Case summary A 7-year-old male neutered domestic shorthair cat, previously diagnosed and treated for diabetes mellitus (DM), subsequently presented in heart failure (HF). Echocardiography revealed biatrial and biventricular dilation with poor myocardial function, and a left atrial-to-aortic ratio of 1.95:1. There was caudal vena cava dilation, hepatomegaly and ascites. The HF was treated with furosemide for 5 weeks, but thereafter the cat presented recumbent and moribund, and was euthanased. Post-mortem findings included dilation of all four cardiac chambers with an increased heart weight. Microscopic examination of the heart revealed mild, predominantly interstitial or perivascular fibrosis throughout most of the myocardium, with small-to-medium-sized foci of replacement fibrosis within the left ventricular free wall and interventricular septum. There was evidence of myocyte degeneration, but myofibre disarray was mild and there was minimal evidence of inflammation.

Relevance and novel information Cardiac disease is common in cats and while HF is less common, it is a frequent cause of clinical signs and death. DM is a relatively common feline endocrinopathy. This case report describes DM and HF presenting as comorbidities, including detailed ante- and post-mortem findings. The case, and the epidemiology of these conditions, raise the question of whether a form of diabetic cardiomyopathy exists in cats, as it appears to do in humans.