Neutering Surgery - Opinions Needed

chenxiaoshuai

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Hi Gang -

My 10-month male maine coon cat Mushe is not neutered yet for a reason - a vet once 'guestimated' that he might have heart issue and that might influence the anesthesia to be used. The guestimate was due to some skin-twitching symptom and my inital fear that maine coons are more prone to HCM. She did urine test and bloodwork on him, declaring bloodwork results could potentially indicate heart problems yet did not find anything associated to heart. She also recommended echo, which is $400. I myself have done loads of research but didn't see any association between skin twitching behavior and heart issues. I also consulted with another vet and he didn't think there was either.  However, I don't want to risk Mushe's life, not even for a chance of 0.0001%, therefore have been postponing the surgery until a more definitive answer is found. I'd like to see what is the group's intel like on this matter, and, what would be the best timing for the surgery considering there's a new kitten home now and we are moving places in 1.5 months?

Thanks. 
 
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chenxiaoshuai

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@NBrazil  Thanks, the vet indicated a few possibilities given his symptoms and I'm not sure if I want to do all exams involved. It was close to $400 for my last visit, including office visit, bloodwork, urine testing and deworming, which I did not ask for but she kind a pushed. For bloodwork, the vet saw the record from last Nov when we first got Mushe - negative for both FELV and FIV, but still strongly recommended doing it another time because "it takes twice to be sure", which I had never heard about before. On top of all these, she recommended Echo (another $400).  I like that cat hospital only because of the lead vet who I've always taken my kitten to for candid and unbiased opinions -- I had unfavorable experience with the other two vets. For that single time I didn't mind if this vet was in since the plan was to have Mushe neutered and a surgery should be no problem for any vet. I of course have never thought that simply asking a general question about ONE symptom would lead to a series of testing plus the complication now,  and yes I ended up spending 3 times of the money without him being neutered. 

The concern about this vet I like is that he is a bit conservative in bringing up issues since he doesn't like people to consider him ripping customers off. What if there is some disease that gets missed? Btw, this is the vet who I later called for a second opinon re: the association between skin twitching and heart issues. I was relieved for the answer he gave, but again was hesitant to have Mushe do the surgery just because someone raised up an intimidating possibility . 
 
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catpack

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I suggest doing the Echo. I think this is the only way you are going to get the answers you are seeking.

I have 3 Maine Coon mixes and we opted to do an Echo on the youngest because of symptoms he displayed (easily tired/open-mouthed breathing.) I was relieved that his heart was not the cause. The peace of mind was certainly worth the money.
 
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chenxiaoshuai

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I suggest doing the Echo. I think this is the only way you are going to get the answers you are seeking.

I have 3 Maine Coon mixes and we opted to do an Echo on the youngest because of symptoms he displayed (easily tired/open-mouthed breathing.) I was relieved that his heart was not the cause. The peace of mind was certainly worth the money.
Thanks. But the symptom I was referring to was skin-itching. Mushe's respiratory rate and energy level are about alright...do you happen to know if skin-itching is a symptom for heart diseases?
 

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I understand where you are coming from, but realistically, even with the cumulative "wisdom" of a forum, for something more serious I would stick with a medical professional. Odds of someone knowing of some quirky association while not zero, are pretty low for something this significant.

For instance, you mention respiratory rate... and, yes - that IS something that is associated with heart problems (particularly when it leads to lung congestion), but sometimes a cigar is just a cigar. To wit, my Ragdoll would get to panting with very little provocation as a kitten! Even the hint of play would sometimes get him going!

Even with genetically clean parents my vet strongly suggested an echo. Did I do it? Yes. How much? About $575. Results? He is fine! Talk about an excitable personality. He still can get to panting when very excited playing with his sister, but he has calmed down.

Do I regret doing it? Not at all. However, I have the advantage of not needing 20/20 hindsight! Y'see I decided on pet health insurance within two months of getting him, so it was 90% covered (after a deductible). 

So, if you truly believe his health is good and the vet thinks so to, it isn't too late - he is very young, you can get insurance for about $15 to $25 a month - or about $150/year. Go from there. I'll let you decide how you may be able to make it work for you in this circumstance. 

And unfortunately and regardless, there are no guarantees in any medicine... there have been sad tales of flukey stuff happening. Fortunately, by flukey means rare.

The choice is yours - internet forum "medicine" isn't - although sometimes there is a flash of insight. Y'never know.
 
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chenxiaoshuai

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I understand where you are coming from, but realistically, even with the cumulative "wisdom" of a forum, for something more serious I would stick with a medical professional. Odds of someone knowing of some quirky association while not zero, are pretty low for something this significant.

For instance, you mention respiratory rate... and, yes - that IS something that is associated with heart problems (particularly when it leads to lung congestion), but sometimes a cigar is just a cigar. To wit, my Ragdoll would get to panting with very little provocation as a kitten! Even the hint of play would sometimes get him going!

Even with genetically clean parents my vet strongly suggested an echo. Did I do it? Yes. How much? About $575. Results? He is fine! Talk about an excitable personality. He still can get to panting when very excited playing with his sister, but he has calmed down.

Do I regret doing it? Not at all. However, I have the advantage of not needing 20/20 hindsight! Y'see I decided on pet health insurance within two months of getting him, so it was 90% covered (after a deductible). 

So, if you truly believe his health is good and the vet thinks so to, it isn't too late - he is very young, you can get insurance for about $15 to $25 a month - or about $150/year. Go from there. I'll let you decide how you may be able to make it work for you in this circumstance. 

And unfortunately and regardless, there are no guarantees in any medicine... there have been sad tales of flukey stuff happening. Fortunately, by flukey means rare.

The choice is yours - internet forum "medicine" isn't - although sometimes there is a flash of insight. Y'never know.
I get you @NBrazil, I do have insurance plan for Mushe with Pet's Best for 40 dollars per month and 90% coverage. What I wasn't comfortable with is, after hearing I've got the insurance plan, the vet kind a pushed for all exams whether that was related or the least related to Mushe's symptom. About Echo, I did ask her if that'd get me absolutely definitive answer, her response was nothing was guaranteed 100%. Yes, I can spend as much as she recommended in name of my kitten's well-being, have him needle stitched at different body parts, get indefinite answers these exams and ultimately fatten her wallet. Sorry if this sounds straightforward.  Given all she has declared, including the association between skin twitching and heart problem that no empirical evidence has supported so far, the common practice of doing blood work twice to assure results etc etc, I would have to pass her for any further conversation/treatment for my cats. 

Doing an echo isn't a bad idea @NBrazil, and it's not what I'm against. Now Mushe is totally against going to a vet given the painful experience last time (before he was ok with getting into the carrier). This time I just need to figure out the right vet to go to. 
 
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catspaw66

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Doing an echo isn't a bad idea @NBrazil, and it's not what I'm against. Now Mushe is totally against going to a vet given the painful experience last time (before he was ok with getting into the carrier). This time I just need to figure out the right vet to go to. 
I would completely agree that you need to choose a vet that you trust.  It will cause you and Mushe less stress.
 
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chenxiaoshuai

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I would completely agree that you need to choose a vet that you trust.  It will cause you and Mushe less stress.
Thanks, that was very stressful moment , definitely caused bad sleep for a couple of nights....
 

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I know Mushe isn't exhibiting the same symptoms. I simply offered *my* experience and reason for doing the Echo on this particular cat. We wanted to rule his heart out as a problem. For us, the Echo did this. It was worth the cost to me to get some peace of mind.
 

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Is he an actual purebred Maine Coon? If so, did the breeder do the proper testing on his parents? If not, then he shouldn't have any higher chance of HCM than the general cat population :dk:. Anyway, of course there's always a small risk with any kind of surgery/anesthetic, but it really is a very small risk. If you're really worried about his heart, paying for the testing may be the only way to settle your own feelings. Also ask yourself what you would do if he started spraying or otherwise acting "tomcatty"---that could be riskier for him than any surgery!
 
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chenxiaoshuai

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Does he have a heart murmur? Get the echo...
Thanks very much for responding to both of my posts...now you have a complete view of what has happened to my cat under stress. He doesn't have heart murmur and yes will probably get the echo done later this month. 
 

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Hi

So you know the associations between Maine Coon cats and HCM. In a perfect world you would do an echo with lovely techs and wonderful vets al;l singing bird songs and playing with dancing mice when they did it. Reality is that it is stressful for the cat just to have an echo done. Other thing is it is useless to do it with a regular vet as ultrasounds are so subjective. So if you do it have it done with a boarded cardiac vet and make sure he or she has been doing them a while. Whenever you decide to get it done.

Here is the million dollar question. What exactly would your vet do differently if your cat had HCM during the anesthesia? What would he use instead of what? Does that make sense? If they are recommending you have an echo done based on the breed he is, then if it comes back as he has it I would like to know how they will adjust the anesthesia.

A cat neuter takes about 30 seconds to prep and about 60 seconds to actually do the surgery. That is it. That doesn't mean he is safe because it all depends on what drugs they use and most importantly how he is recovered. Animals that die from anesthesia for the most part die in the cage recovering. They die because they aren't being watched and have complications. Not all but allot. That is why it is so important that he be monitored (all animals) be monitored closely after any anesthetic procedure. Vitals must continue to be monitored after the procedure and that includes blood pressure.

One problem with hypertrophic Cardiomyopathy is that the cat would be prone to IV fluid overload if on IV fluids. Chances are he will not be on IV fluids due to it being such a short procedure. You also wouldn't want them to give a drug they call "Kitty Magic" which is a cocktail of different drugs including Ketamine, Torbugesic, Dexdomator. or Dormosedan. I don't remember exactly but anyway you don't want the Dormosedan/Dexdomitor in a cat that could have HCM. You don't want meticam either due to kidney issues that you don't need him to have. You don't want them using propofol because it to can be hard on them and if you don't have a tech with experience giving it and it is given to quickly they can stop breathing. You really don't want them to do something called "Boxing" him down because that is really hard on cats and can cause a significant drop in blood pressure as well as all the other stress as they flip around a Plexiglas fish tank. Gruesome procedure if you ask me.

So ask them what they use to induce anesthesia.

What they use for pain medications

who does the anesthesia, the vet or the tech?

Who is with the cat in recovery?

How long you have to leave him?

Can you wait for him?

What paramaters are monitored during and after the procedure?

If they are still insisiting on the ECHO ask them what they would do differently?

He does need to be neutered, and of course you are concerned. I am not telling you what to do, only saying what I would do, and giving some warnings.

To be perfectly blunt and honest here, the cats that I have known that died of HCM either were suffering from being kept alive far to long or the owners knew nothing of it and came home to their cat having passed quickly while they were out for ten minutes. I think the later is the better way to go. SHocking but at least quick.

But your cat hasn't been diagnosed with the disease. If he was there are some medications that could be given but usually are not given till there are symptoms.
 
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