Anestesia in cani con malattie cardiache: una sfida con rischi gestibili?

Abstract

The popularity, the attention and average age of the companion animals are gradually increasing; this is accompanied by a higher incidence of pathologies, including heart disease. The increase in veterinary diagnostic and therapeutic capabilities and possibilities is always combined with the need for sedation or general anesthesia. The aim of the study is to review the main heart diseases and rhythm disturbances in dogs, the effects of anesthetics on the cardiovascular system by contributing case reports to evaluate different anesthetic protocols. Fifty-three anesthesia protocols of 50 dogs with heart disease and/or rhythm conduction disorders who underwent sedation or general anesthesia for surgical and/or diagnostic intervention at the University Veterinary Teaching Hospital of the University of Parma during the period from April 2022 to July 2023 were enrolled in the study. Side effects, complications during the procedure and their management were recorded. Data were analyzed using the chi-square test and the Yates chi-square test. Statistical significance was established for P ≤ 0.05. Twenty-one breeds were represented, of which 32% were Mongrels followed by Cocker Spaniels (10%), 54% male and 46% female, an average age of 10.5 years and average weight of 15 kg. Most of the subjects had myxomatous mitral valve disease (72%), mainly belonging to ACVIM class B1 (67%), followed by dilated cardiomyopathy (10%) and subaortic stenosis (10%), while in patients with arrhythmias (18%) atrial fibrillation was the most represented alteration (44.4%). The most used anesthetic protocol was the combination of methadone, propofol and isoflurane followed by butorphanol, propofol and isoflurane. No significant differences in the development of hypotensive complications in relation to anesthetic protocol, type of underlying heart disease, age of the patient and procedure were recorded. A significant increase of incidence of death in patients undergoing emergency surgery, regardless of the underlying cardiac alteration, as well as in subjects presenting with afflictions other than valvular disease, was recorded. In conclusion, anesthesia in dogs with cardiac disease remains a challenge with important risk factors that can be adequately controlled by careful choice of drugs and monitoring the patient.