Recurrent transient myocardial thickening and congestive heart failure in a cat.

Recurrent transient myocardial thickening can occur in cats with complete reversibility.

This case report documents a five-year-old female domestic shorthair cat presenting with recurrent episodes of left-sided congestive heart failure separated by approximately two years. Initial presentation included acute respiratory distress with echocardiographic findings of left ventricular thickening, left atrial dilation, and elevated cardiac troponin I. Following treatment with furosemide, clopidogrel, ondansetron, and supportive care, the cat achieved complete cardiac remodeling normalization within one year. Medical therapy was discontinued. Two years later, identical clinical and echocardiographic findings recurred with again elevated troponin I levels. Second episode treatment included furosemide, clindamycin, enrofloxacin, doxycycline, and clopidogrel, resulting in complete normalization again within one year. Comprehensive infectious disease testing was negative both episodes. This unusual presentation of transient myocardial thickening with spontaneous resolution followed by recurrence challenges typical diagnostic paradigms for feline cardiomyopathy and suggests possible myocarditis or other reversible pathophysiologic mechanisms.

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