Spaying a cat with Restrictive Cardiomyopathy

[ShahnazAC]

Hello everyone I'm new on here but have been a silent reader for a number of years.

(I apologise for the lengthy post)

I have a 6-yr 5-mnth, intact, strictly indoors, tiny, female Persian (heaviest she's been 3.3kg) that has been scheduled for a spay (diagnosed with restrictive cardiomyopathy). She has had 2 echocardiograms, first in December 2021 where she was first diagnosed with HCM and the second in November 2022. In the 2nd visit we were told she has RCM with features of HCM. We were told she is still on stage B1 and there’s been little progression within that year. At present she isn’t on any medication.

We had attempted a spay before, this was shortly after her initial diagnosis (January 2021) at our local vets. Unfortunately, she reacted to the anaesthesia and was woken up without the spay. She struggled to breathe and had some fluid build-up. They treated this immediately and a few hours later she was discharged. We were told to keep a close eye on her overnight and take her back for a check-up first thing. She was fine and we were told to do a Pro BNP test in 2 weeks and avoid spaying her for 6 months, (it came back with 98). We have kept a very close eye on her since and check her sleeping respiratory rate religiously (always between 18 and 26).

However, as she still cycles through heat, she continues to have inappetence every couple of months. We have also noticed some behavioural issues (aggression towards her younger sibling). She had been checked for neurological issues the same day as her last Echo scan and they said everything looked normal. We decided that spaying her would be a good option but opted to do it at Queen Mother Hospital for Small Animals that has more specialists available. Needless to say I’m still petrified to get her spayed due to her RCM and the reaction to anaesthesia last time.

Now I understand that this forum is no place for medical advice but I would to hear if anyone else had their baby's under anaesthesia with restrictive cardiomyopathy? The Cardiologist and my local vet keep reassuring me she will be fine and that her current level of heart disease it should be fine but I can’t help but worry. I tell myself that she will be in the hands of specialists with a lot of resources, but it does little to help ease me. I also suddenly lost her sibling suddenly for some unidentifiable sickness in October 2021.

Can anyone share the experience with middle aged cats with heart disease going under anaesthesia?

 

[di and bob]

I had a 15-year-old male that needed surgery for an abscess with heart disease too. Enlarged with fluid buildup. He was on Lasix at the time. He came through fine. Just make sure the vet that is performing the surgery knows everything they can about the heart condition and the negative reaction to the anesthetic so they can be prepared if anything does come up. Get the brand and name of the anesthesia to pass on too, and make sure they understand she had a reaction to it. She would be much more comfortable and healthy if she was spayed. There are MANY anesthesias out there, and for that and heart problems sometimes they can do surgery under lighter anesthesia too. I'll keep you and her in my thoughts and prayers, please keep us informed!

 

[ShahnazAC]

I had a 15-year-old male that needed surgery for an abscess with heart disease too. Enlarged with fluid buildup. He was on Lasix at the time. He came through fine. Just make sure the vet that is performing the surgery knows everything they can about the heart condition and the negative reaction to the anesthetic so they can be prepared if anything does come up. Get the brand and name of the anesthesia to pass on too, and make sure they understand she had a reaction to it. She would be much more comfortable and healthy if she was spayed. There are MANY anesthesias out there, and for that and heart problems sometimes they can do surgery under lighter anesthesia too. I'll keep you and her in my thoughts and prayers, please keep us informed!

Thank you for keeping us in your thoughts and prayers, I will definitely keep you posted how she does. She’s scheduled for her spay next month. I have sent over all the medication that had been given to her from her initial spay attempt. I think I’ve been a bit overbearing with my back-and-forth questions but, I want to take my baby in knowing all that I can. We have been advised to get her spay done at QMH because of her history of reacting to anaesthesia. I regret no getting her spayed when I first adopted her, It’s a big lesson learned.

 

[iPappy]

Thank you for keeping us in your thoughts and prayers, I will definitely keep you posted how she does. She’s scheduled for her spay next month. I have sent over all the medication that had been given to her from her initial spay attempt. I think I’ve been a bit overbearing with my back-and-forth questions but, I want to take my baby in knowing all that I can. We have been advised to get her spay done at QMH because of her history of reacting to anaesthesia. I regret no getting her spayed when I first adopted her, It’s a big lesson learned.

I'm sure the vets understand the difference between an anxious owner with a healthy animal undergoing surgery vs. someone with a cat with heart disease doing so. It sounds like she will be in excellent care during her surgery.
Based on your description of her, she sounds adorable. Pictures are always welcome here!

 

[Astragal14]

One of my cats has a mild heart condition so I understand how you're feeling right now, and I'm so sorry for the loss of her sibling.

You're in great hands at Queen Mother Hospital. Two important aspects of performing surgery on a cat (or any animal) with a heart condition is to make sure 1) you're at a facility that is large enough to have trained specialists on staff and also 2) have any anesthesia-related drugs available on hand. QMH is a great hospital with a large staff that will surely have any drug that your cat could potentially need. Smaller hospitals don't always have the specialists or drugs to cover every potential situation.

Any heart condition means you need to consider a different anesthesia protocol. In it's most simple terms, the anesthesia protocol is basically comprised of three major parts - before surgery, during surgery and after surgery (there is so much more to it, but my vet handles the more granular details). Your cat's specific case of RCM with HCM will determine which parts need to change and how.

In our case, we're fortunate that my cat only needs a change to his pre-surgery routine. He needs an additional medication to help control his heart rate, and it's a medication that needs to be administered prior to anesthesia. His heart rate also needs to be closely monitored during anesthesia. And he's generally in the clear once the anesthesia is stopped.

Here are two good articles that discuss anesthesia protocols for heart conditions in greater detail.

Sedation for Cats with Cardiovascular Disease

The ideal sedative or anesthetic agent for cats with cardiac disease would be one that causes sedation or anesthesia without cardiorespiratory depression. Unfortunately, for cats, no single drug provides the optimal balance of sedation without cardiorespiratory depression; therefore, the clinician must select a drug combination that produces the least amount of cardiorespiratory depression with the best quality of sedation.

Anesthetic management of small animals with preexisting cardiac conditions (Proceedings)

To safely anesthetize small animal patients with preexisting cardiac condition, it is important that specific hemodynamic goals are set for the particular heart condition. It is easy to state that for patients with cardiac problem, "heart-friendly" drugs need to be used. A specific anesthetic drug will be appropriate for a certain heart condition and not for another. Understanding the underlying problem(s) in a cardiac disease will help in planning the appropriate anesthetic regime.

 

[ShahnazAC]

One of my cats has a mild heart condition so I understand how you're feeling right now, and I'm so sorry for the loss of her sibling.

You're in great hands at Queen Mother Hospital. Two important aspects of performing surgery on a cat (or any animal) with a heart condition is to make sure 1) you're at a facility that is large enough to have trained specialists on staff and also 2) have any anesthesia-related drugs available on hand. QMH is a great hospital with a large staff that will surely have any drug that your cat could potentially need. Smaller hospitals don't always have the specialists or drugs to cover every potential situation.

Any heart condition means you need to consider a different anesthesia protocol. In it's most simple terms, the anesthesia protocol is basically comprised of three major parts - before surgery, during surgery and after surgery (there is so much more to it, but my vet handles the more granular details). Your cat's specific case of RCM with HCM will determine which parts need to change and how.

In our case, we're fortunate that my cat only needs a change to his pre-surgery routine. He needs an additional medication to help control his heart rate, and it's a medication that needs to be administered prior to anesthesia. His heart rate also needs to be closely monitored during anesthesia. And he's generally in the clear once the anesthesia is stopped.

Here are two good articles that discuss anesthesia protocols for heart conditions in greater detail.

Sedation for Cats with Cardiovascular Disease


Anesthetic management of small animals with preexisting cardiac conditions (Proceedings)

Thank you for the links, I'll be reading these. I'm glad your cat is in the clear once the anaesthesia is stopped, I’m hopeful my cat also recovers without any complications. It's really reassuring me that as I’ll be taking my cat to QMH that she will be in the best hands. The cardiologist has told me on several occasions that with the current level of heart disease it shouldn’t be too risky. I keep telling myself that these are trained and experienced specialists and if anything were to happen, they will be bale to act swiftly. I will keep you all posted how my cat does.

 

[ShahnazAC]

Hiya everyone,

I wanted to update everyone that my sweet baby has had her spay today. The surgery went smoothly and she has recovered and returned home in the evening.

She's currently rather unhappy being confined in a small space. She also has developed some gurgly rattling sound from her throat. I was informed its from the tube that was inserted during the surgery. As long as there is no other symptoms, I need to keep a close eye on her. I'm a little worried but I'm hoping she'll be fine.

Thank you all for the ongoing support.

 

[di and bob]

I'm so happy she's done! I'll pray for her to have a quick and full recovery....