Not for the faint of heart

I was going through my photos today and saw this picture. It is a case that did not end so well.

An owner brought in her cat, roughly five years old, that was having trouble breathing. His gums were a pale pink and he was using his abdominal muscles to help him breathe. When I tried to listen to the heart, I could barely hear it. We took a radiograph of him laying on his side (he became a bit panicky when my AHTs, PJ and Kelly, tried to take a picture of him on his back). The radiograph showed so much fluid in the chest that I couldn't see the heart. As his prognosis was so guarded, his owners chose to humanely euthanize him.

In odd cases like this, that just don't seem to add up, I asked the owners to let me do a necropsy (autoposy on an animal). Fortunately, they also wanted to know why they had to loose him at such a young age.

I always start by looking in the abdomen and in this case, it was clean. The chest, on the other hand was surprising and amazing (more proof that I don't get out much). The fluid I could see on the radiograph was bloody. The reason he was having problems breathing was because the blood was basically squishing the lung lobes. There was no evidence of trauma, so I knew there was something pretty weird going on. Once I was able to remove the blood, I found the heart. It was huge because there was also blood in the pericardial sac (sac around the heart).

Blow the picture up (sure, it is a bit gross, but you have to admit it is cool too!!). Alright, the blue dashed lines outline the very thin layer that should be muscle. The arrow points to my thumbnail that you can actually see through the fibrous layer. The yellow line indicates how thick the muscle should be throughout the heart.

My hypothesis is this heart defect was something he was born with. Over time, the area became thinner and blood began to ooze into the pericardial sac. Since he was starting to have difficulty breathing, it cause increased stress on the lungs leading them to ooze bloody fluid. There is no way he could have survived.