Need inputs on my non-FD cat re. DCM/RCM - Cardiomyopathy

[Nimi S]

Hello All!

Hope everyone and their sugar kitties have been doing well.

I'm back nearly 2.5 years post Shen's FD remission (Aug 2023).
He's 14.5 yrs and doing great (got a reading of 82, 2-3 hours post meal today).

Posting here today to get any inputs I can to understand what I'm looking at and dealing with wrt one of my other cat's recent diagnosis.

Chiu (female, 8.5 years, spayed, indie DSH, weighs 3.3kgs) had been showing symptoms of wheezing since mid-May 2025.
We've been doing the vet rounds since then and yesterday had a diagnosis of Dilated cardiomyopathy with valvular dysfunction after doing a 2d Echo of her heart.

The very kind @Bandit's Mom suggested that I post here as many senior members have had experience with H/R/DCM in their sugar kitties.
Tagging some of them here:
@Wendy&Neko
@Marje and Gracie
@Suzanne & Darcy
@JL and Chip
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Some background (apologies if I am all over the place) first for why it's taken so long:
When the wheezing started, in June, the vet started us on a syrup to relieve bronchospasms, a veterinary supplement syrup used to treat respiratory issues and another syrup to treat bacterial infections.
That didn't make any difference and 10 days later she was put on an antibiotic (Taxim O), Deriphyllin and Udiliv. This was a 10 day course - her wheezing went away by the 3rd day but came back 8-9 days post medication course.

In early July, she got an x-ray (don't have a copy of this), where the vet said she had moderate bronchitis and prescribed Azithromycin, Frenzyme (to support wound healing and reduce inflammation), the supplement syrup and Udiliv. There was no major improvement. In mid-July at the next appointment, the vet gave a guarded prognosis of allergic rhinitis/ asthma and put her on Omnacortil for 15 days (gradually tapered) along with syrip. The wheezing went away 2-3 days in and stayed so for about 2 weeks. Said that we'd have to see if the treatment sticks, else it would probably be Asthma and there's no cure, episodes would just have to be managed with an inhaler/pump.

In early August, we got a repeat x-ray (attached) done which still showed bronchial lung pattern. She got Lasix and Penetrat (similar to Frenzyme). She stayed ok for about a month before symptoms returned.

In mid Sept, she again got an x-ray with bloodwork (both attached) and got prescribed Omnacortil (Prednisolone), Bioclan (Clindamycin Hydrochloride) and Fexorise (Fexofenadine Hydrochloride IP 120 mg). She was ok for nearly 1.5 months before the wheezing returned along with a sort of cough too.

The vet kept going back and forth between Asthma and bronchitis. I even ordered a feline aerosol chamber which we don't get here in India thinking we'd eventually confirm a diagnosis and start the treatment, but there was no discussion on switching to it.

At this point, I decided to switch vets. The vet prescribed a combination of syrups (N-acetylcysteine and L-lysine)and nebulisation (Budesonide + Salbutamol 2.5 mg respules) for 15 days. There wasn't major improvement again and it felt like her wheezing had taken a new form, where I could hear some sort of phlegm but nothing would come out. We got an x-ray taken, vet felt the congestion had reduced and prescribed the same course along with Salbutamol/Asthalin syrup added and asked to repeat x-ray after 15 days.

Yesterday was the x-ray which still showed congestion. We did a 2d echo (scans attached). Vet said stuff like HCM, regurgitation, dilation. I had briefly read about HCM and got overwhelmed and didn't ask the vet for more details. But she sent me off with 30 days medicines (long list of meds below) and we'll do a repeat 2d echo after a month. ETA: she lost about 0.5 kg in the last 15 days.
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Back to where we are today:
Have just given the 1st dose of 7 tablets today morning to Chiu after breakfast - She ended up throwing it up semi digested after 3 hours. Probably got too heavy for her.
Vet suggested to give 2 at a time and after a gap of 20-30 minutes.

I'm going to be taking Chiu to a veterinary cardiologist in a couple of days, once I hear from them about an appointment - to get an understanding of what I am dealing with, what I can expect realistically, how hopeful I can be.. because the internet so far hasn't had any good things to say about RCM. The current vet has diagnosed her with DCM but I'm not sure how much to trust the diagnosis. If it's RCM, I've read Clopidogrel is missing in her prescription right now, for preventing blood clots.
----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
I feel I've wasted too many months already and the steroids have probably made things worse and we are dealing with an end/advanced stage situation.

Please help me by sharing your experiences and advices for things I should be doing/ not doing at this point, any further tests, and questions I should ask the vet/cardiologist.

I'm attaching her labs (Mar/Jul/Sep), x-rays (Aug/Sep/Nov/Dec) and 2d-echo (Dec).

Chiu is on a dry food diet (Farmina N&D chicken and pomegranate - around 17% carbs on a DMB). She's been an anxious cat all her life and prefers to stay solo.
She's sort of stressed out by the 2 overactive cats in our house (Ages 2 and 3, both girls). Just throwing any information that might be helpful to give advice on what to do/ avoid going forward.

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Her current prescription:

1. tab Enam 2.5 mg - 1/4 - x - 1/4 for 30 days (contains Enalapril 2.5 MG - angiotensin converting enzyme (ACE) inhibitor)

2. tab Lasix 40 mg - 1/4 - x - x for 20 days (Furosemide, to treat fluid retention and High Blood Pressure (hypertension))

3. tab Petmedin 1.25 mg - 1/2 - x - x- for 30 days (Pimobendan (non-sympathomimetic, non-glycoside inotropic drug) which is indicated for the management of canine congestive heart failure originating from dilated cardiomyopathy or valvular insufficiency.)

4. tab Omnipulse - 1/2 - x - x- alternate days for 30 days (Heart Supplement : contains L Carnitine 200mg, Taurine 200mg, N-Dimethylglycine 50mg, Vitamin E 30IU, EPA 84mg, DHA 56mg, Selenium 75mcg, EnQ10 20mg, Magnesium Citrate 0.5mg, Folic acid 260mcg, Potassium Citrate 0.1mg, Arginine 100mg.)

5. tab Doxicon 100 mg - 1/4 -x -x for 10 days post meal (Doxycycline & Lactic Acid - antibiotic)

6. tab Deriphyllin 100mg - 1/2 -x - x - for 7 days (contains Etofylline (77mg) + Theophylline (23mg) - bronchodilator used to treat symptoms of asthma and chronic obstructive pulmonary disease (COPD).

7. tab MPS Mullein Lung support - 1/4 - x- 1/4 fpr 10 days (supportive therapy - MPS Mullein Lung Support 3500mg tablets for dogs & cats, 20 tabs - LoyalPetZone India) ( Each MPS Mullein lung support tab contains Mullein Leaf 10:1 extract (equivalent to 3500mg of dried mullein leaf) 350mg, Vitamin C(L-ascorbic acid) 50mg, Zinc Picolinate 5mg, quercetin 100mg, N-Acetyl cysteine 100mg, Bromelain 50mg, Turmeric 100mg, Marshmallow root extract 200mg.)
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Thank you for reading so far
Nimisha

 

[Marje and Gracie]

Hello All!

Hope everyone and their sugar kitties have been doing well.

I'm back nearly 2.5 years post Shen's FD remission (Aug 2023).
He's 14.5 yrs and doing great (got a reading of 82, 2-3 hours post meal today).

Posting here today to get any inputs I can to understand what I'm looking at and dealing with wrt one of my other cat's recent diagnosis.

Chiu (female, 8.5 years, spayed, indie DSH, weighs 3.3kgs) had been showing symptoms of wheezing since mid-May 2025.
We've been doing the vet rounds since then and yesterday had a diagnosis of Dilated cardiomyopathy with valvular dysfunction after doing a 2d Echo of her heart.

The very kind @Bandit's Mom suggested that I post here as many senior members have had experience with H/R/DCM in their sugar kitties.
Tagging some of them here:
@Wendy&Neko
@Marje and Gracie
@Suzanne & Darcy
@JL and Chip
----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
Some background (apologies if I am all over the place) first for why it's taken so long:
When the wheezing started, in June, the vet started us on a syrup to relieve bronchospasms, a veterinary supplement syrup used to treat respiratory issues and another syrup to treat bacterial infections.
That didn't make any difference and 10 days later she was put on an antibiotic (Taxim O), Deriphyllin and Udiliv. This was a 10 day course - her wheezing went away by the 3rd day but came back 8-9 days post medication course.

In early July, she got an x-ray (don't have a copy of this), where the vet said she had moderate bronchitis and prescribed Azithromycin, Frenzyme (to support wound healing and reduce inflammation), the supplement syrup and Udiliv. There was no major improvement. In mid-July at the next appointment, the vet gave a guarded prognosis of allergic rhinitis/ asthma and put her on Omnacortil for 15 days (gradually tapered) along with syrip. The wheezing went away 2-3 days in and stayed so for about 2 weeks. Said that we'd have to see if the treatment sticks, else it would probably be Asthma and there's no cure, episodes would just have to be managed with an inhaler/pump.

In early August, we got a repeat x-ray (attached) done which still showed bronchial lung pattern. She got Lasix and Penetrat (similar to Frenzyme). She stayed ok for about a month before symptoms returned.

In mid Sept, she again got an x-ray with bloodwork (both attached) and got prescribed Omnacortil (Prednisolone), Bioclan (Clindamycin Hydrochloride) and Fexorise (Fexofenadine Hydrochloride IP 120 mg). She was ok for nearly 1.5 months before the wheezing returned along with a sort of cough too.

The vet kept going back and forth between Asthma and bronchitis. I even ordered a feline aerosol chamber which we don't get here in India thinking we'd eventually confirm a diagnosis and start the treatment, but there was no discussion on switching to it.

At this point, I decided to switch vets. The vet prescribed a combination of syrups (N-acetylcysteine and L-lysine)and nebulisation (Budesonide + Salbutamol 2.5 mg respules) for 15 days. There wasn't major improvement again and it felt like her wheezing had taken a new form, where I could hear some sort of phlegm but nothing would come out. We got an x-ray taken, vet felt the congestion had reduced and prescribed the same course along with Salbutamol/Asthalin syrup added and asked to repeat x-ray after 15 days.

Yesterday was the x-ray which still showed congestion. We did a 2d echo (scans attached). Vet said stuff like HCM, regurgitation, dilation. I had briefly read about HCM and got overwhelmed and didn't ask the vet for more details. But she sent me off with 30 days medicines (long list of meds below) and we'll do a repeat 2d echo after a month. ETA: she lost about 0.5 kg in the last 15 days.
----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
Back to where we are today:
Have just given the 1st dose of 7 tablets today morning to Chiu after breakfast - She ended up throwing it up semi digested after 3 hours. Probably got too heavy for her.
Vet suggested to give 2 at a time and after a gap of 20-30 minutes.

I'm going to be taking Chiu to a veterinary cardiologist in a couple of days, once I hear from them about an appointment - to get an understanding of what I am dealing with, what I can expect realistically, how hopeful I can be.. because the internet so far hasn't had any good things to say about RCM. The current vet has diagnosed her with DCM but I'm not sure how much to trust the diagnosis. If it's RCM, I've read Clopidogrel is missing in her prescription right now, for preventing blood clots.
----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
I feel I've wasted too many months already and the steroids have probably made things worse and we are dealing with an end/advanced stage situation.

Please help me by sharing your experiences and advices for things I should be doing/ not doing at this point, any further tests, and questions I should ask the vet/cardiologist.

I'm attaching her labs (Mar/Jul/Sep), x-rays (Aug/Sep/Nov/Dec) and 2d-echo (Dec).

Chiu is on a dry food diet (Farmina N&D chicken and pomegranate - around 17% carbs on a DMB). She's been an anxious cat all her life and prefers to stay solo.
She's sort of stressed out by the 2 overactive cats in our house (Ages 2 and 3, both girls). Just throwing any information that might be helpful to give advice on what to do/ avoid going forward.

----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
Her current prescription:

1. tab Enam 2.5 mg - 1/4 - x - 1/4 for 30 days (contains Enalapril 2.5 MG - angiotensin converting enzyme (ACE) inhibitor)

2. tab Lasix 40 mg - 1/4 - x - x for 20 days (Furosemide, to treat fluid retention and High Blood Pressure (hypertension))

3. tab Petmedin 1.25 mg - 1/2 - x - x- for 30 days (Pimobendan (non-sympathomimetic, non-glycoside inotropic drug) which is indicated for the management of canine congestive heart failure originating from dilated cardiomyopathy or valvular insufficiency.)

4. tab Omnipulse - 1/2 - x - x- alternate days for 30 days (Heart Supplement : contains L Carnitine 200mg, Taurine 200mg, N-Dimethylglycine 50mg, Vitamin E 30IU, EPA 84mg, DHA 56mg, Selenium 75mcg, EnQ10 20mg, Magnesium Citrate 0.5mg, Folic acid 260mcg, Potassium Citrate 0.1mg, Arginine 100mg.)

5. tab Doxicon 100 mg - 1/4 -x -x for 10 days post meal (Doxycycline & Lactic Acid - antibiotic)

6. tab Deriphyllin 100mg - 1/2 -x - x - for 7 days (contains Etofylline (77mg) + Theophylline (23mg) - bronchodilator used to treat symptoms of asthma and chronic obstructive pulmonary disease (COPD).

7. tab MPS Mullein Lung support - 1/4 - x- 1/4 fpr 10 days (supportive therapy - MPS Mullein Lung Support 3500mg tablets for dogs & cats, 20 tabs - LoyalPetZone India) ( Each MPS Mullein lung support tab contains Mullein Leaf 10:1 extract (equivalent to 3500mg of dried mullein leaf) 350mg, Vitamin C(L-ascorbic acid) 50mg, Zinc Picolinate 5mg, quercetin 100mg, N-Acetyl cysteine 100mg, Bromelain 50mg, Turmeric 100mg, Marshmallow root extract 200mg.)
----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------

Thank you for reading so far
Nimisha

I know you said Chiu is a DSH but any particular breed you can see in her as certain breeds are genetically predisposed to dilated cardiomyopathy?

Going to a cardiologist is the best thing and if he/she wants to do the echo again, it is smart to do because they are the experts. My one cat had an echo and the vet said she had an enlarged heart so I took her to a cardiologist and he said her heart was totally normal….they just had her in a weird position.

I have a cat now with hypertrophic obstructive cardiomyopathy caused by a congenital valve issue that, after 15 years, started a bit of back flow. Our cardiologist said steroids are not good for heart patients so I would discuss that with the specialist.

She is on quite a few meds. I would suggest you join a cardiomyopathy group on groups.io. You can google groups.io and the group that helped me in the past is Feline Heart. You might want to post there and get some input as cardiomyopathy can present very differently from cat to cat.

I wish you good luck with the cardiologist.

 

[Nimi S]

You can google groups.io and the group that helped me in the past is Feline Heart.

Thanks Marje! On it.

any particular breed you can see in her

No breeds...She's the kid of a local Indian stray cat who delivered the litter (Chiu and her sis Twiggy) at our home. Almost no scope of her having mated with a Persian or some other breed.

She is on quite a few meds.

Yes..kind of concerned if something will go wrong with so many meds or they'll accelerate the progress of her condition in the wrong direction. Hoping I get the cardiologist's appointment soon and that it's not to late for us.

 

[Marje and Gracie]

Thanks Marje! On it.


No breeds...She's the kid of a local Indian stray cat who delivered the litter (Chiu and her sis Twiggy) at our home. Almost no scope of her having mated with a Persian or some other breed.
View attachment 75957View attachment 75958


Yes..kind of concerned if something will go wrong with so many meds or they'll accelerate the progress of her condition in the wrong direction. Hoping I get the cardiologist's appointment soon and that it's not to late for us.

She’s adorable. I’m glad you will post to the Feline Heart board. I found them very knowledgeable back when I had my first kitty with heart issues.

Dilated HCM, if it’s that, is more seen in breeds like Burmese, Abyssinians, and Siamese.

Please let us know what you find out.

 

[Nimi S]

Hello All!

Dropping in to give an update (a positive one!) on my appointment with a veterinary cardiologist for Chiu’s ECG on Mon 22nd Dec.

Turns out the earlier vet completely misdiagnosed Chiu on Sat evening. Her heart is totally fine, her lungs are not. For some of the ECG indices the cardiologist said ‘brilliant’ - so I’m completely boggled how the earlier vet’s readings and impressions could be so off.

I was advised by the cardiologist to stop all the heart medicines and to continue with an antibiotic for any infection that may be going on in her lungs.
They referred me to another vet over there for an assessment on and treatment for the lungs.
They did her bloodwork and repeated the X-rays (attached).

We had a follow-up appointment again the next day to advise on the treatment based on her lab results.
They think it could be pneumo-bronchitis and have prescribed:

- 5 day course of antibiotics (Amoxicillin+ Potassium clavulanate and Cefixime)
- ⁠3 weeks of a Multivitamin to bring up her Phosphorus levels (folic acid 0. 04 mg calcium pantothenate 2mg nicotinamide 2. 25 mg calcium 110 mg phosphorus 80 mg iron 6. 75 mg zinc 2. 5 mg)
- ⁠a 15 day tapered dose of Prednisolone 5mg

I also sought another vet’s (friend of a friend) opinion on the 1st ECG report and that vet also echoed the cardiologist’s findings. She also felt that the earlier vet was trying to treat everything with the amount of medicines she'd prescribed.

I also checked on the feline heart group that @Marje and Gracie had suggested. While not many responded I got the same feelers from all - that it sounds more like a lung issue, the doctors were shooting in the dark and the medication was possibly overdone.

I’m glad Chiu’s heart is fine but I’m just not sure how I’ll ever be able to trust any single vet with all cat issues. Always end up having mixed experiences.
This one was just too traumatic and I had honestly started grieving and expecting just the worst outcomes. Even now it’s hard to be completely relieved and assured. But I’m glad her heart is all ok.

We've already done with a few days of medication and the frequency and duration of wheezing has gone down from twice every hour to once every 6-8 hours.
Hoping the treatment with this vet sticks


Hope everyone and their sugar kitties had a great Xmas and wishing you all a Happy New Year ahead!

And as always, thank you for all the support - I know I can always turn to FDMB for all things cat!

 

[Lara & Luciole (Lu)]

Thank goodness for your persistence and self-advocacy.
Here's to a full recovery for Chiu, and it sounds like you found better veterinarians, thank goodness!
Best wishes for a happy and healthy new year.

 

[Wendy&Neko]

This is great news! When Neko got her heart diagnosis, we were going to an internal medicine vet for other issues, though she had seen the cardiologist previously for an echo and "only" diagnosed with HCM at the time. Going to a clinic with multiple specialists can be more expensive but worth it, as they work together.

I hope the lung treatments work quickly.