Key result
Cardiac disease in anemic cats is linked to ~4-fold higher odds of a gallop sound.
Why the study?
Heart murmurs and gallop sounds are common in anemic cats, but their association with underlying cardiac disease and changes in anemia severity was unclear.
Are heart murmurs and gallop sounds associated with anemia severity and underlying echocardiographic cardiac disease in anemic cats?
Observational (n=64)
primary investigator was not blinded to the clinical picture or PCV of the cat that was being auscultated
No
Are heart murmurs and gallop sounds associated with anemia severity and underlying echocardiographic cardiac disease in anemic cats?
In anemic cats, both heart murmurs and gallop sounds are inversely related to PCV and decrease as anemia improves, but only gallop sounds are significantly associated with underlying echocardiographic cardiac disease.
Gallop sounds may indicate underlying cardiac disease in anemic cats; leaves open whether auscultation should guide echocardiography.
Background Heart murmurs and gallop sounds are common in anemic cats; however, their association with underlying cardiac disease is unclear. Hypothesis/Objectives Determine the prevalence of murmurs and gallops in anemic cats. Investigate the association of auscultatory abnormalities with anemia severity and heart disease. Investigate whether change in anemia severity affects the audibility of murmurs and gallop sounds. Animals Sixty-four anemic cats (packed cell volume [PCV] below 30%) presenting to a referral hospital. Methods Single-center prospective observational study. On presentation, cats were examined and had PCV measurement. Each cat underwent echocardiography. Cats had PCV checks and daily auscultation to document heart sounds. Results Fifty-eight percent (37/64) had a murmur and 23% (15/64) had a gallop. Mean PCV at enrollment was 18% (±6). Lower PCV was associated with the presence of a murmur (P = .03) and gallop (P = .016). Cardiac disease was present in 34% (22/64) of cats. After adjusting for anemia severity, murmur presence showed no statistically significant association with cardiac disease (P = .636 (OR: 1.31, 95% CI, 0.43-3.95)). A gallop sound was associated with greater odds of cardiac disease (P = .037 (OR: 3.97, 95% CI, 1.09-14.5)). Murmur intensity (P = .001) and likelihood of a gallop sound (P = .022) were lower in individuals when their PCVs increased. Conclusions and clinical importance Murmurs and gallop sounds are common in anemic cats with and without cardiac disease. Anemic cats with gallops are more likely to have underlying cardiac disease than anemic cats without gallops.
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Robertson et al. (2026) conducted an observational in Anemic cats (PCV < 30%) (n=64). Underlying cardiac disease (cardiomyopathy on echocardiography) and anemia severity (PCV) vs. No underlying cardiac disease (normal heart or anemia-related volume overload) was evaluated on Presence of an audible gallop sound on cardiac auscultation (adjusted for admission PCV) (OR 3.97, 95% CI 1.09-14.5, p=0.037). Underlying cardiac disease in anemic cats was associated with higher odds of a gallop sound (OR 3.97, 95% CI 1.09-14.5, P=0.037), whereas heart murmurs showed no significant association (P=0.636).
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