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Surgical and nonsurgical management of patent ductus arteriosus in cats: 28 cases (1991–2012)

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  • 1 Veterinary Medical Teaching Hospital, School of Veterinary Medicine, University of California-Davis, Davis, CA 95616.
  • | 2 Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California-Davis, Davis, CA 95616.
  • | 3 Department of Clinical Studies-Philadelphia, Matthew J. Ryan Veterinary Hospital, School of Veterinary Medicine, University of Pennsylvania, Philadelphia, PA 19104.
  • | 4 Animal Medical Center, 510 E 62nd St, New York, NY 10065.
  • | 5 Veterinary Medical Teaching Hospital, School of Veterinary Medicine, University of California-Davis, Davis, CA 95616.
  • | 6 Department of Population Health and Reproduction, School of Veterinary Medicine, University of California-Davis, Davis, CA 95616.

Abstract

Objective—To characterize the clinical features and outcome of cats treated for patent ductus arteriosus (PDA) with attenuation (extravascular or intravascular) versus medical treatment only.

Design—Retrospective case series.

Animals—28 client-owned cats with congenital PDA.

Procedures—Medical records for cats with PDA diagnosed by means of echocardiography were reviewed. Data retrieved included signalment; history; clinical signs; results of physical examination, ECG, echocardiography, and thoracic radiography; response to medical management if attempted; type of attenuation procedure if attempted (surgical or intravascular); procedural details; intraoperative and postoperative (≤ 2 weeks) complications; and long-term (> 2 weeks) complications. Follow-up was obtained from medical records and via telephone interviews.

Results—All 28 cats were referred for evaluation of a cardiac murmur, but 17 of 26 (65%) for which initial clinical signs were available did not have overt signs at initial evaluation. Multiple congenital cardiac defects were identified in 6 of 23 (26%) cats. Seventeen of 26 (65%) cats were documented as treated with 1 or more vascular attenuation procedures; vascular attenuation was not attempted in 11 cats receiving an angiotensin-converting enzyme inhibitor or loop diuretic (n = 2) or no medical treatment (9). Surgical ligation was successful in 11 of 15 cats, and coil embolization was successful in 2 cats. Procedural or postoperative complications included death (n = 2), left-sided laryngeal paralysis (2), voice change (1), fever (1), hemorrhage (4), and chylothorax (1). Long-term follow-up was available for 16 of 28 (57%) cats. Three of 4 cats that did not undergo surgical attenuation died of cardiac-related disease.

Conclusions and Clinical Relevance—Results suggested that PDA occurs rarely in cats, and clinical signs and diagnostic findings were consistent with those previously reported for dogs. Surgical versus nonsurgical treatment did not result in a significant difference in life expectancy in this small cohort. Evaluation of laryngeal function after surgical ligation is recommended. Further study of the outcome associated with various treatment options in a larger population of patients is recommended.

Abstract

Objective—To characterize the clinical features and outcome of cats treated for patent ductus arteriosus (PDA) with attenuation (extravascular or intravascular) versus medical treatment only.

Design—Retrospective case series.

Animals—28 client-owned cats with congenital PDA.

Procedures—Medical records for cats with PDA diagnosed by means of echocardiography were reviewed. Data retrieved included signalment; history; clinical signs; results of physical examination, ECG, echocardiography, and thoracic radiography; response to medical management if attempted; type of attenuation procedure if attempted (surgical or intravascular); procedural details; intraoperative and postoperative (≤ 2 weeks) complications; and long-term (> 2 weeks) complications. Follow-up was obtained from medical records and via telephone interviews.

Results—All 28 cats were referred for evaluation of a cardiac murmur, but 17 of 26 (65%) for which initial clinical signs were available did not have overt signs at initial evaluation. Multiple congenital cardiac defects were identified in 6 of 23 (26%) cats. Seventeen of 26 (65%) cats were documented as treated with 1 or more vascular attenuation procedures; vascular attenuation was not attempted in 11 cats receiving an angiotensin-converting enzyme inhibitor or loop diuretic (n = 2) or no medical treatment (9). Surgical ligation was successful in 11 of 15 cats, and coil embolization was successful in 2 cats. Procedural or postoperative complications included death (n = 2), left-sided laryngeal paralysis (2), voice change (1), fever (1), hemorrhage (4), and chylothorax (1). Long-term follow-up was available for 16 of 28 (57%) cats. Three of 4 cats that did not undergo surgical attenuation died of cardiac-related disease.

Conclusions and Clinical Relevance—Results suggested that PDA occurs rarely in cats, and clinical signs and diagnostic findings were consistent with those previously reported for dogs. Surgical versus nonsurgical treatment did not result in a significant difference in life expectancy in this small cohort. Evaluation of laryngeal function after surgical ligation is recommended. Further study of the outcome associated with various treatment options in a larger population of patients is recommended.

Contributor Notes

Address correspondence to Dr. Steffey (masteffey@ucdavis.edu).