Congestive heart failure in cats



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Congestive heart failure in cats and dogs is a common clinical problem that is associated with high morbidity and mortality. The heart can be affected by multiple disorders that may vary in pathogenesis and severity from one case to the other. Among these, dilated cardiomyopathy, ischemic cardiomyopathy, myocarditis, hypertrophic cardiomyopathy, pericardial disease, valvular disease, and infiltrative disease are the most common causes of heart failure. Although all the different types of dilated cardiomyopathy may share common characteristics, the prognosis and treatment options may vary among cases. In humans, congestive heart failure in adults is most often associated with coronary artery disease, hypertension, and myocardial ischemia and infarction. In dogs and cats, heart failure is typically associated with idiopathic dilated cardiomyopathy.

Dilated cardiomyopathy (DCM) is a primary heart disease characterized by ventricular dilatation and systolic dysfunction. The incidence of DCM in dogs is high, and can be found in all breeds, but the highest prevalence has been recorded in Great Danes and Great Pyrenees.

In humans, DCM occurs in young adults with idiopathic cause in approximately one third of cases. DCM occurs in children at a frequency similar to adults, but it is idiopathic in less than 20% of cases.

Although not common, congenital heart disease is one of the primary causes of heart failure in humans. The congenital heart defects can be associated with DCM, even when they occur before the onset of DCM in the child.

Dilated cardiomyopathy is associated with a poor prognosis in humans, dogs, and cats, and is often the result of a primary disease of the heart muscle. Heart failure is often associated with progressive left ventricular dilation, which eventually leads to heart failure. Cardiomyopathy of a non-dilated etiology, including infiltrative, hypertrophic, valvular, pericardial, or idiopathic causes, is less likely to progress to failure.

Idiopathic dilated cardiomyopathy is the most common heart disease in humans. Although the disease is most often diagnosed in middle-aged individuals, the incidence in young people has been reported to be as high as 3% in some studies. Idiopathic DCM is frequently hereditary, but it can also be caused by toxins, trauma, and infection.

In humans, idiopathic DCM is usually not associated with significant clinical signs until end-stage disease, although patients with DCM may have an early, insidious onset of heart failure. Most patients with idiopathic DCM have a life expectancy of several years, but most of them will eventually die as a result of congestive heart failure.

A variety of pathological conditions have been reported in dogs. The most common are idiopathic, but several forms of congenital and acquired disease can also present as DCM. Most cases are diagnosed as idiopathic DCM based on the histological or histochemical appearance of the myocardium. These forms of DCM are progressive and associated with congestive heart failure and death.

In humans, idiopathic DCM has a wide range of phenotypes. The most common form of idiopathic DCM is familial or familial-like, with a variable clinical course. The disease is characterized by myocardial dilation, reduced systolic function, and the absence of significant cardiac histological abnormalities or other cardiac diseases. A subgroup of patients presents with an earlier, insidious onset of congestive heart failure. Patients usually do not have any clinical signs of the disease, and therefore do not seek medical attention until end-stage disease.

Other subgroups of idiopathic DCM present with variable clinical courses, including a rapidly progressive congestive heart failure, and sudden or fatal collapse without clinical signs. The patients may have a progressive cardiomyopathy, with a reduced left ventricular ejection fraction and a left ventricular enlargement that can result in sudden death. The patients may present with cardiac arrhythmias, or the disease may be associated with conduction disturbances.

Other subgroups of idiopathic DCM are familial with congenital or non-congenital forms. The patients have an early onset of severe heart failure, and the myocardium may show histological abnormalities, or myocardial scars. This form of idiopathic DCM is associated with sudden death, and is usually seen in young individuals.

Most patients with idiopathic DCM are diagnosed late in the course of the disease, because the clinical signs are usually mild and progressive until the disease reaches an end-stage. In most of the cases, the disease is not diagnosed until late-stage heart failure occurs.

In humans, idiopathic DCM occurs with a female:male ratio of around 2:1.

In dogs, idiopathic DCM has been reported in various breeds. Great Danes have been found to be the most affected breed. The disease has also been diagnosed in German shepherd dogs, dachshunds, beagles, and poodles.

Several factors have been reported to be associated with the onset of congestive heart failure in humans. These factors include a genetic component, a reduced myocardial blood supply, exposure to toxins, infections, congenital heart disease, and systemic diseases. In humans, the risk of idiopathic DCM is associated with several gene mutations. In the most recent years, the most common mutations have been detected in desmoplakin 1 and desmoplakin 2 genes. Mutations in these genes are associated with a wide range of phenotypes, ranging from mild to lethal dilated cardiomyopathy. In Great Danes and Great Pyrenees, mutations in the feline major histocompatibility complex (FMC) have been detected as an etiologic factor in idiopathic DCM.

Several clinical and biochemical markers have been described for idiopathic DCM, and these may have prognostic and/or therapeutic implications. For example, high



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