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Dear Most Esteemed and Knowledgeable Kitties:

Two years ago, we had a group of feral cats that camped out under our house. One of them, a small black cat, adopted us. We took him to my vet and had him treated him for a respiratory infection. We nursed him back to health and he began growing. We fell in love with him and gave him the name Lil Bit.

One night about a year later, we found him laying on the floor, and when we tried to play with him, he looked up at us and meowed but would not stand up like he usually did. When my husband picked him up, he was limp. Since it was late at night and we do not have any 24-hour vets, we decided to put his bed in our room and take him to the vet in the morning. The next morning, we woke up to him meowing, running, and jumping like nothing had happened. We assumed he may have been bitten by something and gave it no more thought since he was clearly back to his old self.

Four or five months after that, my husband came in and told me that something was wrong with Lil Bit. I followed him into the living room where Lil Bit lay still like he had the first time — only this time he was opening and closing his mouth gasping for breath. We scooped him and put him in the car to take him to the vet. I noticed during this time that his front legs were functional but his hind legs were dead. The nearest decent vet that we have is about 25 miles away, and our Lil Bit died before we made it there. Now I am haunted wondering what happened and if there was anything we could have done to prevent it.

~Donna

Siouxsie: Donna, we’re so sorry for your loss. It’s terrible to lose a beloved cat, especially one so young. We don’t think there’s anything you could have done to prevent Lil Bit’s death, though.

Thomas: We’re not vets, and even if we were, there’s no way we could determine your cat’s cause of death simply from an e-mail. However, we did some research on conditions that cause similar symptoms, and it sounds like your little guy may have died from a condition called arterial thromboembolism — a blood clot getting stuck in one of his arteries.

Dahlia: His earlier spell and subsequent recovery might have been the result of a smaller clot that eventually broke up.

blood flow through the heart

This image shows how blood flows into and out of the heart. The left atrium (the red part on the top right of the picture) is where blood clots form. From there, they get pushed out through the aorta (the big red blood vessel at the top of the heart) and become lodged in places where the blood vessel gets smaller than the clot.

Siouxsie: Although vets don’t know why blood clots form, they are much more common in cats that have a heart disease called cardiomyopathy. There are three types of cardiomyopathy: dilated cardiomyopathy, hypertrophic cardiomyopathy, and restrictive cardiomyopathy.

Thomas: Dilated cardiomyopathy, a condition where the heart muscle gets weak and swells (dilates), isn’t seen much these days because it’s typically caused by a lack of taurine in the diet.

Dahlia: In hypertrophic cardiomyopathy, the muscles of the left side of the heart (that’s the side that pumps blood out of the heart to the rest of the body) thicken so much that abnormalities can occur inside the heart.

Siouxsie: Hypertrophic cardiomyopathy is generally a hereditary condition and is found more often in Maine Coons and Persians than in other purebreds or mixed-breed cats.

Thomas: Restrictive cardiomyopathy occurs when the inner lining of the heart becomes stiff and has to work harder to pump blood. This also sets the stage for blood clots. Vets don’t know what causes restrictive cardiomyopathy.

Dahlia: All three of these conditions cause turbulence, or swirling of the blood inside the heart rather than the normal flow of blood out of the aorta (the artery that brings blood out of the heart).

Siouxsie: When blood clots do form, they tend to get pushed out of the heart and go down the aorta toward the legs. The blood clots can also go to the front legs or to the brain, where the clot causes a stroke.

Thomas: When blood clots get stuck, they cause a blockage in the flow of blood, which means the cells in the blocked part of the body aren’t getting the oxygen they need to stay alive.

Dahlia: You might think that if your cat had a heart disease like cardiomyopathy, you would have noticed. But cats are notorious for hiding symptoms of illness: it’s in our instinctive nature not to show we’re sick until we’re just so badly off that we can’t hide it anymore.

Siouxsie: Your vet might have picked up subtle symptoms of heart issues, such as a heart murmur or an arrythmia (when the heart beats irregularly), during a checkup. But sometimes even that doesn’t show until the disease is pretty advanced.

Thomas: When a cat gets a blood clot stuck in an artery, it’s extremely painful, and you can clearly tell that the cat is suffering. He might be rolling around on the floor and meowing desperately, or, as Lil Bit was, opening and closing his mouth and gasping for breath.

Dahlia: Heartworms can also block blood vessels. Although heartworm disease is not as common in cats as it is in dogs, cats can and do get heartworms. Sudden death is one possible result of heartworm disease.

Siouxsie: Cats get heartworms from being bitten by an infected mosquito, so outdoor cats are more likely to have the disease than indoor-only cats.

Thomas: So, Donna, neither of these conditions would have been predictable.

Dahlia: If you had taken Lil Bit to the vet after his first episode, it’s possible that he or she might have been able to make a diagnosis and undertake some form of treatment.

Siouxsie: But that’s really neither here nor there. The fact is, Lil Bit died a totally unexpected, and far too early, death, and most likely from a condition that even if it had been diagnosed, might not have had any effective treatment.

Thomas: He was blessed to have a warm, safe home with a loving family, and that’s an amazing and beautiful thing for a cat that was born feral.

Dahlia: You did the best you could, so please don’t beat yourself up over Lil Bit’s death. Even Mama has had situations where animals got extremely sick and she did the best she could but she didn’t know how to take care of them — and she’s had to live with the burden of that, too.

Siouxsie: Mama’s learned from her painful experiences that you can’t go back and make suffering and death un-happen, but you can learn from your mistakes and lack of wisdom and, by knowing better the next time, prevent other animals from suffering a similar fate.

Thomas: That’s part of the reason she wanted to help us start writing this column — to share what she’s learned, from us and from her other cat teachers, with other cat caretakers.

Dahlia: You saved Lil Bit’s life by bringing him inside when he was a kitten. Many feral kittens die from respiratory infections and other contagious diseases. I’m sure he knew it and he loves you for it still, even from the other side of the Bridge. Purrs and many blessings to you and your husband.

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