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Mocha's Matters of the Heart

A hidden problem

The signs of heart and lung problems in cats are not as obvious to their owners as they often are in dogs. Whilst dogs usually enjoy daily exercise with their owners, cats often have a sedentary lifestyle involving lots of lying about and sleeping. As a consequence of this, often heart and lung problems can be very advanced in cats before clinical signs are noticed.

This situation arose in a lovely little Birman cat called Mocha, who visited us in June with a vague history of reduced appetite and a subtle increased rate and effort of breathing.

A chest x-ray showed an enormous growth in Mocha’s chest which was displacing his heart and reducing his lung capacity by around 2/3rds. Further investigations by one of our cardiologists, Liam, including an ultrasound-guided biopsy, confirmed the presence of a thymoma in the mediastinal connective tissue of his thorax.

This is a rare, but relatively benign tumour of lymphatic tissue in the chest. This tumour cannot be treated with chemotherapy or radiation therapy and the only effective treatment is surgical removal. Surgery can be complicated by the tumour wrapping (“infiltrating”) around the heart and major blood vessels in the chest though, and before surgery it is impossible to be certain whether surgical removal of the thymoma is possible or not.

Mocha’s chest x-ray showing the large thymoma tumour and displacement of his heart

X-ray of a normal cat’s chest                                   

Complicated matters of the heart 

Mocha’s surgery was complicated and required planning and co-ordination between the surgeon and the anaesthetist. We are very fortunate at Woodcroft to have a highly experienced veterinary nurse in Paula Bagshaw-Wright who is head of anaesthesia. Paula furthered her nursing studies and gained the much coveted nursing Certificate in Anaesthesia and Critical Care (NCert. (A&CC)). Her knowledge and experience is essential when assisting with such major surgery. When the chest is opened, the lungs must be mechanically ventilated. The patient is kept alive by the anaesthetist breathing for the patient guided by real-time measurements of oxygen, carbon dioxide and anaesthetic levels in the patient’s blood. In addition, blood pressure and an ECG are continuously monitored during surgery to maintain the patient’s circulation. This tumour was too big to be removed through the ribcage so a median sternotomy was performed to delicately dissect the tumour out of the chest. An air-powered, surgical saw was used to divide the breast-bone to open the chest and allow meticulous dissection around the tumour and heart.

Fortunately surgery went well, but Mocha remained in a critical condition for 24 hours after surgery before he turned the corner and started to recover. During this time he was nursed as an intensive care patient, with supplementary oxygen, blood pressure monitoring and various infusions to help him maintain his blood pressure. Such care is only possible in a 24-hour hospital environment with dedicated critical care vets working overnight. His lungs expanded to normal size within 2 days and his heart moved back into a normal position once the tumour was removed.

Within a few days he was back at home but needed to be kept indoors for a few weeks whilst his breast-bone healed. His owners were delighted with his new lease of life and his rapid recovery from such major surgery.

Now it is now 3 months after surgery and Mocha continues to do well.

Thank you to Mocha's owners for allowing us to share his amazing story.

If you would like more information about our state of the art anaesthestic protocols, please download our anaesthesia information leaflet.

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