Country: Ukraine Cat: Murka, 12 years old, mixed breed, female, weight 4.1 kg

Country: Ukraine Cat: Murka, 12 years old, mixed breed, female, weight 4.1 kg. Mammary gland masses have been known since at least July 2024. Cytology dated 17 July 2024 described a mammary gland cyst, but also identified cells consistent with a mammary adenoma undergoing malignant transformation; histopathology was recommended. As of August 2026, Murka has two mammary gland masses, approximately 0.5 cm and up to 1.5 cm in size. Repeat cytology dated 6 August 2026 showed that one mass is most consistent with mammary adenocarcinoma. The second mass has cystic changes; no signs of malignant epithelial neoplasia were identified in the examined sample, but malignancy cannot be completely excluded. In July 2026, urinary tract abnormalities were also identified. Urinalysis dated 12 July 2026 showed marked leukocyturia and a urine specific gravity of 1.025. A urine culture from the same date identified Enterococcus faecalis. Murka is currently completing a prescribed course of Marfloxin. On repeat urinalysis dated 2 August 2026, urine specific gravity was 1.030, leukocytes were +++, and microflora was ++. Kidney function is also a concern because Murka has been drinking a large amount of water for a long time, currently approximately 400 ml per day. Blood chemistry dated 12 July 2026 showed creatinine 91 µmol/L, urea 11 mmol/L, and phosphorus 1.9 mmol/L. SDMA dated 2 August 2026 was 16.84 µg/dL, with the laboratory reference range up to 18.2 µg/dL. Hyperthyroidism was diagnosed in August 2026. Total T4 dated 2 August 2026 was 71 nmol/L, with the laboratory upper reference limit of 60 nmol/L. Treatment with Thyrozol (thiamazole/methimazole) has been started, and T4 and other laboratory parameters are being monitored at our local veterinary clinic. An echocardiogram was performed in 2024. Before possible surgery, we plan to repeat the cardiac examination and measure blood pressure, considering Murka’s age and newly diagnosed hyperthyroidism. The main purpose of this consultation is to assess anesthesia safety and determine how Murka should be stabilized before surgery. We would like to understand how safe general anesthesia would be after stabilization of hyperthyroidism and treatment of the urinary infection, taking into account possible underlying kidney disease and the need for an updated cardiac assessment. We would especially like advice regarding which parameters should be stabilized before surgery, which examinations are necessary for proper anesthetic risk assessment, what type of anesthesia and which anesthetic medications would be preferable for a patient like Murka, what monitoring should be mandatory during surgery, how perioperative fluid therapy should be managed, and how Murka should be monitored during recovery from anesthesia.