If Your Cat Is Panting Repeatedly — Warning Signs of Pulmonary Hypertension and When to Go to the Vet

HeartDiseasesMeongsiljang Veterinary Advisory Board

Feline pulmonary hypertension is a cardiovascular disease characterized by abnormally high pressure in the pulmonary blood vessels, and early detection along with consistent medication is crucial for maintaining your cat's quality of life.

What Is Feline Pulmonary Hypertension?

Pulmonary hypertension — an overview of feline heart health

Feline pulmonary hypertension is a condition in which abnormally high pressure persists chronically in the pulmonary arteries. Prolonged elevation of this pressure causes the right ventricle to dilate and thicken; if it can no longer cope with the increased workload, right-sided heart failure may develop, leading to a poor prognosis. Although relatively uncommon in cats, the condition is often diagnosed only after significant strain has accumulated on the heart and lungs. Therefore, it is crucial to seek veterinary care promptly if you notice signs such as difficulty breathing or fainting.

Why Does It Occur? Main Causes

Pulmonary hypertension is broadly classified into two types based on its underlying cause.

Secondary (Acquired): This is the most common form. In cats, it is almost always caused by left-sided heart failure resulting from left-sided heart disease, such as hypertrophic cardiomyopathy (HCM). Other potential causes include chronic respiratory (lung) disease, heartworm infection, and pulmonary thromboembolism.

Primary (Idiopathic): This refers to cases where no clear underlying cause can be identified and is relatively rare.

The key to management lies not just in treating pulmonary hypertension itself, but in identifying and concurrently treating the underlying disease driving it.

Symptoms to Watch For — Checklist

Difficulty breathing: Rapid, shallow breaths and abdominal breathing, where the belly rises and falls noticeably.

Exercise intolerance: Becomes tired quickly and sits down after minimal activity.

Coughing: Persistent, dry, repetitive coughing.

Fainting or collapse: Sudden collapse or temporary loss of consciousness.

Cyanosis: Gums or tongue turn blue or grayish.

Weight loss: Decreased appetite and gradual weight loss.

Cats showing symptoms of pulmonary hypertension — difficulty breathing and exercise intolerance

Go to an Emergency Veterinary Hospital Immediately If You See These Symptoms

If your pet is panting with its mouth open, shows cyanosis (bluish gums or tongue), or suddenly collapses or loses consciousness, seek emergency veterinary care immediately. These are signs of severe hypoxia, which can deteriorate rapidly within hours.

How Is It Diagnosed?

Echocardiography is the cornerstone of diagnosis. As a safe and convenient imaging test, it is typically performed first, allowing indirect estimation of pulmonary artery pressure via tricuspid regurgitation velocity while simultaneously assessing right ventricular dilation and hypertrophy. This is complemented by thoracic radiography and electrocardiography. Although direct pulmonary artery pressure measurement via catheterization is the gold standard for confirmation, it is rarely performed in cats due to its invasive nature. Additionally, further blood tests are often conducted to identify underlying conditions contributing to pulmonary hypertension.

Treatment Methods — Medication and Management of Underlying Conditions

Pulmonary vasodilators (sildenafil class) are used to lower pulmonary artery pressure. If congestive heart failure is present, diuretics and cardiac inotropes are administered concurrently. Underlying conditions (such as heart disease or heartworm infection) must also be treated simultaneously for the therapy to be effective. Because your veterinarian will adjust medication dosages and types based on the patient’s response to treatment, regular follow-up visits are essential.

A cat undergoing an ultrasound examination at a veterinary clinic — Diagnosis and treatment of pulmonary hypertension

Care Points You Can Do at Home

Respiratory rate monitoring: A rate of more than 30 breaths per minute while sleeping is a sign of worsening condition. Measure and record it at the same time every day.

Minimize stress: Reduce exposure to intense play and unfamiliar environments, and maintain a quiet space.

Adhere to medication schedule: Never stop or change the dosage of prescribed medications without consulting your veterinarian.

Regular follow-up visits: Attend check-ups consistently according to the schedule set by your veterinarian.

A cat resting comfortably at home — key points for managing feline pulmonary hypertension at home

Breed-Specific Precautions & Senior Cat Care

Hypertrophic cardiomyopathy (HCM) is the most common heart disease in cats, and left-sided heart disease is the leading cause of feline pulmonary hypertension. Therefore, breeds known to be prone to HCM, such as Maine Coons and Ragdolls, require extra vigilance for the risk of pulmonary hypertension complications. Even in the absence of symptoms, regular cardiac ultrasound screenings are recommended. For senior cats, early detection is best achieved through routine blood pressure monitoring and heart examinations.

Reviewed by a veterinarian

Dr. Tony — Punnawat Phongkittirak

Veterinarian

A veterinarian who majored in veterinary medicine at Khon Kaen University, Thailand, and completed the IVSA program at North Carolina State University in the United States. Drawing on clinical experience at animal hospitals, he works in the pet healthcare field and is dedicated to building a digital care environment that connects pet parents with veterinarians.

Frequently Asked Questions

Can feline pulmonary hypertension be cured?

Pulmonary hypertension is often difficult to reverse once it has progressed, so lifelong management is usually necessary. However, improvement is possible if the underlying cause can be corrected, such as left-to-right shunts (e.g., patent ductus arteriosus, PDA) that can be repaired surgically, or heartworm infection that can be treated. With medication to stabilize pulmonary artery pressure and manage symptoms, many dogs can still enjoy a good quality of daily life.

How is pulmonary hypertension diagnosed?

Echocardiography is the most important diagnostic tool. It allows us to indirectly measure pulmonary artery pressure based on tricuspid regurgitation velocity and to assess for right ventricular hypertrophy. While pulmonary artery catheterization is required for a definitive diagnosis, it is too invasive for cats, so echocardiography is primarily used for diagnosis in clinical practice.

Are pulmonary hypertension and systemic hypertension different conditions?

They’re different. Systemic hypertension is when blood pressure is elevated throughout the body’s arteries, whereas pulmonary hypertension is a condition in which pressure rises only in the blood vessels within the lungs. Because both can occur at the same time, pulmonary hypertension is often checked alongside a diagnosis of systemic hypertension.

How do I measure my pet’s respiratory rate at home?

Count one breath each time your cat’s chest rises and falls while they’re resting comfortably. If you count 30 or more breaths in one minute, it’s a good idea to contact your veterinarian. Keeping a daily log at the same time each day makes it easier to spot any changes.

Even after giving the medication, my pet still seems to be struggling to breathe. What should I do?

The medication dosage may need to be adjusted. Do not change the dose on your own; instead, contact your veterinary clinic to describe your pet’s condition and schedule an earlier follow-up appointment. If you notice a sudden increase in respiratory rate or cyanosis, seek emergency veterinary care immediately.

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References

[1] Egner B. Hypertension. In: Little SE (ed). The Cat: Clinical Medicine and Management, 2nd edition. Elsevier Saunders, 2012.

[2] Brown SA, Henik RA. Diagnosis and treatment of systemic hypertension. Vet Clin North Am Small Anim Pract 1998;28(6):1481–94.

[3] Maggio F, DeFrancesco TC, Atkins CE, et al. Ocular lesions associated with systemic hypertension in cats: 69 cases (1985–1998). J Am Vet Med Assoc 2000;217:695–702.

[4] Côté E, MacDonald KA, Meurs KM, Sleeper MM. Feline Cardiology. Wiley-Blackwell, 2011.

[5] Reinero C, et al. An Abbreviated International Collaboration on Pulmonary Hypertension Consensus Statement. J Vet Intern Med 2020;34(5):2026–2029.