Severe cardiomegaly secondary to anemia in a kitten

Severe anemia in a weanling kitten resulted in volume overload hypertrophy of the heart and signs of congestive heart failure. A 6-week-old moribund kitten was admitted to the hospital with a PCV of 3%. The anemia was determined to have resulted from severe flea infestation and iron deficiency. Supportive therapy consisted of flea removal, blood transfusions, and oral nutritional support. On day 3 of hospitalization, the kitten had signs of depression and became tachypneic. Auscultation revealed a systolic murmur, gallop rhythm, and crackles over the ventral lung fields. Thoracic radiography revealed pulmonary edema and massive cardiomegaly. Echocardiographic evaluation revealed dilatation of all cardiac chambers. The addition of furosemide to the kitten's treatment protocol resulted in resolution of the pulmonary edema. On follow-up examination 1 month later, the kitten had mild residual cardiomegaly and the anemia had resolved. Anemia is a well-known sequela to severe flea infestation in young animals. A less commonly reported, but potentially life-threatening, sequela to anemia may include the development of volume overload hypertrophy of the heart and congestive heart failure.