A 23-Year-Old Cat with Heart Disease — Is Treatment Still Possible?

In this real-life case, we share how23-year-old Dan Dan was successfully diagnosed with advanced heart disease andstabilized with appropriate treatment — regaining a good quality of life.

Senior Cat + Heart Disease = Hopeless?

Many owners worry that the older a cat gets, the harder it becomes to treat illness. While age is indeed an important factor in medical decision-making, early intervention can still make a significant difference — even for very senior cats.

Below is Dan Dan’s journey, from seizure episodes to the discovery of advanced heart disease, and ultimately, stabilization.

Patient Profile

Name: Dan Dan
Species: Domestic cat
Age: 23 years

Before onset:

• Considered a super senior cat
• Living normally at home
• No known history of chronic heart disease
• Stable appetite and elimination

“What Age Is Considered Senior in Cats?”

Cats are generally considered senior from the age of 7 onward.

While older cats require closer monitoring, being senior does not mean untreatable.

Early Stage: Seizures with Unknown Cause

At around 19 years old, Dan Dan began experiencing seizures approximately once per month, sometimes accompanied by brief loss of consciousness.

At that time, the seizures were thought to be neurological in origin, possibly epilepsy. There were no respiratory symptoms, and annual health checks were performed. The condition remained relatively stable.

Disease Progression: Increased Seizures and Rapid Breathing

Four years later, at over 20 years old, Dan Dan’s condition worsened.

Seizure frequency increased to three to four times per week. Her breathing rate also became noticeably faster.

Abnormal breathing is a serious warning sign. This prompted a shift in diagnostic focus — from neurological evaluation to cardiopulmonary assessment.

Acute Deterioration: Immediate Intervention Required

Within a week, Dan Dan’s condition rapidly declined. She experienced multiple seizures per day and developed clear respiratory distress.

Immediate medical intervention was necessary.

Comprehensive Diagnostics: Identifying the Root Cause

Dan Dan underwent both echocardiography and thoracic radiography.

Findings:

• End-stage Hypertrophic Cardiomyopathy (HCM)
• Significant pleural effusion (fluid accumulation in the chest cavity)
• Severe enlargement of the left atrium
• “Smoke-like” blood flow pattern on ultrasound, indicating high thrombus risk

The heart structure had undergone irreversible changes. The heart was overloaded and had entered heart failure.

Dan Dan’s life was at imminent risk.

What Is End-Stage Hypertrophic Cardiomyopathy?

Hypertrophic cardiomyopathy (HCM) is a condition where the heart muscle thickens abnormally.

This thickening reduces the ventricular space, impairs blood flow, and increases pressure in the atria. In advanced stages, heart failure develops.

HCM Stages

Stage A:
At-risk breeds, but no structural changes yet.

Stage B1:
Mild thickening, normal heart size, no symptoms.

Stage B2:
Moderate to severe thickening with chamber enlargement.

Stage C:
Clinical signs of heart failure (e.g., pleural effusion, breathing difficulty).

Stage D:
Refractory heart failure, difficult to control with medication.

Dan Dan was in Stage C, already experiencing heart failure.

Atypical Presentation: Seizures Masking Cardiac Disease

Seizures alone did not initially point toward heart disease.

Only after respiratory symptoms appeared did further cardiac investigation reveal the underlying issue.

To relieve the life-threatening pleural effusion, thoracocentesis was performed. Approximately 80 cc of clear fluid was removed.

Dan Dan’s breathing improved immediately — confirming correct diagnostic direction.

Important Note

When pleural effusion is present, thoracocentesis is not optional.

It is not a treatment for cardiomyopathy itself, but a life-saving emergency procedure to relieve respiratory compromise.

Stabilization and Ongoing Management

After the emergency intervention, Dan Dan was no longer in immediate danger.

With appropriate long-term medication, her condition stabilized.

Treatment Plan

• Diuretics: Control fluid accumulation
• Cardiac medication: Support heart pumping function
• Clopidogrel: Reduce risk of fatal thromboembolism
• Anti-seizure medication: Reassessed and adjusted

Follow-Up and Outcome

Dan Dan continued regular follow-ups.

Results showed:

• Clearer lung fields on radiographs
• Normalized respiratory rate
• Stable kidney function
• No recurrence of seizures

She returned to a stable daily routine — eating, drinking, and moving independently.

This is considered clinical stability.

Stability Is Not Luck — It Is Medical Decision-Making

Dan Dan’s case demonstrates that even a 23-year-old cat can stabilize with timely diagnosis and appropriate intervention.

Age alone should never determine whether treatment is pursued.

If you are concerned about your senior cat’s health, Swanston Veterinary Hospital provides comprehensive diagnostic services and individualized care plans tailored to each life stage.

📞 Phone: 2123 9206
🌐 Online booking: https://www.swanstonvet.com/#Booking
📍 Address: Shop 9, 38 On Ning Road, Yuen Long, Hong Kong
🕘 Opening Hours: 10am – 8pm (Monday to Sunday)

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