Funnel-Chest (Pectus Excavatum) in Kittens
Pectus excavatum (PE) is a congenital malformation of the sternum and costochondral cartilages causing narrowing of the chest primarily on the posterior side. The middle chest appears to be flat or concave, rather than slightly convex. Chest compression may also reduce pulmonary and cardiac functions. The presentation of defects ranges from mild to severe. The severity of the thoracic defect does not always correlate to the severity of clinical signs, which might be more a reflection of concurrent defects like a cardiac and respiratory abnormality. In many animals without clinical signs, pectus excavatum is just an incidental finding. However, if signs do occur, it includes difficulty in breathing, inability to perform a routine exercise, recurrent lung infection, weight loss, coughing, poor appetite, failure to gain weight, and vomiting.
Mocha – The Kitten with Pectus Excavatum
Mocha is a female stray kitten and she is approximately 5 months of age. She was found and rescued near a coffee shop in Al Ain and was brought to the City Vet Clinic due to wounds in different parts of her body. Upon physical examination, depression on the posterior chest was observed, and an x-ray revealed an abnormality on her sternum and ribs, and was diagnosed with Pectus Excavatum or funnel-chest. The thoracic space is severely narrow, and as a result, the heart is displaced away from its natural orientation.
The findings were discussed with the owner and though there are no clinical symptoms at present, there would be a possibility that this condition might lead to cardiorespiratory problems in the future. And since the owner would like to give the cat the best life, she agreed to surgically correct the kitten’s chest abnormality.
An external fixator made from plastic splint was customized according to Mocha’s chest conformation and a layer of foam was added to provide a cushion to the skin.
Surgical correction involves placing several sutures over the sternum and anchoring them on the plastic external fixator. The sutures were then pulled and once the sternal defect was reduced, the sutures were tightly secured. At present, Mocha is still with an external fixator and the initial post-operative check showed a big difference. It reveals that the sternum is straighter and there is more space in the thoracic cavity. Moreover, the heart is properly positioned.
The plastic brace should remain in place in Mocha for 4-8 weeks until the sternum feels palpably noncompliant after the splint removal.
Mocha’s X-ray before the surgery.
Mocha’s X-ray after the surgery
The Diagnosis of Pectus Excavatum
Your veterinarian should have a thorough history of the cat’s health, any information you have of its genetic background, and the onset of symptoms. Routine laboratory tests may include complete blood tests, biochemical profiles, and a urinalysis. To confirm the diagnosis, your veterinarian will conduct series of x-rays of the thoracic cavity which will reveal the actual deformities and any related structural abnormalities. In some patients, the heart may be shifted from its normal place on the left side of the thoracic cavity. Echocardiography (ECHO), a sonographic image of the heart, may be used to further evaluate the heart, it’s functioning ability, and possible cardiac defects.
The Treatment of Pectus Excavatum
Surgery is still the best treatment option for repairing pectus excavatum. However, if the disease is mild and your cat has only a flat chest, then it may be improved without surgery. In such cases, your vet will instruct you to manually compress the chest in such a way that it will encourage the sternum and costal cartilages to take on a more convex shape. Mild defects could be treated with a splint application in some patients. However, with the moderate or severe inward sinking of the sternum, surgery is needed to correct the deformity. The technique used by the veterinary surgeon will depend on your cat’s age and the severity of the case. Patients with respiratory problems that are directly related to this condition generally improve substantially after surgery and will start breathing comfortably.
The Management of Pectus Excavatum after Surgery
Prognosis is poor for severely affected patients, but it will be improved with timely intervention and repair at an early age. If your cat has a mild case of the condition, follow the doctor’s guidelines for physical therapy at home.
After surgery, your cat may feel sore and will need proper rest. It should be placed in a quiet room and away from other pets and children. You might consider cage rest for a short time until the cat can safely move around again without overexertion. Your veterinarian will also prescribe a short course of pain killers until fully recovered, along with a mild course of antibiotics. Medications will need to be given precisely as directed at the proper dosage and frequency.
To make the recovery period easier, place a litter box close to where the cat is resting so that it does not need to make a lot of effort. Similarly, for the feeding dishes. While you want to give him as much peace as possible, you will need to check the cat frequently, observing its breathing pattern and rate. If you see any abnormalities in the breathing, in regards to the movement of its chest, or its behavior, immediately call our veterinarian for assistance.