– Gus is a MN approx. 3 year old cat that was rescued from a shelter
– he is asymptomatic for heart disease and successfully underwent anesthesia for a fracture repair
– an echocardiogram was performed due to presence of a heart murmur; he was sedated with alfaxan for the echo
– cardiac chambers, aortic and pulmonic flows were wnl (velocities may have been lower than normal due to sedation)
– I did not appreciate SAM or a VSD (although I thought the perimenbranous area looked thin but could not convince myself on colour Doppler that there was a defect)
– Gus is a MN approx. 3 year old cat that was rescued from a shelter
– he is asymptomatic for heart disease and successfully underwent anesthesia for a fracture repair
– an echocardiogram was performed due to presence of a heart murmur; he was sedated with alfaxan for the echo
– cardiac chambers, aortic and pulmonic flows were wnl (velocities may have been lower than normal due to sedation)
– I did not appreciate SAM or a VSD (although I thought the perimenbranous area looked thin but could not convince myself on colour Doppler that there was a defect)
– an eccentric MR jet was seen that hugged the intra-atrial septum (coanda effect); the CW Doppler was likely under estimated because of this
Could this be mitral valve dysplasia? Past endocarditis?
Comments
Im not sure about the
Im not sure about the eccentric jet or the murmur.
I wonder if we we are getting some bleed from the aorta even though I don’t see it on 2D.
I see lots of images that look like normal flow from the L atrium into the L ventricle.
Did you measure the IVS. It looks a little plump to me.
Hi!
Yes, I totally agree,
Hi!
Yes, I totally agree, there is an eccentric MI jet. In most cases with mild dysplasia, you won’t find any major valvular changes on 2D. I would appreciate some mild thickening of the leaflet tips in this case. Sometimes, they have little clefts.
I don’t think this is endocarditis – particularly, if the Duke criteria are not fulfulled, which I think is the case here.
Just follow up this guy – maybe in 6 months. In most cases, the MI will stay as it is, sometimes there is some progression.
Peter
Thank-you Peter!
Thank-you Peter!
Jacquie,
I have not
Jacquie,
I have not used alfaxan. Did you go IM? How long did you get sedation?
What dose did you use.
When refrigerated- how long does it last before you discard?
So many questions.
Randy, you can give Alfaxan
Randy, you can give Alfaxan IM as a premed but I don’t like using it that way.
I give it IV and use it more commonly as an induction agent where I give a max induction dose of 2 mg/kg at anyone one time (but I think you can go to 3mg/kg if needed) You start with a 0.5mg/kg dose slowly, wait 30 seconds, top up with another 0.5 mg/kg dose. Rarely do I ever need to reach the total 2 mg/kg dose for intubation.
You can also top up to effect as as needed if not intubating and using it for sedation for other procedures. I use it for ultrasound-guided liver biopsies, x-rays, minor procedures etc.
You should have a premed on board such as butorphanol or hydromorphone +/- ace or midazolam for smoother induction and recovery. Otherwise they kind of stiffen and shake which turns alot of people off of using this drug. It works quite similar to propofol. Metabolism is quick and recovery fast.
Jacquie
Oh forgot to answer the last
Oh forgot to answer the last question – once we crack a vial, we draw up the remaining into syringes and will store in the fridge for up to 48 hours (I think some will keep longer). We usually have no problem using it up within this time period at our hospital.
Thanks Jacquie
Thanks Jacquie