Sonopath Forum

Feline heart

Hello

I was hoping for some input on how to manage this case. We have Fluffy a 5year old Sphinx who was in for a dentistry and we did a pre-anesthetic echo. He previously had elevated pro-BNP.

Today we found significant changes on US. It is my thought to forgo the dental cleaning. Teeth have M1-M2tartar but client really wants the dentistry. I was wondering what course of action we should take.

Would you be hesitant to place this cat under GA? I feel this are moderate to severe changes that require medication (No clinical signs)

Hello

I was hoping for some input on how to manage this case. We have Fluffy a 5year old Sphinx who was in for a dentistry and we did a pre-anesthetic echo. He previously had elevated pro-BNP.

Would you be hesitant to place this cat under GA? I feel this are moderate to severe changes that require medication (No clinical signs)

No weight loss. BPs are 138/101 (118)

Thanks. Brent.

Comments

Pankatz

February 24, 2016 at 12:58 pm -

There is evidence of advanced

There is evidence of advanced heart disease on this echo so I would personally be concerned about anethetizing this one due to the left atrial size alone as stress of anesthesia could push this one into CHF – even days after anesthesia. If you do it, I would make sure the owner is well informed of the risks. I would at least start this cat on Plavix at this stage.

tosullivan

February 24, 2016 at 1:22 pm -

Thanks for the advice. Much

Thanks for the advice. Much appreciated

randyhermandvm

February 24, 2016 at 1:42 pm -

I agree with Pankatz. To me

I agree with Pankatz. To me the IVS and VFW look thickened. It also appears that there may be SAM on the 2nd cine. No murmurs?

I would be concerned about sudden death in this cat.

It sounds to me like this owner needs to understand her priorities here.

Peter

February 24, 2016 at 1:55 pm -

Hi!
This is certainly a

Hi!

This is certainly a cardiomyopathic cat with hypertrophy and suspected SAM as already mentioned by Jacquie and Randy.

I would start this cat on Furosemide (1mg/kg bid) and an ACEI. Since the cat will certainly need Clopidogrel in the (near) future I would inform the owners throroughly:

– It is likely that this cat will develop symptoms due to the cardiac disease, the long term prognosis is guarded. She will need further re-checks and additional medication.

– If the dental workup is really needed because of painful or severe infectious dental disease, it is better to do that earlier than too late because the heart disease will progress and the risk that is already high will become even higher. If the dental disease is not that severe or painful, I would probably not do the GA here

– If the owners want to take the risk of anesthesia I would do the dental sx and then put the cat on clopidogrel as well, otherwise start with clopidogrel right now.

Best regards

Peter

tosullivan

February 24, 2016 at 2:01 pm -

Thanks everybody! Fabulous

Thanks everybody! Fabulous info. Much appreciated!!

Brent