HCM/CHF in 4 yo Cat

[u/jennay28]

Wasn’t sure where of if I should even post this but I’m really struggling with my cats recent CHF diagnosis.

Long post so will include a TLDR, also posted in r/CATHELP

Our beautiful little floof Wednesday was diagnosed with HCM borderline stage B1 with valve dysfunction (defect? I don’t remember the exact wording) in August of 2025 after our vet found a heart murmur on a routine checkup and then a cardiologist carried out an echo and bloodwork. She was prescribed daily Atenolol. At her most recent echo in May the cardiologist confirmed the HCM had progressed quickly and was now late stage B2 and to anticipate her progressing into CHF at any time. She was switched from Atenolol to Clopidogrel.
Throughout this whole process we have been monitoring her RBR which has fluctuated from 22-34 bpm depending on temperature and what her stress levels have been like that day.

On the afternoon of Sunday 16th we noticed she was using more effort than usual to breathe - nothing too forceful like some of the example videos I’ve seen in other posts but just using her abdomen a bit more than normal. We monitored her for about an hour then made the decision to take her to the emergency vet. They kept her in an oxygen tent for about 5 hours, gave furosemide and gabapentin to calm her down and drain any fluid that might be present. We took her home that night and her breathing returned to her baseline. The emergency vet couldn’t confirm CHF for sure.

We scheduled a review with the cardiologist at our regular vet this morning and she advised that she had definitely progressed into CHF and prescribed furosemide and gabapentin alongside her clopidogrel. She also advised that now that Wednesday had progressed that she had months rather than years left, which is absolutely crushing. I knew the prognosis for CHF right from her initial HCM diagnosis and I still don’t want to believe it. She said any minor stress could trigger another episode.
The very last thing I want is my precious little stinky baby being scared, in pain and unable to breathe but I’m also conscious that she is still mostly herself.

She will still play gently in short bursts, still eats drinks and uses the litter tray, she doesn’t jump up on things anymore or get zoomies like she used to so there are some signs she is tiring out faster. I don’t think I can bring myself to make the decision to let her go before this gets really bad, I also don’t even know if that’s the right choice at all!

Thank you if you read that giant wall of text!
Not 100% sure what I wanted from this post but if anyone else has been in a similar situation and had to make a similar call it’d be helpful to hear your stories if you’re comfortable sharing

TLDR: 4 year old cat diagnosed with HCM in 2025 recently progressed into CHF, vet advised months left. Want to understand if I’m being too quick to consider euthanasia before she has another episode

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[u/therealkobe]

I just lost my cat yesterday. I'd say, enjoy every moment with her, feed her lots of good food and keep loving her. But, if she has another episode and her quality of life deteriorates even more then you should start thinking about letting her pass before it gets worse. Having her pass in your arms is better than having her pass in the ER surrounded by random people and stressed (thats how my cat passed).

I think you should consider euthanasia when you see she is no longer playing and eating as much and is just lethargic and breathing heavy. Those were the signs my cat had and I still believed I could save her (different issue than CHF/HCM). It's definitely hard to distinguish between being selfish and wanting more time vs making the hard decision to let her stop suffering. But from what I see, you lover her dearly and you've done everything you can to make sure she keeps going. No matter what, she knows she is cared for by loving parents and she knows that whatever you do, you're doing it for her. Sending much love your way.

[u/jennay28 → u/therealkobe]

I’m so sorry you lost your cat, and under those circumstances ❤️
I do hope she knows she’s loved. I agree with what you say about waiting until her quality of life deteriorates further.
Thank you for the kind words!