Association between Survival Time and Changes in <scp>NT</scp>‐pro<scp>BNP</scp> in Cats Treated for Congestive Heart Failure

Pierce, Kursten V.; Freeman, Lisa M.; Cunningham, Suzanne M.; Yang, Vicky

doi:10.1111/jvim.14690

Cited by 11 publications

(8 citation statements)

References 47 publications

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“…Also, using MCS allows for identification of cachexia at a single point in time (rather than requiring 2 separate body weights) and avoids the requirement for prediagnosis body weight measurements or masking of cachexia by fluid accumulation. The prevalence of 41.6% using MCS from all 125 cats is similar to that reported in 1 smaller study of cats with CHF (48%) and in 3 studies of dogs with varying stages of CHF (48%‐54%), although lower than 1 study which reported a prevalence of 69% in dogs with advanced heart failure due to degenerative mitral valve disease . Prevalence reported in studies of human heart failure ranges from 10.5% to 42% (but is most commonly reported to be approximately 10%) .…”

Section: Discussionsupporting

confidence: 78%

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Cardiac cachexia in cats with congestive heart failure: Prevalence and clinical, laboratory, and survival findings

Santiago

Freeman

2019

Veterinary Internal Medicne

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Background: Cardiac cachexia is common in people and dogs with congestive heart failure (CHF). However, the prevalence and effects of cardiac cachexia in cats are unknown. Objectives:To determine the prevalence of cachexia and its associations with clinical laboratory and survival data in cats with CHF.Animals: One hundred twenty-five cats with CHF.Methods: Medical records of cats evaluated during a 40-month period were retrospectively reviewed to identify cats with cardiac cachexia using 7 different definitions. Clinical, laboratory, and survival data were compared between cats with and without cachexia.Results: Prevalence of cachexia ranged from 0 to 66.7% for the 7 definitions, with a prevalence of 41.6% using muscle condition score (MCS). Cats with cachexia (determined by MCS) were older (P < .001), more likely to have pleural effusion (P = .003), had significantly higher blood urea nitrogen (P < .001) and neutrophil concentrations (P = .01), and significantly lower body condition score (P < .001), body weights (P < .001), hematocrit (P = .007), and hemoglobin concentrations (P = .009). Survival time for cats with cachexia (determined by MCS) was significantly shorter than for cats without cachexia (P = .03). Cats that were underweight (P = .002) and cats with dilated cardiomyopathy (DCM) also had shorter survival times (P = .04).Conclusions and Clinical Importance: The association between cachexia and reduced survival time emphasizes the importance of identifying and addressing this common problem in cats with CHF.

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Section: Discussionsupporting

confidence: 78%

“…In dogs, the prevalence of cardiac cachexia (based on muscle loss) is 48%‐69% . The prevalence of cardiac cachexia in cats with CHF (based on muscle loss) was 48% in one small study …”

Section: Introductionmentioning

confidence: 99%

Cardiac cachexia in cats with congestive heart failure: Prevalence and clinical, laboratory, and survival findings

Santiago

Freeman

2019

Veterinary Internal Medicne

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“…Cats that develop CHF associated with stress, IV fluid therapy, general anesthesia, or extended‐release corticosteroid treatment might have longer survival times compared with cats that develop CHF in the absence of these factors . Factors associated with longer survival times after treatment for CHF include a greater decrease in NT‐proBNP concentrations during hospitalization and resolution of CHF at reexamination …”

Section: Prevalence and Natural Historymentioning

confidence: 99%

“…3,17,39 Factors associated with longer survival times after treatment for CHF include a greater decrease in NT-proBNP concentrations during hospitalization and resolution of CHF at reexamination. 40 In contrast to HCM in people, in whom dynamic left ventricular outflow tract obstruction (DLVOTO) has been associated with increased morbidity and mortality, 41 DLVOTO does not appear to be a poor prognostic factor in cats. 17,21,22 This might be a true difference between HCM in humans and cats, but also could reflect differences in how DLVOTO is defined between species, or the result of bias in retrospective studies (cats with DLVOTO are more likely to be investigated for an incidentally detected murmur than cats with nonobstructive HCM, which often are not diagnosed until clinical signs develop).…”

Section: Prognosismentioning

confidence: 99%

ACVIM consensus statement guidelines for the classification, diagnosis, and management of cardiomyopathies in cats

Fuentes

Abbott

Chetboul

et al. 2020

Veterinary Internal Medicne

146

204

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Consensus Statements of the American College of Veterinary Internal Medicine (ACVIM) provide the veterinary community with up-to-date information on the pathophysiology, diagnosis, and treatment of clinically important animal diseases. The ACVIM Board of Regents oversees selection of relevant topics, identification of panel members with the expertise to draft the statements, and other aspects of assuring the integrity of the process. The statements are derived from evidence-based medicine whenever possible and the panel offers interpretive comments when such evidence is inadequate or contradictory. A draft is prepared by the panel, followed by solicitation of input by the ACVIM membership that may be incorporated into the statement. It is then submitted to the Journal of Veterinary Internal Medicine, where it is edited before publication. The authors are solely responsible for the content of the statements. AbstractCardiomyopathies are a heterogeneous group of myocardial disorders of mostly unknown etiology, and they occur commonly in cats. In some cats, they are welltolerated and are associated with normal life expectancy, but in other cats they can result in congestive heart failure, arterial thromboembolism or sudden death.Cardiomyopathy classification in cats can be challenging, and in this consensus statement we outline a classification system based on cardiac structure and function (phenotype). We also introduce a staging system for cardiomyopathy that includes subdivision of cats with subclinical cardiomyopathy into those at low risk

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“…There is one study that suggests that, as a group, cats that experience a greater decrease in NT-proBNP during hospitalization for treatment of heart failure live longer. 214 However, how that translates to individual cats is unknown. That same study found that cats whose owners had difficulty administering medication fared worse.…”

Section: Prognosismentioning

confidence: 99%

The Feline Cardiomyopathies: 2. Hypertrophic cardiomyopathy

Kittleson

Côté

2021

Journal of Feline Medicine and Surgery

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Practical relevance: Hypertrophic cardiomyopathy (HCM) is the most common form of feline cardiomyopathy observed clinically and may affect up to approximately 15% of the domestic cat population, primarily as a subclinical disease. Fortunately, severe HCM, leading to heart failure or arterial thromboembolism (ATE), only occurs in a small proportion of these cats. Patient group: Domestic cats of any age from 3 months upward, of either sex and of any breed, can be affected. A higher prevalence in male and domestic shorthair cats has been reported. Diagnostics: Subclinical feline HCM may or may not produce a heart murmur or gallop sound. Substantial left atrial enlargement can often be identified radiographically in cats with severe HCM. Biomarkers should not be relied on solely to diagnose the disease. While severe feline HCM can usually be diagnosed via echocardiography alone, feline HCM with mild to moderate left ventricular (LV) wall thickening is a diagnosis of exclusion, which means there is no definitive test for HCM in these cats and so other disorders that can cause mild to moderate LV wall thickening (eg, hyperthyroidism, systemic hypertension, acromegaly, dehydration) need to be ruled out. Key findings: While a genetic cause of HCM has been identified in two breeds and is suspected in another, for most cats the cause is unknown. Systolic anterior motion of the mitral valve (SAM) is the most common cause of dynamic left ventricular outflow tract obstruction (DLVOTO) and, in turn, the most common cause of a heart murmur with feline HCM. While severe DLVOTO is probably clinically significant and so should be treated, lesser degrees probably are not. Furthermore, since SAM can likely be induced in most cats with HCM, the distinction between HCM without obstruction and HCM with obstruction (HOCM) is of limited importance in cats. Diastolic dysfunction, and its consequences of abnormally increased atrial pressure leading to signs of heart failure, and sluggish atrial blood flow leading to ATE, is the primary abnormality that causes clinical signs and death in affected cats. Treatment (eg, loop diuretics) is aimed at controlling heart failure. Preventive treatment (eg, antithrombotic drugs) is aimed at reducing the risk of complications (eg, ATE). Conclusions: Most cats with HCM show no overt clinical signs and live a normal or near-normal life despite this disease. However, a substantial minority of cats develop overt clinical signs referable to heart failure or ATE that require treatment. For most cats with clinical signs caused by HCM, the long-term prognosis is poor to grave despite therapy. Areas of uncertainty: Genetic mutations (variants) that cause HCM have been identified in a few breeds, but, despite valiant efforts, the cause of HCM in the vast majority of cats remains unknown. No treatment currently exists that reverses or even slows the cardiomyopathic process in HCM, again despite valiant efforts. The search goes on.

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Association between Survival Time and Changes in NT‐proBNP in Cats Treated for Congestive Heart Failure

Cited by 11 publications

References 47 publications

Cardiac cachexia in cats with congestive heart failure: Prevalence and clinical, laboratory, and survival findings

Cardiac cachexia in cats with congestive heart failure: Prevalence and clinical, laboratory, and survival findings

ACVIM consensus statement guidelines for the classification, diagnosis, and management of cardiomyopathies in cats

The Feline Cardiomyopathies: 2. Hypertrophic cardiomyopathy

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