Long-term Incidence and risk of noncardiovascular and all-cause mortality in apparently healthy cats and cats with preclinical hypertrophic cardiomyopathy

Background: Epidemiologic knowledge regarding noncardiovascular and all-cause mortality in apparently healthy cats (AH) and cats with preclinical hypertrophic cardiomyopathy (pHCM) is limited, hindering development of evidence-based healthcare guidelines. Hypothesis/Objectives: Characterize/compare incidence rates, risk, and survival associated with noncardiovascular and all-cause mortality in AH and pHCM cats. Animals: 1730 client-owned cats (722 AH, 1008 pHCM) from 21 countries. Methods: Retrospective, multicenter, longitudinal, cohort study. Long-term health data were extracted by medical record review and owner/referring veterinarian interviews. Results: Noncardiovascular death occurred in 534 (30.9%) of 1730 cats observed up to 15.2 years. Proportion of noncardiovascular death did not differ significantly between cats that at study enrollment were AH or had pHCM (P = .483). Cancer, chronic kidney disease (CKD), and conditions characterized by chronic weight-loss-vomiting-diarrhea-anorexia (CWLVDA) were the most frequently recorded noncardiovascular-causes of death, respectively. Incidence rates/risk of noncardiac death increased with age in AH and pHCM. All-cause death proportions were greater in pHCM than AH (65 vs 40 percent, respectively; P<.001) because of higher cardiovascular mortality in pHCM cats. Comparing AH with pHCM, median survival (study entry to noncardiovascular death) did not differ (AH-9.8 years; pHCM- 8.6 years; P = .105), but all-cause survival was significantly shorter in pHCM (P = .0001). Conclusions and Clinical Importance: All-cause mortality was significantly greater in pHCM cats due to disease burden contributed by increased cardiovascular death superimposed upon noncardiovascular death.