Cardiac pre-anaesthetic assessment
Assessment of the heart before anaesthesia in patients at higher risk: seniors, cats of breeds predisposed to HCM, and animals with a murmur or heart disease. The result changes how the anaesthetic is managed and only rarely rules it out.
What it involves
A cardiac pre-anaesthetic assessment extends the standard pre-anaesthetic assessment (STD-01) with a heart examination: echocardiography and, if needed, an ECG and blood pressure measurement. It answers the question of whether the animal’s heart will safely tolerate anaesthetic drugs, fluids and the stress of surgery, and if the heart is diseased, how to modify the protocol: different drugs, slower fluids, extra monitoring, or starting cardiac treatment beforehand.
The aim is not to refuse the procedure but to carry it out safely. Most patients with diagnosed heart disease can be anaesthetised, provided that the anaesthetist knows about it beforehand and has a plan. Undetected cardiomyopathy in a cat is one of the most common causes of serious perioperative complications.
We enter the result in the anaesthetic record, which the team goes through before every procedure (procedure checklist STD-03).
When it is used
We recommend it before any anaesthetic in dogs and cats over 8–10 years of age, in cats of breeds predisposed to HCM (Maine Coon, Ragdoll, British Shorthair, Sphynx, Persian) regardless of age, in all animals with a murmur, an arrhythmia or diagnosed heart disease, in giant-breed dogs and Dobermans, and in patients with diseases that affect the heart (hyperthyroidism, kidney disease, hypertension).
For planned procedures we do it a few days before the operation so that there is time to start drugs; for urgent ones, immediately beforehand and in a limited form.
Indications: symptoms that should prompt a visit
- My Maine Coon cat is booked for dental treatment under anaesthesia.
- An older dog with a heart murmur needs a tumour removed.
- A cat has started breathing faster and is booked for neutering.
- A dog being treated for heart disease is going to have a procedure and I do not know whether to stop the drugs.
- The animal tolerated its previous anaesthetic badly: it was weak, turned bluish or took a long time to wake up.
- A veterinary dentist has asked for a cardiology consultation before extractions.
Conditions for which we use it in particular
Diagnostics beforehand
The assessment combines listening to the heart, echocardiography, an ECG and blood pressure measurement where indicated, and the standard pre-anaesthetic package STD-01: a clinical examination and a blood count and biochemistry (including kidneys and electrolytes and, in cats, T4). We add a chest X-ray for a cough, breathlessness or suspected fluid. Everything is done on site, without sedation.
How it proceeds
The visit takes 45–60 minutes. After the examination and echo, the vet determines the ASA risk class and, together with the anaesthetist, sets out the anaesthetic plan: choice of drugs, limits on fluids, the extent of monitoring, and whether oxygen therapy or drugs to support the heart are needed. If we find a disease that needs treatment, we start it and postpone a planned procedure by 1–2 weeks, until the animal is stable.
The owner receives the echo result, the risk class and written instructions before the procedure, saying which drugs to give in the morning and which to leave out.
Aftercare
After the examination the animal goes home with no restrictions. If cardiac drugs have been started, a check just before the procedure confirms that the animal is stable. The result of the assessment is valid for about 3–6 months if the animal’s condition is stable; for later procedures after that time we repeat the examination.
Frequently asked questions
Can an animal with heart disease have a general anaesthetic?
In most cases yes — provided the protocol and monitoring are adapted. We postpone the procedure only when heart failure is unstable, until it has been brought under control.
Should heart drugs be stopped before the procedure?
Usually not. Some are also given on the morning of the procedure and others are left out. You will receive exact instructions in writing after the assessment.
Is listening to the heart enough?
In cats definitely not, because HCM often causes no murmur. In seniors and at-risk breeds, an echo is the only way to detect the disease before anaesthesia.
Is the assessment needed in a young, healthy dog?
Usually the standard assessment STD-01, with a clinical examination and blood tests, is enough. We add the cardiac assessment for a murmur, an at-risk breed or poor tolerance of a previous anaesthetic.
We manage every case individually. The scope, indications and course described above are indicative; we agree the exact diagnostic and treatment plan during the consultation. This content is for information only and does not replace a veterinary consultation.
Do you have questions about the cardiac pre-anaesthetic assessment?
Call us or book a consultation. We will set out the diagnostic and treatment plan in writing, before you decide.