I have a 10 year old male cat currently in the hospital for a urinary blockage. The vet unblocked him and he has a catheter in, but he has large bladder stones. He also has a minor VSD found via echo at A&M when he was 6 months or a year old. Hasn't had an echo since. His murmur never changed in the years since based on vet examination.

The issue is the vet originally recommended surgery. When I asked about the murmur, he backtracked and seemed to doubt if surgery was the best route before an echo. The soonest I can get an echo done is Tuesday. I'm having him transferred to Blue Pearl here in SA tomorrow and will get another opinion then, but I'm just trying to understand if I'm doing the right thing waiting for the echo prior to surgery, or if the risk of infection with having a catheter in for 3.5-4 days is higher than the risk of surgery with a VSD. He has had an antibiotic injection already, but I just don't know if I'm doing the right thing.

Please, no cat jokes.

I'll go first. Doubt if you need an echo. Stones large enough to require surgery is still going to require surgery. You did the right thing to raise the question. It also triggered your veterinarian to fall back to "oh s….t" cya. Living with the VSD and asymptomatic for 10 years I would move forward. I am both sides of this fence. As a veterinarian it's a damned if you do and damned if you don't. Fricking echo does not change that your cat needs surgery. Now do you want an anesthesiologist, boarded surgeon and cardiologist present for the procedure?
Me…..get done what needs to be done. Not an answer but my thoughts. Catheter for 3-4 days not the determining factor. Good luck.

Urinalysis May determine stone type. Some can be medically managed. Some require surgical removal. "Large" stones do not usually have the chemical composition to lend themselves to medical/dietary management. Sorry but need more info to guide the decision.

Right. And to be clear I'm on board with surgery. I guess what I'm struggling with is the risk of him having complications now vs a fully informed decision on Tuesday. I know surgery will be happening. I guess the only way it wouldn't is if the echo shows he may die on the table and so then I just spend a day or so with him before taking the risk.

I plan on listening to the vet and Blue Pearl tomorrow and getting a feel that way, then making a decision. I don't want to prolong the inevitable unnecessarily. I'm just really struggling because the vet at the current hospital was so wishy washy, I just don't trust them to do the surgery at this point. They knew about the murmur, recommended surgery without addressing the risk of the murmur, and then when I brought it up he backtracked. That may not be fair that I don't trust them, but that's what has happened.

I know this is a very difficult conundrum For any vet. He is stable for now, and if BP recommends surgery tomorrow, I'll move forward.

Good luck. Hope it all goes well.

I'm assuming they sedated or anesthetized to unblock him, depending on what drugs were used could make you more comfortable with surgery (ie if he handled that, he could be more likely to handle anesthesia for surgery). If you want to minimize risk, an echo first would tell you the most about his heart function.

Thank you. I'll talk with the vet today about that aspect of it. That if he handled sedation for the catheter, does that make them feel more confident for surgery.

Well as an update - Blue Pearl surprisingly called me this morning and said they were uncomfortable treating my cat, even performing the echo. They are transferring us to A&M. I guess I'm glad they told me eventually before operating, just somewhat confused if even a specialty place like Blue Pearl is washing their hands of my cat.

Is a small, asymptomatic VSD really that rare of a condition in a cat? I get that it's unknown, but they basically said without a cardiologist, the echo would be meaningless. Which makes me wonder why they offer it in the first place.

Hopefully, it all works out. I know what having cats with medical issues is. Our current cat has renal failure along with thyroid issues. She wasn't supposed to live longer than 1-2 months more. 14 months later - she does fine. The thyroid issues kind of cancel out the kidney issues - her kidney levels went from level 3 down to 2. Cats respond in weird ways just like humans do. I have to give her subcutaneous fluids 3-4 times a week and pills for the thyroid, but again, she does fine.

Update - A&M did an awesome job. They did a blood test to see if an echo was necessary; it was. Echo showed no reason to avoid surgery...minor dilation (I think I got that term correct) of a part of his heart but could be due to the fluid therapy he was getting and there was nothing indicating progression of his heart disease (I've since learned general term for his VSD). So they proceeded with surgery today, and now my little guy is awake and in recovery and making friends with all of the students and technicians.

Probably will be picking him up tomorrow or first thing Friday.