Subaortic Stenosis and Emergency Cystotomy

Subaortic Stenosis and Emergency Cystotomy.

Chapa, an approximately 13 year old mixed breed dog, was admitted to Veterinarium. Her exact age is unknown, as she had been rescued from the street.

During the physical examination, cardiac auscultation revealed a pathological systolic murmur. As a result, echocardiographic evaluation was performed, leading to a diagnosis of subaortic stenosis. The patient exhibited compensatory concentric hypertrophy of the left ventricle as well as dilation of the aorta. These changes resulted in signs of congestion within the pulmonary circulation.

Despite the presence of significant cardiac pathology, Chapa required urgent surgical intervention in the form of a cystotomy. Due to urolithiasis, including bladder stones and struvite formation, she was unable to urinate normally and was experiencing persistent pain.

The Veterinarium team carefully considered the fact that patients with subaortic stenosis carry a high anesthetic risk. Structural and functional cardiac alterations lead to impaired hemodynamics, which may result in reduced coronary perfusion and increase the risk of myocardial ischemia, arrhythmias, and heart failure.

For this reason, an individualized anesthetic protocol was developed for Chapa by the clinic’s Anesthesiologist, Natia Robakidze. The protocol included measures aimed at stabilizing cardiac function. As a result, the anesthetic management proceeded successfully. The cystotomy was performed by the clinic’s Head Veterinarian, Lasha-Giorgi Japaridze. The surgeon was assisted by Barbare Kurtsikidze.