EP (N)Simkan's Charade
   
My C-litter was born 1999.12.23, and I was delighted when I after a short while could see that I got the tortie I hoped for. But, when the kittens were a few weeks old, I started to realize that there was something wrong with Charade. When I hold her in my hand, it felt like her hart were lying directly in the palm of my hand. That, and the fact that you didn't need at stethoscope to hear a swooshing sound in her chest, made me realize that something was seriously wrong.

EP (N)Simkan's Charade

Photo by MH
Except from this, there was nothing obviously wrong with her. She was just as active and playful as other kittens. She ate well, but she was a bit smaller than her two siblings

My vet, Veterinarian Bernt K. Lande didn't need more than a moment to confirm what I already knew, but hoped wasn't true: Charade had an organic heart disease, and it was a serious one. But, I am so lucky that I have a vet who is willing to try, so instead of offering me to put her to sleep, he said: "There is no doubt in that she has a serious hart condition. But, because of the characteristic swooshing sound, I am almost sure that I know what kind of failure it is. In the textbook it is rather easily to fix with an operation, I have never done it before, but I am willing to try if you are."

I guess I don't have to say what my answear was?
Figure 1: Schematic sketch of peristering ductus arteriosus. In the fetus, the blood flows from the pulmonary artery to the aorta through the ductus arteriosus, but this opening will normally be closed a short time after the birth.  When this closing don't happen as it normally would, there will be a continuous blood throughput, generally from the aorta to the pulmonary artery. This causes a continuous blowing sound in the chest. The sound could be weak and only be heard at the leading edge of the hart on the left side.

As you can see, there were nothing wrong with the hart itself, but with the two main blood vessels to the hart. A connection between them that should have closed itself at birth remained open and caused the blood to going in a circle.
What was clear was that the fault had to be corrected while she was a kitten, she would not be able to be fully-grown with such a condition. What was also clear was that at that stage, she was much too small to survive such an operation. As I mentioned before she was smaller than her siblings were, at ten weeks she was only 800 grams, more than 300 grams smaller than the other two. One thing was that she was to small, the medical equipment that was necessary for such an operation was to big! So, we had to wait and give her time to grow.

With that another chapter started: The waiting time.  Charade put on weight, slowly, but steadily, and we regularly visited the vet for a checkup. During this time she was just as other kittens, she was no slower than the others regarding fun and play. She got to be with her siblings and mother all the time, when the brother, Classic Tabby, moved to a new home, the tempo was only slightly slowed down by the fact that they no were only two; Charade and her sister Cleo. She got tired faster than her sister, and needed more sleep, but only twice did I notice that she had wear her self out so much that she had trouble breathing. It might have been better for her health if I had limited her movement, but I meant then, as I do now, that her chance of surviving this were so small that her short lift shouldn't be limited, but lived to the fullest.

A day or two before the Easter Holiday we were on another checkup, and at that time it was clear that we had to set at date for the operation. She lived on borrowed time, and we couldn't wait any longer. The  D-day was set for May 3rd, Charade was at that time a little more than four  months old and weight 1,5 kilos.

I wasn't much self assure that morning I delivered her for the operation, and I was rather sure that that would be the last time I ever saw her. It has to be mentioned that we had an agreement that the purpose with the operation was to correct the fault. If that was impossible to fix, or the failure was in the hart itself, she should be put to sleep on the operation table. I let Vet. B. K. Lande tell about the operation itself:

   
Vet. Bernt K. Lande tells his part of the story:

Ductus arteriosus is a short, specialized blood vessel, which, in the uterus makes a connection between the aorta and the arteria pulmonalis. When a kitten is born (or a human), this blood vessel automatically closes, so that the blood can reach the lungs that starts to work after the birth.

At this kitten something went dramatically wrong, the blood vessel didn't close, so the blood went in a circle and would lead to a hart failure and, after a while, death. When the kitten started to show signs of weakening, we decided to try to open the chest and treat the condition surgical. The kitten was so small that this would be a special challenge.

Picture taken just after the operation, before she wakes up from the anesthesia.

Photo: B. K. Lande
We had no possibility to close the windpipe with a tube, so the solution was to put the whole head in a bag and squeeze it through the whole period of anesthesia.

The actual blood vessel is placed just outside the hart, and to reach it, it was necessary to move some of the left lung and a nerve had to be moved downwards without being damaged. In this very small operation area we at last found the little blood vessel and closed it.  (Quotation ends)

   
I was so sure, that afternoon, that the only thing for me to pick up at the vets office would be an empty carrier, but I got "my baby" home with me. She was still sleeping, but absolutely alive. Her stitches should be removed after ten days, and the order was to limit her movements for that period. Climbing in the curtains and attacking other four-legged animals would have to wait. The day after the operation she was awake, she cleaned her self, and wanted to be cuddled, but had no interest in food or water. Day two her appetite was back, and on Saturday, which was day three, she was ready to do play again.

The biggest problem in connection to her hart condition was to keep her somewhat quiet this ten days. She was kept in a large carrier with room for a bed, litterbox, food and water, but in her point of view, that was not good enough.A four-month-old Siamese has other things to do than to be quiet, even if it is in her own best interest. We could not have her in the same room as her mother and sister, which made her desperate to get out of the cage. The solution was to place the carrier in my mother's kitchen, just because there were people there almost all the time. During these days, she had company by one of us around the clock. In the beginning because we wanted to keep an eye on her in case there were any complications, later on because we didn't have the conscience to leave her all alone. She didn't need long before she realized that a sound from her were enough to make us give her all the attention she wanted. Everyone who have owned a Siamese kitten knows how often that was, she spent more time on the kitchen table beeing cuddled than she did being quiet in her cage.

Friday May 12th, nine days after the operation, the stitches were removed, and she got a clean bill of health: The hart had normal heartbeat and all swooshing sounds were gone. Never have I seen a kitten happier than Charade when we got home: She got to run around again and do as she pleased. Poor Cleo was the one that had to pay for the days of unused energy, none got much sleep that first night.

Charade and Cleo the day the stitches were removed.

Photo: MH

 When this is written, we write April 2002, Charade is now 2,5 years old, neutered, and absolutely of good health. She is a small female, but I don't believe that it has anything to do with her hart condition, her sister Cleo were also a rather small cat. She is just as full of ideas and actions as she was as a kitten, and has no problems with tiring a couple of other cats before she needs a rest. She is a bit spoiled, but who cares.....

She is not to happy with travelling in carriers, so the shows she attends during a year are few, but selected.  I still acknowledge that she had a heart failure and went through a large operation, even if she obviously has forgotten it all a long time ago.