Having your pet undergo general anaesthesia and surgery can be stressful and a source of worry – there is always a degree of risk associated with these interventions. Most of the time, the risk of serious complications is extremely low and very much outweighed by the benefits of the planned procedure. However, there are certain situations where there is greater reluctance to undertake surgery, and when it becomes clear that an operation is necessary, we know the stakes are that bit higher. This was the case for 13-year-old Bazil and his lump removal.

We first met Bazil at our Wells branch about a year ago, when he came to see Vet Harry for his Well Pet Welcome appointment. Harry reviewed Bazil’s history in detail and learned that there had previously been some concerns about his heart. One of Bazil’s littermates was known to have died of heart failure, and earlier tests had suggested that Bazil might also have some underlying heart issues.

Harry had no immediate concerns about Bazil’s heart function based on his clinical examination, but he recommended a follow-up heart scan to determine whether Bazil might benefit from medication. During this visit, a very small cystic lump was also noted on Bazil’s shoulder, which his owner reported had been present for around a month. The lump did not appear worrying and was too small to sample at that stage, so it was decided to monitor it for the time being.

Bazil later visited Vet Josh at our Shepton branch for his echocardiogram (heart scan). Josh holds a postgraduate certificate in cardiology and is our go-to vet for heart patients, so we knew Bazil was in excellent hands. The detailed scan showed some thickening of the heart muscle wall, but no changes to suggest increased pressures or cardiac stress. Josh advised that Bazil likely had early, mild hypertrophic cardiomyopathy, but that this was not currently affecting his heart function and did not require treatment. The plan was therefore to monitor Bazil and repeat the scan in around a year.

For several months, Bazil continued to live his best life at home, but his owner became increasingly concerned that the lump on his shoulder was gradually growing. When we rechecked it in August, it had increased to around 1 cm in diameter. We discussed the possibility of surgical removal, but there was understandable reluctance at that stage due to Bazil’s age and heart diagnosis.

However, when Bazil returned two months later for re-examination, the lump had doubled in size and had started to ulcerate and rupture. We discussed sampling the mass to try to identify its nature, but felt it was unlikely that this would yield a diagnostic result. Given the behaviour of the mass, surgical removal was likely to be necessary regardless. After thorough discussion with Bazil’s owner, the decision was made to proceed with surgery.

On the morning of surgery, I talked through the plan with Bazil’s owner, explaining that his anaesthetic risk was higher than average due to his age and early heart disease, but also outlining the steps we could take to minimise those risks. Bazil was his usual lovely self and looked great on his pre-operative examination, so he was admitted to the ward.

Pre-anaesthetic blood tests showed no concerns regarding Bazil’s liver or kidney function. We therefore started intravenous fluids and administered a light, heart-friendly premedication before inducing anaesthesia. Bazil was closely monitored throughout the procedure by Nurses Iara and Nat, with continuous tracking of his vital parameters, particularly his heart rhythm and blood pressure. His fluid rate was carefully adjusted to maintain healthy blood pressure while avoiding strain on his heart, and a continuous infusion medication was used to provide further cardiovascular support.

Local anaesthetic was also applied around the mass to block pain signals, allowing us to keep Bazil’s anaesthesia as light as possible. The surgery itself was quick and relatively straightforward. We were able to remove the mass with good margins and close the wound efficiently using two layers of sutures. Within half an hour, Bazil was back in his bed recovering well, and he was soon happily enjoying a post-operative meal of chicken.

Bazil returned home and took his recovery in his stride. He experienced some mild wound inflammation, which resolved quickly. I was delighted to inform his owner that laboratory analysis confirmed the mass was benign, with no invasion into surrounding tissues, meaning that removal should be completely curative.

Despite our initial concerns due to Bazil’s age and heart condition, careful planning and informed decision-making alongside his owner allowed us to tailor our approach to his individual needs. Bazil is a great example of how we can balance risks and benefits to achieve the best possible outcome. A year on, we look forward to seeing him again soon for his follow-up heart scan.