Pseudohypertrophy due to dehydration on feline echocardiography
3-year-old cat with 4 days of vomiting and diarrhoea, estimated 8% dehydration and tachycardia. On emergency ultrasound the LV walls measure 6.8 mm, the LV cavity is almost obliterated in systole, the papillary muscles look prominent and the left atrium is small.
What is the most appropriate interpretation?
chevron_right Show answer and explanation
A. Hypertrophic cardiomyopathy: cardiac treatment should be started
With hypovolaemia the LV is underfilled and its walls look thicker. HCM cannot be diagnosed in a dehydrated cat.
B. Pseudohypertrophy due to hypovolaemia: rehydrate and repeat the echocardiogram once normovolaemic
Correct. Lack of preload shrinks the cavity and makes the walls look thicker; the small left atrium fits hypovolaemia, not HCM. After rehydration the thickness usually normalises.
C. Restrict fluids because of the risk of heart failure and give furosemide
A hypovolaemic cat needs fluids. Furosemide would worsen hypovolaemia and low output. With a small left atrium there is no immediate risk of CHF.
D. Hypertrophy due to hyperthyroidism
Hyperthyroidism is exceptional in a 3-year-old cat and does not explain the obliterated cavity with a small atrium, which indicates lack of volume.
lightbulb Key takeaway
Look at the left atrium: large suggests heart disease; small with an obliterated cavity suggests hypovolaemia. If a cat with thick walls needs fluids, give them with monitoring and reassess the heart once stable.
References: ACVIM consensus statement guidelines for the classification, diagnosis, and management of cardiomyopathies in cats (2020)
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Updated: October 31, 2026 · Educational content for veterinary professionals. It does not replace current clinical guidelines or the judgement of the attending veterinarian.