The Cat Heart: What Are The Signs of Disease?

Tiger Cat with Hypertrophic CardiomyopathyTiger, the kitty pictured to the left, is only 6 and has a cat heart disease called Feline Hypertrophic Cardiomyopathy. He doesn't know it though. As you can see, he loves to hang out in crazy places, even upside down in the sink! He is on medication which he gets twice daily every day and he has been doing well for the two years he has been with me.

HCM isn't the only heart disease cats can get. Cats can have "heart attacks" and leaky valves and other congenital defects. They can develop heart failure and experience a buildup of fluid in their lungs. Cats get high blood pressure and can have strokes.

Many of the same symptoms we associate with heart disease in people are likewise symptoms that cats can experience. The following letter from a reader concerns symptoms she is observing in her cat and her concern about them.

Meghan from Mountain View, CA writes to ask about
her young cat's gagging which occurs after exercise.

Dear Dr. Neely,

Recently I have started noticing that my 2 1/2 year old cat, Mariposa, has a strange reaction when playing chase the string on a stick. I like to run her (and her brother) up and down the hall as they play chase. I also find it amusing to start moving it around in circles, and back and forth, so fast that their little heads are going in circles. They love it, and little Mariposa is CONSTANTLY begging to play. She has TONS of energy and a zest for stalking the string and running up and down.

However, I have noticed that after the running up and down, when there is the time she is just sitting, stalking and watching it as I quickly (I mean quickly, it has to make her dizzy) swirl it in circles, Mariposa has had this strange reaction where:

1) She starts licking her lips
2) her little tongue starts to come out of her mouth
3) She starts to gag, I can see it convulse up through her body. (she doesn't throw up though)

She seems undisturbed by this, the whole time her eyes are on her prey. However, it is strange to me, and upon investigation, one site suggested gagging is a sign of the cat heart disease called "hypertrophic cardiomyopathy." She does not display the other symptoms of difficulty breathing, increased respiratory rate or reluctance to move around (she is constantly running), I think her appetite is less than her brother who is twice her size, but she eats.

However, in this condition, it does seem that increased heart rate may lead to symptoms as there is less time to fill the heart with blood. I know when she was a kitty, the vet said she had a very mild heart murmur that I shouldn't worry about, so I hope this doesn't make her more susceptible to this condition.

I am happy to take her to the vet, however, I am also wondering if perhaps this is actually something more common place than heart disease. I am wondering if there are possibly more benign causes.

Thank you!!!Meghan

Hi, Meghan,

Several things need to be considered.

(1) Mariposa is very young
(2)She is also female
(3) She feels energetic, begs to play
(4) She plays energetically, has tons of energy
(5) she doesn't exhibit difficulty breathing
(6) she doesn't tire easily

These are all facts that point away from cat heart disease as the cause. The most common form of heart disease occurs much more frequently in males, usually shows signs when the cat is a bit older, seems to make the cat slow down, gain weight, and be much less active. Also, difficulty breathing is often the first sign, and Mariposa is not having difficulty breathing.

On the other hand, she had a heart murmur detected. Cat heart disease most often includes a heart murmur. However, many young kittens have heart murmurs that are not significant and often go away.

What are her symptoms? (1) She starts licking her lips. (2) Her tongue comes out of her mouth. (3) she starts to gag.

Are these signs of cat heart disease? Generally not. When a cat licks its lips, it is usually due to nausea. If her tongue being out of her mouth is accompanied by open mouth breathing (difficulty breathing) then it can indicate heart disease, but that doesn't sound like what is happening here. The fact that she licks her lips and ends up gagging would seem to indicate that the tongue out of the mouth is just the middle stage of nausea leading to gagging.

Cat heart disease is most often silent until a clot forms in the aorta, blocking blood supply to the hind legs OR until the cat is having difficulty breathing from accumulation of fluid in the chest. Surprisingly, coughing is not a common sign of cat heart disease.

As odd as this seems, it really sounds like Mariposa is getting dizzy and then nauseous. To find out would be simple. Stop playing with her in that manner. Play in a more subdued manner for awhile and leave out the speed, circles and swirls. If she isn't having this symptom at any time other than play and if she stops having it when the method of play changes, you will have your answer.

Dizziness in people leads to nausea. That can happen to cats too. I would make the changes I suggest above and see what happens. Of course, if she, at any time, has difficulty breathing or loses sensation and movement in a limb, she should be rushed to the hospital immediately.

It also wouldn't, in general, be a bad idea to have that heart murmur listened to again if it hasn't been recently to see if it is still there and if so, if it has changed or other irregularities of the heart are noted.

Nausea and gagging in cats can be the result of many things, including licking something that tastes bad to them, eating bad food, certain medications, kidney disease, a reaction to something toxic that has been ingested, hair balls, and many other things. It is, however, not commonly a sign of heart disease.

Thank you for writing, Meghan, and sharing your story,
Dr. Neely

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