Background:
Hypertrophic cardiomyopathy is the most common acquired
cardiovascular disease in the feline species. A frequent complication of this
cardiomyopathy is the development of cardiac congestive failure, left atrial enlargement and subsequent development of arterial
thromboembolism. In a significant percentage of affected
animals there is progression to
congestive heart failure, resulting in
cyanosis and
dyspnea, often the first clinical signs reported by owners. This is a
report of a 10-year-old Persian
cat with
hypertrophic cardiomyopathy and venous and arterial
thromboembolism of non-cardiogenic origin. Case The
patient was referred for cardiac evaluation, arterial
thromboembolism was the suspected cause of tetraparesis. On clinical examination, a metacarpal
pulse was present in all
limbs; there was no
cyanosis or peripheral
hypothermia thus, ruling out a thromboembolic event in the
limbs. Changes consistent with feline
asthma and
pulmonary edema were seen on radiographs, therefore
hypertrophic cardiomyopathy was suspected.
Treatment with
enalapril (0.25 mg/kg every 12 h) for the
heart condition and
prednisolone (1 mg/kg every 24 h) for
asthma was started. Nine days later, the
patient developed mixed
dyspnea (inspiratory and expiratory) and was hospitalized with signs consistent with arterial
thromboembolism paralysis and
cold extremities in the right and left pelvic
limbs. The
patient was euthanized due to the poor
prognosis. Postmortem and histopathological findings revealed left ventricular concentric
hypertrophy, with no valvular changes;
disseminated intravascular coagulation, with thrombi in the arterial (
iliac arteries, pancreatic and renal vessels) and venous (pulmonary and
renal veins)
beds; as well as multiple neoplastic
lung masses, identified as scirrhous pulmonary
adenocarcinoma, responsible for increased interstitial radiopacity.
Metastasis was also identified at the tracheal bifurcation, causing radiographic changes
similar to the alveolar pattern of
pulmonary edema
(AU)