Bilko Samantha J, Veytsman Stan, Amsellem Pierre M, Chow Rosalind S
Department of Veterinary Clinical Sciences, University of Minnesota Veterinary Medical Center, St Paul, MN, USA.
JFMS Open Rep. 2021 Jul 15;7(2):20551169211026921. doi: 10.1177/20551169211026921. eCollection 2021 Jul-Dec.
A 12-year-old spayed female domestic shorthair cat presented for chest wall resection and radiation therapy following incomplete surgical excision of a feline injection site sarcoma. A CT scan for surgical planning was performed under general anesthesia and showed extensive tumor infiltration of the soft tissues of the right thorax. The cat recovered uneventfully from this anesthetic event. Nineteen days later, the patient was reanesthetized for forequarter amputation plus radical chest wall resection, including ribs 3-8 and all associated soft tissues plus adjacent spinous processes. Postoperatively, the patient developed acute respiratory failure secondary to hypoventilation. The cat was mechanically ventilated for 12 h prior to being successfully weaned from the ventilator. However, the improvement was transient and mechanical ventilation was reinitiated 6 h later owing to respiratory fatigue. On the second day, the cat developed unexplained central nervous system signs and was euthanized.
To our knowledge, this is the first case report to describe ventilatory failure secondary to radical chest wall resection in a cat. Hypoventilation with subsequent need for mechanical ventilation is a potential complication that should be considered during preoperative planning in patients requiring extensive chest wall resections.
一只12岁已绝育的雌性家养短毛猫因猫注射部位肉瘤手术切除不完全而前来接受胸壁切除术和放射治疗。在全身麻醉下进行了用于手术规划的CT扫描,结果显示右胸软组织有广泛的肿瘤浸润。这只猫从这次麻醉事件中顺利恢复。19天后,该患者再次接受麻醉以进行前肢截肢加根治性胸壁切除术,包括第3 - 8肋骨以及所有相关软组织和相邻的棘突。术后,患者因通气不足继发急性呼吸衰竭。这只猫在成功脱离呼吸机之前接受了12小时的机械通气。然而,改善是短暂的,6小时后由于呼吸疲劳再次进行机械通气。第二天,这只猫出现不明原因的中枢神经系统症状并被实施安乐死。
据我们所知,这是第一例描述猫根治性胸壁切除术后继发通气衰竭的病例报告。通气不足以及随后对机械通气的需求是一种潜在并发症,在需要广泛胸壁切除术的患者术前规划时应予以考虑。