Heart murmur

So a few months back I got told that my cat has a low level heart murmur and they recommended me to get a heart scan to see if he needs any further treatment. The thing is he's 4 years old and hasn't had any issues related to his heart and the heart scan itself is in the range of £400+ and doesn't include further treatment.. my question is would the scan be worth getting if he's not had any issues and the murmur isn't a big deal. The question may seem stupid as I'd love to be able to get him the scan but £400 is a lot of money I simply don't have and insurance is an issue as not a lot of places do pre existing condition cover and if they do its incredibly expensive.. what do I do?

Hello!  It must indeed be frustrating to be told that your cat may be ill and needs scans, when everything looks absolutely perfect from the outside.  Heart disease isn't the only time this happens; bowel cancer, liver disease, splenic tumours, kidney failure and even diabetes can also be found in clinic before signs of disease have been perceived as a problem by the owner.  Screening tests - such as listening to the heart - have been developed over the years to catch illness early.  Many a cynic has muttered that this way, vets can sell you medication, but the fact is that in many of these cases, early intervention and medication can help to preserve quality of life for longer. More to follow

Heart murmurs can simply come about from pressing the stephoscope too hard against the chest, but your vet will by now have reduced the pressure and listened again, and in several places, to rule this out.  Other causes are more serious and include structural diseases which have often been present since birth, such as holes in the heart, abnormally sized chambers, incompletely formed heart-valves and so on.  These can lead to secondary problems as animals get bigger and older.  Other heart murmurs are acquired ie develop later,  such as leaky valves (which in turn cause backflow and impact the mechanism of the heartbeat), and thickening heart muscle.  Some murmurs are secondary to other things going on in the body, such as fever, anaemia and hyperthyroidism.

So you can see that there is an absolutely huge list of possible causes for a heart murmur.  Your vet may already have their suspicions as to what is causing this one.  However, according to experts Heidi and Luca Ferasin writing in the Veterinary Times, more than 50% of cats with a murmur do not have echocardiographic (visible on ultrasound) evidence of heart disease, so listening to the murmur doesn't really discriminate between cats that need treatment or not.  There are various blood tests that look for evidence of stretch within the heart cells, but these do not tell you where the stretch is occuring.  Ultrasound is likely to show (heart reasons) causing a murmur, and which, if any, treatment is appropriate.

Ultrasound is the most specific way to find the cause of a murmur and whether or not treatment is needed.   As to the ethical questions i.e. is it ok to know that a cat has a murmur and not check it out?  What if humans need that money first? - I don't think that anyone except the patient's owner should be making judgements about these things.  Your vet can give you the technical information.   Questions such as, what are the chances that my cat will need medication?  If they don't, will they need to be scanned again?  - may be useful.

I have just looked through the Vet Help Direct blog and Rebecca Martin has written an article, 'Does My Cat have Heart Disease?' in which she goes into much more detail but appears to reach a similar conclusion.