Cardiac Tamponade and Feline Infectious Peritonitis

Cheesy is a mixed-breed cat approximately 9 to 10 months of age. His exact age is unknown, as he was rescued from the street several months before being admitted to Veterinarium.

Cheesy was referred to Veterinarium by another veterinary clinic for a cardiology consultation. His owner had initially presented hIS to that clinic 8 days earlier with lethargy, loss of appetite, and dyspnea (difficulty breathing). Despite 8 days of treatment, Cheesy’s condition progressively deteriorated, and he stopped eating entirely during the final 4 days. His attending veterinarian suspected cardiac disease and referred him to Veterinarium for further evaluation.

Cheesy’s diagnostic workup and treatment were managed by Veterinarium’s cardiologist and anesthesiologist, Natia Robakidze.

On physical examination, Cheesy had pale, icteric (yellowish) mucous membranes, weak peripheral pulses, and a prolonged capillary refill time. Thoracic auscultation revealed muffled heart sounds and an irregular cardiac rhythm. His respiratory rate exceeded 80 breaths per minute, compared with a normal resting rate of approximately 30 to 35 breaths per minute in cats. He was also dehydrated.

Based on the physical examination findings and vital parameters, Cheesy was assessed as being in critical condition and required immediate diagnostic evaluation and intensive care.

A thoracic focused assessment with sonography for trauma (TFAST) was performed as the initial diagnostic procedure because the auscultation findings raised Natia Robakidze’s suspicion of cardiac tamponade secondary to pericardial effusion. The ultrasound examination confirmed this suspicion.

Cheesy urgently required pericardiocentesis. The fluid accumulated within the pericardium, the sac surrounding the heart, was compressing the cardiac muscle and preventing the heart from filling properly and pumping blood effectively. This resulted in impaired circulation, inadequate organ perfusion, and a life-threatening arrhythmia.

Sedation was required to perform the pericardiocentesis. Cheesy’s owner was thoroughly informed that sedation carried additional risks because of his critical condition. However, the procedure was urgently required to save his life, as he was unlikely to survive without it. Following the owner’s consent, pericardiocentesis was performed. This was the first procedure of its kind to be performed in a cat at Veterinarium. 

Immediately after the procedure, intensive stabilization and oxygen therapy were initiated. A complete blood count, serum biochemistry profile, and electrolyte analysis were performed. The results revealed hepatic failure, hypoalbuminemia, and hypokalemia. Correction of his albumin and potassium levels was initiated without delay.

Based on the combined ultrasonographic, physical examination, and laboratory findings, feline infectious peritonitis (FIP) was strongly suspected. In addition to intensive supportive care, FIP-specific treatment was initiated.

Cheesy remained hospitalized at Veterinarium for 7 days. Although his condition was initially unstable, his vital parameters gradually stabilized in response to treatment. He was subsequently discharged and continued treatment at home under remote veterinary supervision.

Cheesy has now recovered and is doing well.