HCM in Ragdoll Cats

| April 28, 2016 | 38 Comments

HCM in Ragdoll Cats

A reader wrote in telling me her kitty suddenly passed of HCM.  She has asked that I re-run this guest post by Lorie Huston – may she RIP.

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Originally published Jul 26, 2012

The other day a Floppycats reader emailed me concerned that her kitten might have HCM, I did not have a good idea of what all it entailed.  So I reached out to Lorie Huston, DVM to see if she could provide insight for us.  Thank you to Lorie Huston, DVM for writing this  – please feel free to ask questions!

Guest Post by Lorie Huston, DVM

Hypertrophic cardiomyopathy, or HCM, is the most common form of heart disease seen in cats. In Ragdolls, most cases of HCM are inherited from the parents and caused by a gene mutation. Fortunately, we have DNA tests that can detect if a specific cat is carrying the mutation. Unfortunately, we don’t have a cure for HCM at this time, although medications are available that may help some cats.

Affected Ragdoll cats may inherit a mutated gene from just one parent (which is referred to a heterozygous) or a mutated gene from both parents (referred to as homozygous.) In Ragdolls, cats that are heterozygous tend to have a milder form of the disease than those that are homozygous although the disease can still be very serious even in heterozygous cats. (This varies in other cat breeds as the specific mutation and the means of inheritance varies from breed to breed.)

Hypertrophic cardiomyopathy affects the heart muscle, causing the muscle to become thickened, resulting in an inability to pump blood normally through the heart. In most cases, the left side of the heart is the most severely affected, leading to left-sided heart failure.

Symptoms associated with HCM include:

  • Difficult breathing.
  • Increased respiratory rate.
  • Increased respiratory effort.
  • Increased heart rate.
  • Weakness.
  • Lack of appetite.
  • Lethargy.
  • An irregular heart rate (arrhythmia) which may cause fainting episodes.
  • Cyanosis due to lack of oxygen.
  • Hind leg paralysis and/or pain due to a blood clot lodged in the aorta (aortic thromboembolism). In this situation, a blood clot breaks off from within the heart and travels through the aorta, becoming lodged at the end of the aorta blocking the flow of blood to the hind legs.

DNA testing can reveal whether your cat carries the gene mutation most commonly responsible for HCM. However, the only way to accurately evaluate how your cat’s heart is functioning is via an echocardiogram. Though the inherited heart disease caused by the gene mutation is the most common cause of HCM in Ragdolls, there are other causes as well. For instance, hyperthyroidism has been implicated in causing toxic changes within the heart that may cause cardiomyopathy. (Some cardiologists argue that these cases are not accurately referred to as hypertrophic cardiomyopathy but the symptoms are still similar.)

An echocardiogram is an ultrasonographic evaluation of your cat’s heart and allows direct visualization of the heart muscle and individual chambers of your cat’s heart. A cardiologist can measure the muscle thickness and determine whether your cat’s heart is pumping blood through its various chambers effectively and efficiently.

Most cats with cardiomyopathy will need to have an echocardiogram performed on a periodic basis to monitor progress of the disease.

There are a number of drugs that are used to HCM.

  • Furosemide (Lasix) is a diuretic and is used to treat congestive heart failure by removing excess fluid accumulating in the lungs and other body tissues because of the heart failure. Another diuretic less commonly used is spironolactone.
  • Enalapril and benazepril are ACE inhibitors (angiotensin-converting enzyme inhibitors). These drugs help HCM cats by causing vasodilation, or opening of the blood vessels, making it easier for the heart to pump blood.
  • Pimobendan (Vetmedin) is a drug that causes both vasodilation and an inotropic effect which causes the heart muscle to contract with a greater force.
  • Anticoagulants are often used in an attempt to prevent or control blood clots. Aspirin and clopidogrel (Plavix) are the two most commonly used anticoagulants.
  • Cats with HCM may have elevated blood pressure also. Medications which lower blood pressure may be necessary and include amlodipine and atenolol.
  • Supplements such as taurine, L-carnitine and coQ10 are sometimes used as well but their effectiveness is questionable.

Thanks again to Lorie for helping us understand HCM in Ragdoll cats!  Please join Lorie on her website – Pet Health Care Gazette

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About the Author ()

Hi, I’m Jenny Dean, creator of Floppycats! Ever since my Aunt got the first Ragdoll cat in our family, I have loved the breed. Inspired by my childhood Ragdoll cat, Rags, I created Floppycats to connect, share and inspire other Ragdoll cat lovers around the world,

Comments (38)

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  1. AM Stewart says:

    As someone who lost a kitty to HCM about a year ago, I am painfully aware of the symptoms and treatments available. I used Lasix, Enalipril and VetMedin (which is normally a canine drug) over an agonizing three month period. The costs of the drugs weren’t the problem – it was having the fluid drained around the lungs and all the diagnostic tests that ran the bill into the thousands. From a strictly unemotional perspective it wasn’t worth it, but I found that I just couldn’t let him go without trying something.

    In hindsight I question whether I held on too long, but since I’d only had him for three years (he was a stray who showed up on my front door step) I was devastated by the thought of losing him. I’ve lost cats who died of age-related issues, but over a span of years it gets easier to accept. Not easy mind you, but I’ve been lucky to have cats that lived near two decades in most cases.

    So if you have a kitty that is diagnosed with HCM, just be realistic on the expected outcome. Be sensitive not only to your own feelings, but also those of your suffering pet. I hope nobody else here gets a diagnosis of HCM for their cats, and I’m just glad my newest Ragdoll was found HCM-negative as a kitten.

  2. Janet Knowlton says:

    This is probably a very stupid question but if both parents test negative for HCM, is there any way the kitten could get this?

  3. JudyLyn Fanning says:

    Janet…..not a stupid question AT ALL!!!!! My six month old male kitten, who did NOT have a heart murmur or any signs of distress, DIED in recovery at six months old, after being neutered. It was shocking and very, very sad. I saw the paperwork where both parents tested “normal/normal” for HCM. My vet did a necropsy to confirm cause of death. I will be taking my other two kittens to Auburn Vet School Cardiologist Specialist before I have the youngest one neutered. The other kitten that was being neutered at the same time, did not have any complications…..they had different mothers, but the same father. The vet said it may have skipped a generation or just been a fluke. I was devastated.

    • Janet Knowlton says:

      That is just awful. I am so sorry to hear this. I can’t imagine how devastated you must have been. I am now wondering why I want to get a Ragdoll at all if they are this fragile! Are they really this fragile? I am on a waiting list for a kitten that is from a breeder in Sacramento who seems very good and diligent and tests her cats for HCM and feline leukemia. I am really interested in who your breeder is as I looked at a couple in Auburn and stayed away from one. Would you mind telling me? if not on this site, you can email me at knowltons4@att.net. I have had cats (humane society rescues) all my life and never dealt with these kinds of problems…just the typical old age. I also am learning about all the horrible breeders out there that do not test at all and sell sick kittens and then they later die. These people should be sit down…but that’s another story.

      • Janet Knowlton says:

        sorry “shut down” not sit down!

      • Melissa B Keefer says:

        Testing for HCM does not prevent it!! We test for one gene in Ragdolls. There are over 100 genes in people which are responsible for HCM. Anyone who tells you it cannot happen is either not educated about the disease or not being honest. Please educate yourself instead of blaming the breeder. Light blue-eyed males of ANY cat species are more likely to suffer from HCM, we don’t know why, but may be gene linked. It is not usual to see symptoms before the death occurs, but you may. The necrotopsy of a cat who died from HCM looks very similar to the necrotopsy of a cat who suffered an anesthetic accident. This lets vets off the hook with a very convenient excuse. Ragdolls are not “fragile.” We just happen to be one the groups more active in testing. ALL cats are susetible to the disease. Persians, Maine Coone and Ragdolls run a higher incidence in the pedigree population. No one is looking for it in the domestic short hair population!

        • Janet Knowlton says:

          I was only pointing out the breeders that do no testing at all. Thank you for all the information…not that it makes me feel any better! Just like anything else, the horror stories are the ones that are generally posted and not all the great stories. I have to keep that in mind.

  4. Briana says:

    I am planning n getting a ragdoll kitten and i have just recently heard about this disease in the ragdoll breed. If the breeder that i am planning to get my kitten from does not test for this problem is that a red flag should i take myself of the waiting list or could I get him tested myself? Also do you test the parents & the kitten for this disease or just the parents, how often should your kitten be checked? When these tests are done should papers be provide to the person adopting the kitten (me) for proof that the kitten and parents are HCM free? Sorry for the overwhelming amount of questions just want to be sure my breeder is reliable & my new kitten will live a long healthy life.

    • Janet Knowlton says:

      All I know is that a responsible and reputable breeder should absolutely be testing for HCM and feline leukemia and a couple others. No exceptions. I am with you…I am a nervous wreck now after reading all these horrible stories. I’ll let the more experienced Ragdoll owners answer the rest. Check out some of the complaints and it is shocking. I would like to know the answer to your questions too.

  5. AM Stewart says:

    I am not a musician and I don’t play one on TV (a bad Jackson Galaxy reference), but I would be VERY surprised if a six-month old kitten could die of HCM while being neutered. As someone else alluded to earlier, I’d be more suspicious of how anesthesia was administered as well as if there was post-surgery monitoring. Animals are just as susceptible to allergic reactions to medicine, so if possible a pet owner should insist upon observation during recovery.

    As for HCM screening, I’m sure there is no 100% certainty. Much like a DNA test can be taken that will show a human’s predisposition towards certain types of cancer, there are other factors such as environment and nutrition that can play a factor.

    I would hate to think someone would pass up the joy of a Ragdoll’s company for fear of what might happen. Nothing is guaranteed, and the love and contentment of holding my big boy “Panda” more than makes up for the risks.

  6. Yuki says:

    Last year around the same time the doctor heard a heart murmur in Zoey. I really didn’t think anything of it at that time. Last week I took her to the vet and a different doctor heard the heart murmur. Today(5/29) Zoey had an echocardiogram done and the results were that the heart murmur is benign. When her heart rate is high you can hear the murmur, but when her heart rate is low it’s absent. But seeing that she is a Ragdoll the cardiologist advised me to have her heart checked a year from now. I’m so relieved, it so worth it. It’s better to know than to worry or stress over it.

  7. Linda says:

    Hi DNA testing is not enough! always do a yearly echocardiogram, its much better to do both of them.
    It seems that a lot of breeders around the world only test through DNA.
    In Holland its normal to do both. That’s the best way to get it out of the lines.

  8. Patricia Holland says:

    HMC is not the only thing to watch for when you purchase a kitten from a cattery, My Ragdoll is 15 months and was just diagnosed with FIP. I knew nothing about FIP until now. It comes from the mother that carries the carona virus. most kittens carry the virus and never get sick but once in a while it mutates and when it does there is no cure.

    • Patricia Holland says:

      My Ragdoll is also 15 months and was just diagnosed with FIP. I would think breeders could have a test that shows if there female carries the carona virus. If so they shouldn’t be breeding.

      • Linda says:

        Almost every cat is a carona carrier, so you can’t do anything about it, they get it or they don’t get it, its just bad luck if your cat had it, the breeder can’t do anything about it

  9. Linda says:

    Fip is nobody’s fold, almost every cat is carrying the carona virus.

    It comes with every age and every breed, the breeder can’t do anything about it, its a nasty and deadly desease that it is, but not to blame on the breeder.

  10. Hello there! I have a 13-month-old Ragdoll. His half-sister recently died from HCM, and now I am a nervous wreck that my beautiful boy is going to contract the disease.

    According to the breeder who I’ve been in contact with it is Blue’s (my cat’s name) father who ended up carrying the gene. She was unaware he carried it as she’d been told his line was clear of it. So confusing.

    Now the question remains, should I have Blue’s DNA checked, and if I find he is a carrier, then what? Apparently, just because his father was a carrier doesn’t necessarily mean Blue is. (Am I making sense?) My husband says, “Why do you want to have him checked? If we discover he carries the gene then every time he sneezes you will suspect he’s getting HCM, and you’ll drive yourself crazy.” I think he’s right. Since there is no cure for HCM (other than to prolong their life for a brief period of time), what is the point in my knowing? He is neutered, so he will never impregnate another cat.

    Right now I’m concentrating on a healthy, grain-free diet, and encouraging plenty of play. He is totally full of vim and vinegar, and the vet has never mentioned anything about a heart murmur.

    Thoughts, anybody?

    Nervous Nellie

  11. Linda says:

    Hi, let her test thruh ultrasound by a specialist, and do the dna.

  12. Jo says:

    Hello

    For me, what is the point in knowing. I would personally enjoy him while he is still young. You can have him get an echocardiogram if you are that concerned. HCM can be present regardless of whether you hear a heart murmur or not. We can only do the best we can.

  13. Amanda says:

    Why bother with a gene test? If he has it, he has it. If he doesn’t, then you’ve spent a lot of money for nothing. He’s not a breeding cat so it’s not important to his “lines”.

    Just make sure your vet knows there is a history of HCM in his family lines and get his heart checked every 6 months, including an ECG annually (or 6 monthly if you can afford it).

    As always, be mindful that his quality of life is the most important thing, not the longevity and try to stop worrying until there is officially something to worry about.

    We all worry about what if, but most of the time they don’t come to anything.

    Enjoy your beautiful kitten. 🙂

  14. Thank you, Linda, Jo, and Amanda! I so appreciate you all taking the time to reply to my concerns and also giving your opinions as to what I should do. I tend to think I’d rather not know. I’d say the chances are he carries the gene if his father was found to carry it. His father, incidentally, is three years old and in perfect health. Of course, the breeder has removed him from the breeding program. Question, can anybody tell me what Blue’s breeder meant when she said she has discovered that Blue’s father carried “one copy” of the gene for HCM? And the father’s mother (Blue’s grandmother) also carried one copy.

    What does “one copy” mean – other than they carry the HCM gene?

    Another question…Blue’s half-sister, the one who shared fathers with Blue and died of HCM…was a white/cream-colored blue-eyed kitten. I’m told there is some truth to the blue-eyed kittens being more susceptible to HCM? Is this true?

    My cat is a “blue mink, lynx point, mitted male”. His eyes are sort of an aqua blue/green color.

    Thanks again, everyone. I am leaning toward NOT wanting to know if Blue has the HCM gene. Hope I’m not being irresponsible.

  15. Cindy Bryce says:

    I would not want to know unless there was something they could do about it..love your cat each and every day.. I had 2 sibling Ragdolls . One came down with kidney disease at the age of 6.. I treated India for 4 years.. They told me I would probably only get 1. But I gave her fluids every day..and loved her. I did worry about her sister China getting it also… But so far so good. And she is now 15…I know it’s hard as we love our cats so very much.. But usnt that the best medicine of all?? Stay strong and enjoy!! XO

  16. AM Stewart says:

    Sharlene, I have some advice as one who lost a Ragdoll to HCM.

    First, talk with your vet about what diagnostic tools are available. If they can do something non-invasive and give you some degree of certainty, it might be worth it. While knowing it might seem more painful, it also arms you with knowledge that might prove helpful later in your kitty’s life. If for instance he’s NOT carrying the gene, you can avoid thinking every ailment suffered by your boy is HCM-related. If he IS carrying the gene, then you can be more aware of his actions and perhaps avoid more serious complications.

    If I had one bit of advice, I’d say make sure to monitor his weight. An overweight cat with HCM is much more serious, and as all cats are notoriously good at hiding illness you might not know he’s in distress until things have gotten pretty advanced. I’m not advocating starving him, but excess weight should be avoided.

    Good luck and don’t automatically assume everything will turn out for the worse. Nothing is guaranteed in life except that your bundle of fluff will bring you much happiness no matter how long his time on earth.

  17. Hi, AM Stewart. Thanks for your kind and wise words concerning my kitty. He is due for his next checkup so I will definitely talk to my vet about what sorts of things I need to do, whether to have him tested or wait it out.

    Excellent point about the weight. He weighs 12# now, which seems an ideal weight for his rather big boned frame. His backbone is still quite prominent when I run my hand across it.

    I so want him to live a long, healthy life. Please, God…

  18. Cindi Marescalchi Pike says:

    Hi. I have what I believe to be a male rag doll. He is 4 years old. Good health. Very skittish but lovely too. His sister, Lily passed away yesterday unexpectedly. She was much thinner in comparison.

    My ex husband owned her and is devastated. She didn’t like going to vets, of course, so the vet prescribed a sedative. Her dad gave it to her put her in crate, and soon after she was dead in the crate.

    Very traumatic for him as he loved her very much and wanted her to be seen by vet for a wellness check.

    When we got to vet, she stated that Lilys intestines were thickened and she probably had a malignancy and the stress on her body from that caused her to die. She was thin but ate and pooped fine from what I’m told.

    My ex thinks he killed her by giving her that pill. He is crushed. But the vet thinks she had cancer and was dying.

    Now looking up info, I’m curious if she had HCM. We won’t know as she was or will be cremated. However I have her brother and just need some guidance. I’m afraid of getting him so stressed to go to vet that he’s going to have a heart attack on me. And I’m afraid of sedating him to get a genetic test. Can my local vet do the test for HCM?

    Please help. This has been an awful 24 hours. Thank you.
    Kittyhugs

    • Catherine Stewart-Mott says:

      Wow, sounds so similar to my cat’s experience. He went in for a first time constipation issue, but it was apparently quite bad so they hospitalized him, did a before/after xray, as well as subcutaneous fluids (he wasn’t eating/drinking well) and a rash of enemas. It wasn’t until he came home that I truly appreciated just how stressful it must have been for my gentle and timid cat. He did not really improve, and I ended up having blood work and then another (chest) xray done as he seemed to be swallowing strange. I was shocked to learn he had an enormous fluid build up on the lungs (which apparently did not show on the periphery of the lungs in the xrays done a week prior. The concern was that it was FIP, triggered by a hospital stay/stress. It was a confusing and alarming time. Try as we might, we could not get ahead of the fluid buildup and he declined to the point that he had no quality of life. I keep wondering what more I could have done. 🙁

  19. Patti Johnson says:

    Thank you so much for this very important information on HCM, Jenny & Dr. Huston! I will save this and hope I never have to refer to this info!

    Big hugs!

    Patti & Miss Pink Sugarbelle 🙂 <3

  20. Teresa Reid says:

    Thank you and feel the same as Patti – hope we never need this as both babies were tested and it was negative. Miss Mari has been really healthy for her 9 years here, so hope that is a good indicator that she is OK. So sorry for all the kitties (and their human parents) who lost their lives to this horrible disease.

  21. Beth says:

    Our first beautiful Ragdoll was an alley kitten, rescued and given to my daughter by her friend. He appeared to be in good health but died suddenly at age 10. Gizmo had been racing around the house, playing with our other cats. When I went to bed he wasn’t waiting there for me on the pillow as usual. I found him lying in another favorite place and he seemed to have passed away peacefully in his sleep. The vet said it was probably a heart attack. At that time (early 1990s), I wasn’t aware of HCM, but I think it may have caused Gizmo’s death.

    Later I found another gorgeous rescue Ragdoll. We had many happy years with Moosie until he died from an different issue, a large mass in his abdomen which was inoperable and probably cancer.

    We loved our Ragdoll boys very much and hope someday to have a Ragdoll – or two – again.

  22. amosam says:

    I have tremendous empathy for each of you who have a sick kitty with HCM or have lost one. My beautiful and incredibly sweet Annie (Ragdoll of the week, December 29, 2014) was diagnosed with HCM about three months ago, at seven years of age. It took close to five months and several vet specialists before a definitive diagnosis could be made. Initial symptoms were elusive, slight lethargy, some loss of appetite, and trouble going up the stairs. The symptoms baffled her vet, who referred her to a feline internist, who suspected HCM, and referred us to a veterinary cardiologist who finally made the diagnosis.

    Having lost another pet to HCM, I am terribly sad, knowing the awful toll this disease takes both on the fureperson and his/her family. It is devastating to watch–helpless–as the disease progresses. And having to make the decision of when the kitty’s decline is severe enough so that her suffering may be averted is heartbreaking. It is fortunate if the kitty can tolerate the medications to improve symptoms, but some kitties cannot. In Annie’s case, the ACE inhibitor and Plavix caused severe diarrhea and vomiting. Also, sometimes Lasix seems to be better tolerated if several smaller doses are administered more frequently (half a dose twice a day, for example), than giving the entire dose once a day.

    Going forward, I can only take care of Annie the best I can, and of course love her, adore her, and insure her every comfort until the awful day when we have to say good-bye. I know her brother George (who is a flame point, and does not carry the HCM gene) will miss her terribly as well.

    • Patti Johnson says:

      I am so very sorry that your Sweet Annie girl has been diagnosed with HCM. You must be devasted (especially since you’ve been through the nightmare of HCM already with a previous, beloved pet)! *BIG LOVING HUGS*

      Sending you prayers of strength and guidance and asking for a miracle that will allow Annie to have many more years of a good quality life filled with love and care with you.

      Big hugs (again)!

      Patti & Miss Pink Sugarbelle 🙂 <3

  23. Patti Johnson says:

    Great and very helpful re-post, Jenny. I am so sorry to hear that a fellow Floppycatter has suffered such a tragic loss. My heart and sympathies go out to her and her family. RIP Sweet Kitteh. <3

    Big hugs!

    Patti & Miss Pink Sugarbelle 🙂 <3

  24. Teresa Reid says:

    Oh my goodness, am so very sorry for your loss and that now you are having to go through it again with your sweet Annie too. That is just heartbreaking beyond words. She is very blessed to have such a loving, caring parent by her side who will ensure everything possible is done to make her happy and comfortable. The knowledge you gained having gone through this with your other little kitty will be of great benefit to your Annie because you are familiar with the meds and their effects, etc. Again, am so very sorry Annie and you have to go through this. Sending you love and hugs. ♥♥♥

  25. Sheila McRae says:

    I lost my 7-1/2 year old ragdoll boy, Rocky, to HCM nearly 3 months ago. He was diagnosed when he had congestive heart failure last November. His sides were heaving because he had so much fluid in his lungs. A 48 hr stay in an oxygen tent and diuretics enabled him to come home where we administered medication to him daily. The nearest cat cardiologist is 250 miles away, so we did palliative care. In early February, we lost him at home. There wasn’t anything different that alerted me that this was the day that he was going to pass. It is a devastating disease but I’m comforted to know that he doesn’t have to suffer any longer. My heart has a “Rocky-shaped” hole that I’m reminded of on a daily basis. It’s my hope that the grief will fade someday.

  26. Karen Jones says:

    My first experience with a Ragdoll ended in tragedy but didn’t stop me from getting my next one. I ended up being “saved” by my first one Missy a stray that had been abandoned and I didn’t even know she was at least part Ragdoll at the time. I had her for a little over 8 years. She was 9 when she died suddenly. She had never been sick a day in her life and always had good check ups at the vet except she was a little overweight. She stopped eating and got really lethargic. I took her to the vets, from their we went to the emergency clinic where they could provide 24 hour care. She was there for 4 days, they called and said she was better and I could come get her. In the 40 minute drive it took to get there, something happened. As I waited in the lobby, wondering why they wouldn’t just simply give me my baby, they finally came and got me and said she had a medical emergency and her heart had stopped and lungs had stopped they brought her back and they asked what me what I wanted them to do. I yelled fix her! They tried, but unfortunately they could not keep her lungs or heart going (I don’t remember which one). Turns out she had HCM. I had never heard of it before. I got my next kitty, a kitten from an excellent breeder who said both parents were negative for the gene. I did a lot of reading and I talked to my vet, who also did a lot of reading, and I STILL had Isabella tested just in case. It was $110 for some piece of mind. And if she had tested positive then I would know in advance if she needed any preventative type of care. Better than not knowing at all and being blindsided!

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