How a Veterinary Cardiologist Prolonged One Cat's Life After Critical Diagnosis

When Susan Sczepanski first began fostering Cocoa Puff, a long-haired, black kitten, she didn’t anticipate that he would soon become a permanent part of her life. Susan, who has fostered over 300 cats from Foothills Animal Shelter in Golden, Colorado, describes Cocoa Puff as a sweet, loving cat.

“He is more than happy to sit in a window, and he enjoys just lying in the sun, and seeing the squirrels and the birds,” says Susan. “He loves to have other cats around too.”

When Cocoa Puff was only nine months old, Susan brought him in for a routine checkup at the shelter where it was determined that he had a heart murmur consistent with an enlarged heart valve. After this abnormality was identified, Cocoa Puff was referred to Dr. Geri Lake-Bakaar, a Board-Certified Veterinary Cardiologist at Evolution Veterinary Specialists, for additional diagnostics.

During Cocoa Puff’s initial visit and examination, Dr. Lake-Bakaar conducted an echocardiogram on him to find out where the cause of his heart murmur was coming from.

“I start off each examination by listening for an irregularity to the heart rhythm, and as long as I hear a heart murmur, then I will conduct the echocardiogram, otherwise known as a heart ultrasound,” says Dr. Lake-Bakaar. “These echocardiograms enable us to look at the blood flow in the heart, the structure of the heart and the function of the heart.”

Based on the findings from his echocardiogram, Dr. Lake-Bakaar diagnosed Cocoa Puff with a congenital heart defect known as ‘Tetralogy of Flow’.

Tetralogy of Fallot is a defect of the heart that is caused at birth. This condition causes four main issues with the heart: a hole between the two pumping chambers of the heart, a blockage that makes it hard for blood to flow out of the heart through a valve, a main artery that's not in the right place and the heart muscle becoming thicker than usual.

This combination of these problems can make it harder for the heart to pump blood properly, which can affect the animal’s health and energy levels.

In order to explain this condition in simpler terms to Susan, Dr. Lake-Bakaar used a chart to show how the blood is supposed to flow through the heart and how in Cocoa Puff’s case it was slightly varied.

“There are two types of Tetralogy of Fallot where the flow is going from left to right versus right to left. When the flow is going from right to left, it's bypassing the lung which doesn't allow the blood to get oxygen, and that's when we have to intervene more with medications,” says Dr. Lake-Bakaar. “However, in Cocoa Puffs case, the flow is left to right, so the heart was actually functioning quite well given the abnormality.”

Because of these findings, Dr. Lake-Bakaar elected to move forward with a non-invasive approach of continuing to monitor Cocoa Puff’s congenital heart defect using echocardiogram checkups. 

“We decided on doing routine echocardiograms yearly to ensure that there are no changes in flow or rhythm,” says Dr. Lake-Bakaar. “As long as his heart continued to be stable, we continued to monitor to make sure that his heart is functioning okay.”

Unfortunately, a few years after Cocoa Puff’s initial diagnosis of congenital heart failure, a traumatic incident occurred that required him to be brought into Evolutionary Veterinary Specialists Emergency Service.

“He didn't go outside very often, but he went out one day and he came back home dragging his back legs,” says Susan. “I didn't know if he got caught on a fence or hit by a car, but both of his back legs were in need of help, so I called Evolution and they said, bring him in.”

When Cocoa Puff arrived at the ER wing of Evolution Veterinary Specialists, he was immediately seen by a team of specialists, including Dr. Matthew O’Donnell, a board-certified veterinary surgeon, who assessed that Cocoa Puff had been struck by a car.

“There was pretty severe trauma to both of his knees,” says Dr. O’Donnell. “In my orthopedic exam, we had identified a condition that's commonly referred to as deranged stifle, which is essentially just torn ligaments that help support the knee and usually requires surgery as a way to reconstruct those ligaments and offer functional use of those legs.”

Because of Cocoa Puff’s preexisting heart condition, surgery of this caliber-that required for him to be anesthetized-was at risk for serious complications.

“This was a traumatic incident that that couldn't really wait too long,” says Dr. O’Donnell. “Due to his condition, it was very important to work collaboratively with Dr. Lake-Bakaar and also Dr. Graham, our anesthesiologist, to try and treat him as best we could.”

Prior to the surgery, Dr. Lake-Bakaar conducted an echocardiogram on Cocoa Puff to check on the strength of his heart function and to ensure that he would be able to survive being put under for surgery.

Luckily, the echocardiogram showed no signs of major distress which was promising for the surgery. Dr. Lake-Bakaar collaborated with Dr. Graham and Dr. O’Donnell during the operation in terms of what plan of anesthesia was needed and then, post operatively, to ensure that the pain management could be done with minimal fluids as to not overload the heart.

“Having a cardiologist come in an evaluate the heart function and then getting an anesthesiologist in to make sure that the anesthesia was functioning appropriately was important,” says Dr. Lake-Bakaar “That way we could keep him anesthetized, keep his heart happy and get his leg fixed.”

Thankfully, Cocoa Puff’s surgery went routinely, as did the post-operative recovery, and he soon began to regain motor function in his legs. Cocoa Puff is still brought in for annual echocardiograms to check for any changes to his congenital heart failure, but his overall prognosis is exceptional.

“If it wasn't for veterinary specialty medicine, I don't think Cocoa Puff would be here today."

 

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According to Dr. Lake-Bakaar, Cocoa Puff's case highlights the importance of collaboration between veterinarians and veterinary specialists in managing complex medical conditions.

“Bringing Cocoa Puff to see a veterinary cardiologist helped in a couple of ways,” says Dr. Lake-Bakaar. “The first is that now between me and between his referring veterinarian, we have a good understanding of what's going on with his heart, so if he ever needs a routine procedure, we have a better understanding of what's going on so that he doesn't undergo anesthesia and have complications. Also, his mom [Susan] has a better understanding of signs to watch for so that if he does have a problem, she will catch it that much sooner. “

Along with his successful recovery and improved quality of life, Cocoa Puff also became a permanent member of Susan’s family.

“I had fallen in love with him and couldn't give him up, so I adopted him from Foothills Animal Shelter.” says Susan. “If it wasn't for veterinary specialty medicine, I don't think Cocoa Puff would be here today. I am thankful that places like Evolution Veterinary Specialists are around to prolong his life and take such good care of him when he needed the help.”