Abstract
History
A four year old male neutered Domestic Short Hair cat presented for general anaesthesia
for hind limb orthopaedic surgery. The cat had been anaesthetized four days previously
with propofol and isoflurane and made an uneventful recovery.
Physical Examination and Management
On pre-anaesthetic examination the cat had a temperature of 38.9 °C and was otherwise
healthy. After a premedication of acepromazine and pethidine, anaesthesia was induced
with thiopental and maintained with isoflurane in oxygen 50% and nitrous oxide 50%.
Increases in heart rate, respiratory rate, end tidal carbon dioxide tension and temperature
were observed, occurring sequentially, from 110 to 175 minutes after anaesthetic induction.
Despite ceasing all warming measures and attempting to cool the patient, body temperature
continued to rapidly rise, reaching 42.5 °C and limb rigidity was observed. Isoflurane
administration was stopped and esmolol was administered. Cardiac arrest occurred.
Cardio-pulmonary cerebral resuscitation was commenced and a lateral thoracotomy was
performed to allow cardiac compressions and internal defibrillation. Atropine, adrenaline,
glucose and dopamine were administered and cold saline was instilled into the thoracic
cavity.
Follow-up
Resuscitation was unsuccessful and the cat died.
Conclusions
A presumptive diagnosis of malignant hyperthermia was made. Malignant hyperthermia
should be considered, even if prior exposure to volatile inhalational anaesthesia
was uneventful, and prompt and aggressive therapy instituted.
Keywords
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Article info
Publication history
Accepted:
March 13,
2013
Received:
December 20,
2012
Identification
Copyright
© 2014 Association of Veterinary Anaesthetists and American College of Veterinary Anesthesia and Analgesia. Published by Elsevier Inc. All rights reserved.
