  New drapes or carpet
  • >  Moving to a new house
  • >  A new pet in the house
  • >  A pet that has recently left the house
  • >  A new cat in the neighborhood that can be seen by the indoor cat
  • >  A cat in heat in the neighborhood
  • >  A new dog in the neighborhood that can be seen or heard by the indoor cat


elimination box

Not cleaning a litter box enough can cause a cat to avoid the box.

Even cats that have used the same litter or litter-box their entire life can suddenly become averse to using it.

Map it to help with the determination

When you come to see us, bring a detailed drawing/map of your home with information such as windows, doors, appliances, stairs and furniture locations. Indicate where your cat’s food and water bowl, litter box(es), scratching post and cat-tree are located. If possible note the type of flooring you have and the location and frequency of the inappropriate elimination. To help us diagnose the problem, we will ask you to fill out a questionnaire about the inappropriate elimination. We’ll use this to better plan for your cat’s individual problems.

elimination layout

Drawing of a cat’s living space.

Therapies for cat elimination disorders

We customize our recommendations for each cat based on all the information we have; initially we attempt behavioral modification. The goals are to deter the cat from eliminating on the inappropriate location (aversion therapy) and encouraging the cat to choose an appropriate location (attraction therapy).

If these therapies do not correct the problem, we may recommend a combination of behavioral and medical therapy. It is also important to note that cats with medical causes for feline elimination disorder can still benefit from behavioral therapy at home.

elimination successWhen managing our feline patients with inappropriate elimination, it is important to be aware of the prognosis. The prognosis for improvement is more likely if several of the following are true:

  1. The duration is less than 1 month when treatment begins.
  2. There are only one or two locations in the house that the cat uses for inappropriate elimination.
  3. It is possible to identify and relieve the stress-causing situation.
  4. It is possible to neutralize the odor caused by the urine or stool.
elimination 2 cats

Multiple cats increases the possibility of inappropriate elimination.

The more cats present in a household, the greater the chance of inappropriate elimination.  One study found that for every cat present there is a 10% chance.  This means that if there are 6 cats in a household, there is a 60% chance of inappropriate elimination occurring.

Cornell University offers another, comprehensive article on feline elimination disorder which you may find helpful:

eliminination Hunter

Let us help you with any inappropriate elimination issues.

Feline elimination disorders are the primary reason cats are relinquished to shelters each year. If you have any questions or concerns about your cat’s elimination habits, please call us. We want to help you and your kitty stay together for a long long time.