Limping cat with heart problems.

Dr. Marie replied:

Hi Amy and thanks for your question.

I'm sorry to hear that Hudson is having problems. I'll see if I can clarify a few things for you.

It is definitely possible for a heart problem to be connected to limping. It's possible that he has a blood clot that is affecting the circulation to his front leg. While we more commonly see back legs affected by blood clots, a front leg can be affected instead.

A normal cat heart will not throw a blood clot. But, if there is a heart disease then this can happen. Usually when this happens we will notice that the affected foot feels much colder than the other feet. Can you notice a difference? Sometimes, if the pawpads are pink we can notice that they are more pale on the affected foot.

Unfortunately if there is a blood clot there is not a whole lot that can be done. There are some medicines that can help prevent more clots from forming but it's hard to get a clot to go away. I have heard of a few cases where a blood clot got better on its own. However, because the heart is diseased, usually a new one will form.

I'll see if I can explain the blood tests for you. It looks like the first set of tests is an ECG (electrocardiogram). It's hard to tell too much from what they've written here though. I would have to see the actual test to see if there is a rhythm abnormality.

In the next block, he has slightly low white blood cells. This likely doesn't mean a whole lot. He has a mildly elevated ALT which is a liver enzyme. At this level it doesn't tell us a lot. AST and CK are muscle enzymes. We will often see them elevated with heart disease. However, in my experience the CK is usually much higher with significant heart problems but it doesn't always have to be. Likely CR is creatinine. This is slightly elevated. This can mean kidney problems or possibly some mild dehydration at the time, which is more likely. LDH stands for lactate dehydrogenase. This level is quite high which can support heart disease as well.

There is a test that I like to run called a BNP level. If your vet is able to do this, this can tell us a lot more about whether there is a heart problem. Have they mentioned if there is a heart murmur? Another test that would be helpful would be to measure his blood pressure on his affected front foot as compared to the back feet. If it is low on the front foot this supports a clot (and also heart disease as well.)

Ultimately, if you were able to have an ultrasound done on his heart this would be the best thing. An ultrasound can often tell us exactly what the problem is and whether or not we can do anything for it.

The most common heart problem in cats is something called HCM (hypertrophic cardiomyopathy). This is a condition where the walls of the heart are too thick. There is no cure for HCM. If he has some rhythm abnormalities then there are medicines that can help his rhythm to stabilize and could possibly reduce the risk of him throwing more blood clots. But, my experience with heart disease in cats is that they tend to go downhill quickly.

It's hard for me to say whether the homeopathic remedies will work. I'm not a huge believer in a lot of natural remedies....but then there are likely a lot of medicines out there that I am not familiar with.

I wish I could give you more concrete information on what is going on with him. I really hope he improves. Let me know if you have more questions. I'll be online till about 10pm eastern tonight but if I miss you I'll check in again in the morning.

Dr. Marie.



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Dr. Marie replied:

You're very welcome Amy. Just a little bit more information about those two tests:

The BNP level is a new test. We've only had it for about 6 months or so so I'm not sure if it will be available to you. It costs around $50 or so in my clinic.

The ultrasound would need a specialist to do it. While many regular vets can do ultrasounds, heart ultrasounds need special equipment. This is not to check for rhythm abnormalities but rather to see if the heart walls are thickening and possibly tell us the exact status of the heart. This test is a lot more expensive (think $400 or so).

If this were my case I'd likely run a BNP and if it was really high then I'd be satisfied that this is a serious heart problem. If it was not high, or if the results were only a little bit high then I'd be thinking there is something else going on.