The Cat Pacemaker

Before l start a disclaimer...Sorry if anyone is looking for correct medical terms and words to describe operations or conditions. I am not into those and rarely use them. I like simple talk that anyone can understand, and anyhow, my spelling and grammar (better add word that before Curley pulls me up yet again) is bad enough as it is

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We had the cat in today for his pacemaker. It is very rare for cats to have a pacemaker fitted. If they are at the stage they need a pacemaker then their hearts are usually to badly damaged to have one fitted.
Cats also clot very easily and throw thrombus (blood clots) a condition that is often critical in them.
Only a few cat pacemakers have been fitted in the USA and this was a rare one for the UK.
Dogs have pacers fitted fairly regularly and generally do very well on them. They have different type of blood (yes it is still red though)that does not clot as easily, and a better heart physiology to tolerate pacemakers.

This appeared to be one of the rare cat hearts that was suitable for a pacemaker. His exact age is unknown as he was rescued but possibly about 10-12years old. The owner was given a very guarded prognosis and all the possible options covered but she elected to go ahead.

Despite the initial worry from the vet about how puss would react being sedated, as opposed to full anaesthetic, to have his temporary pace lead placed via the jugular he was a star, just lay quietly.
It was a bit fiddley as the jugular is so small but Mike (The vet) is very experienced and with fluoroscopy to guide, it went smoothly.
Once the temporary lead was in place he was given propoflo for his anaesthetic and surgery began.

Surgery took about 2.5hrs (including prep). The surgeon made a midline incision in the abdomen and entered the chest through the diaphragm. He attached l believe it is called a unipolar lead (single pad lead) to the heart. This lead fed from the heart back through the diaphragm to the pacer. In cats this is placed in the abdomen. Puss had steady stats all the way through. It was one of those near perfect anaesthetics that you wish for and do not always get.

Recovery was uneventful and within about 3 hours he was awake and having some food. He had a swipe at me at one point when l was trying to sort his food bowl out.
I was giving him another check when the secretary came in, to see how things were going.
I shut his kennel door and was saying “He is…”
At this point puss gave a half mewy cry and crashed. I bellowed for back up as l got him out the kennel and he was being worked on within about 40 seconds of the initial crash, despite about 20 to 30mins of attempted resus we lost him.

A very s**ty end to what started out as a positive day. Why Puss crashed is unknown. The vet came up with a couple of ideas but with no autopsy there is no way of knowing.