HCM, The Silent Killer

By Francesca Doria, 2006.
(Reprinted with permission.)

This is the story of Francesca Doria, a Ragdoll breeder, who has had to deal with HCM in her cattery in a very hard way. This is not a scientific study of HCM, and no rights can be derived from this article. But it does give an expression of the emotions owners have to go through when HCM hits their cats.

The real tragedy started after a few years. As HCM sometimes progresses very slowly, it has different degrees of severity and different times of development, depending on the single cat, we started to know about it just later.

All the kittens from Purrdy were sold/given as pets but two. All the kittens from Piccolo Naviglio were sold/given as pets. Oliver was never mated, thank goodness, although we had planned Osiris for him.

In may 2005 I received a call from a man who had purchased the first daughter from Osiris and Purrdy, Slipperpaws Sara. We were told that she had HCM. She had a stroke, and called the cardiologist (who had settled in Trieste, finally) for an appointment.

After a fight with Piccolo Naviglio, Purrdy collapsed, was rigid, his hind legs were cold and lost urine. His eyes were black. I was in shock, massaged him, after a while he was able to stand. I called the cardiologist hysterically, he received me two days after.

He was shocked himself by what he found out. At listening, Purrdy's heart was perfect. At the scanning, it was an utter disaster. An extremely severe hypertrofic cardiomiopathy, the cinetic gone, the blood circulation gone. He was dying. He couldn't believe he reached 8 years of age, but, he said, cats are much more resistant than dogs.

Hormones also play a key role in protecting cats, like in humans. On the other hand, it is better if they are neutered/spay, in order to avoid stress.

The situation was so desperate as to give him only a "maintenance treatment", that is to say furosemide, spironolattone, Fortekor (benazepril). I also gave him some natural remedies to help. He was very quiet, but still wanted to live, he tried to sit on my lap but couldn't as he started coughing immediately, being the heart too large and touching the sternum.

Émile collapsed with a severe kidney failure, Alison was sick (pancreas cancer, although we didn't know it until a few months later). So I had to stop the scanning because of the high costs and the need to check Purrdy again, but spayed / neutered Rosi, Mini, Pici and Piccolo as the first step. On 3rd November 2005, the day of Merlin's death (he died on 3 rd Nov. 1997 ), Rosi started to be sick. She had difficulty in breathing, didn't climb the stairs, and with her eyes she asked for help.

I immediately run to the cardiologist again. She already had congestive heart failure, and she was two years old. She had had her litter of kittens just a few months before, and never, never had any signed of HCM.

She was put under atenolol, furosemide, spironolattone. I tried to help her with hawthorn, olive, capsicum and Coenzime Q10, taurine, rosemary tea. She looked much better, and started her normal life again.

The Death of Purrdy

On 2nd January 2006 I found Purrdy cold, eyes black, his paws upwards, lying on his back. I started to massage him, and run to the vet. Unbelievably, he came back to life. The cardiologist said he was in apnea, so he gave him more Fortekor.

At the end of January, his hind legs started to fail. They started rapidly to become cold. He was terrorized: his eyes were black, he started to cry loudly, and tried to run, but couldn't. His voice increased quickly, became a terrible, unbearable yelling that was heard by all neighbours, who asked what was happening being so horrible! I called the vet, was unable to speak, at the end he said he was coming immediately. Unfortunately, he was far from our home. Purrdy started literally to fly from the sofa to the table. He banged his head so hard I thought he split it in two. He broke his ribs against the table legs, he chewed his tongue into peaces. He tried to kill himself, to get away from the terrible pain.

My sister went to pick up the vet, and the only cat who stayed in the room was Émile, looking at Purrdy, because Émile has always been so special taking care of all dying cats. Osiris was banging on the door so strongly I thought she would smash it, and shouting to help her fiancé.

Purrdy was a poor bleeding, broken body when the vet arrived. He was still alive, and shouting. The vet was so moved he could barely breathe. I think that if someone had stabbed me in my back, I wouldn't have realized. An injection for 30 kgs of anesthetic was useless, because of his circulation blocked by the aortic thrombosis, caused by a blood clot. So he had to inject him directly in his heart. Purrdy coughed, I caressed his head, he bit my hand. When he realized what he had done, he licked it. We looked into each other's eyes, and he died.

One month later, I heard someone crying in the same way. I run like hell: it was Rosi. Rosi, my little guardian angel, my wonderful fairy, lying on the floor. I just fell on my knees crying, holding her desperately, no, no, Rosi, no! But her eyes were black, she was alive but was paralized. Her brain ischemia, due to a blood clot, put an end to her life. She wasn't two years and a half.

But I couldn't stop there moaning. I had to check the others. Pimpa was HCM negative (9,5 years old). Pici was positive in a slight way (carrier), and Mini had a non obstructive HCM. Oliver was scanned negative for HCM at 2,5 years old, and died of HCM one year later (heart attack). In panic, I had already told all the buyers/owners of Purrdy's offsprings, now I had to tell the owners of Mini's and Rosi's and Piccolo Naviglio's kittens (luckily, Pici never had kittens!). From the most recent checkings, they are developing high pressure, heart enlargement etc.

So, I can say that:

100% of the kittens from Purrdy (HCM) and Slipperpaws Pimpa (HCM negative, but carrier) died or have HCM.
50%-30% of the kittens from Purrdy and Osiris (HCM negative, not HCM carrier) developed HCM.
100% of Rosi's (HCM), Mini's (HCM) and Piccolo Naviglio are developing HCM. We have at home two daughters to Mini that we kept because we had to close the cattery.
Slipperpaws Saranka, daughter to Bluebelle and Jetsam, living at a friend, is to be added to the list.

HCM is a silent killer. You don't know your cat has got it until he/she fails because of congestive heart failure, heart attack and/or blood clotting. A cat with HCM can survive for years, even in cases like Purrdy, that evidently had had it since his first year of age, because they compensate it in some way. The only signs were coughing and some tireness. Cats that are negative to HCM can be carriers.

BUT scanning is a must, because:

if you scan your cat, and at three years old he/she is HCM negative, it may be a carrier, but at last there are chances that he/she will not spread HCM;
if you scan your cat, you can help him/her, you can give it a better quality of life, and a longer life.

I have found that natural remedies can be very effective.

I hope the above can help. It is never too late. And keep this in mind: breeders have a moral and a legal responsibility. If the owners asked to be refund, breeders are obliged to refund them.

The catastrophe that hit my cattery was mainly due to the fact that I had asked for years to the breeder who sold the "pure English lined breeding Ragdolls" to me and my sister if anything was wrong with her cats, and she went on claiming that nothing was wrong. When she couldn't hide it any longer, she avoided me.

My cats paid, because I trusted her. I was so stupid as not to decide to scan them, even when I heard about HCM in late 90ies, (earlier, the vets thought of "heart failure" generally speaking) and I had already lost three cats to "heart failure". Now it is known everywhere: no breeder can say "I don't know anything about HCM". HCM is a terrible plague in the Ragdoll breed, and I was assured that "old traditional lines" were safe.
It isn't so at all. They are a bomb ready to explode, because they are too CLOSELY INBRED. If you check further all the pedigrees they have all common ancestors and they all lead to HCM.

The breeders who say that nothing is wrong with relatives of cats listed in the HCM files are not honest.
An English breeder told me that "it is the will of God who put the cats in our hands". If he put our cats in our hands, it is our duty to try to help them! To have a cat or a child is the same: it is a responsibility towards a life we have in our hands.

Note by Misha Peersmans: (January 2007) There is now HCM research going on in several countries; so far there is one DNA test available for the MyBPC3 mutation in Maine Coons. Research in the mutation(s) in Ragdolls is stil going on and there is now talk about the (suspected?) recessive form of HCM occurring in Ragdolls. In most other breeds the HCM mutations seems to be more dominant, as far as we know at this date.