A Message from the Vet - September 2012
Anesthesia, Part One

Many common pet procedures we perform at Kailua Animal Clinic require anesthesia. While the term "anesthesia" can sound scary, we use these pharmacological agents for the benefit of your pet. Anesthesia reduces stress to the patient, allows us to perform a procedure or surgery in a safe and conscientious manner for your pet as well as for our staff, and alleviates any sensation of pain during the process.

Most of our pets undergo scheduled elective procedures throughout their lives, such as spays and neuters. Dental cleaning is also a necessary and routine hygienic procedure, which can be effectively done only under general anesthesia. Thorough oral cavity exams, assessing depth of gingival pockets, proper scaling and polishing, or removing broken and diseased teeth requires an anesthetized patient.

Many surgeries we do are more urgent and require anesthesia in a wide range of bodies in various levels of health. Emergency use of short duration anesthetics allow removal of fishhooks, trimming of broken nails, lancing cat fight abscesses, and suturing minor wounds. Longer procedures like c-sections, cancer surgeries, or repair of fractured bones or torn ligaments require longer duration anesthetics delivered with oxygen.

Some clients relate to me that they are concerned about anesthesia. There is a fair amount of anxiety in our society about anesthesia and quality of services. Not to say there is no risk, but a recent study showed general anesthesia associated with surgery runs a very small risk of mortality, in the neighborhood of 0.1%. Risk can be minimized by thorough physical exam, pre-anesthesic bloodwork and other routine diagnostic tests, selection of anesthesia agents appropriate to the age and condition of the patient, and vigilant monitoring during anesthesia and during recovery.

The American Animal Hospital Association published an Anesthesia Guidelines for Dogs and Cats last year, which validates the anesthetic regimen we practice here at Kailua Animal Clinic, in the normal course of caring for your pets.

The abstract of the article is as follows:

Safe and effective anesthesia of dogs and cats rely on preanesthetic patient assessment and preparation. Patients should be premedicated with drugs that provide sedation and analgesia prior to anesthetic induction with drugs that allow endotracheal intubation. Maintenance is typically with a volatile anesthetic such as isoflurane or sevoflurane delivered via an endotracheal tube. In addition, local anesthetic nerve blocks; epidural administration of opioids; and constant rate infusions of lidocaine, ketamine, and opioids are useful to enhance analgesia. Cardiovascular, respiratory, and central nervous system functions are continuously monitored so that anesthetic depth can be modified as needed. Emergency drugs and equipment, as well as an action plan for their use, should be available throughout the perianesthetic period. Additionally, intravenous access and crystalloid or colloids are administered to maintain circulating blood volume. Someone trained in the detection of recovery abnormalities should monitor patients throughout recovery. Postoperatively attention is given to body temperature, level of sedation, and appropriate analgesia. (J Am Anim Hosp Assoc 2011; 47:377-385. DOI 10.5326/JAAHA-MS-5846)

"There are no safe anesthetic agents, there are no safe anesthetic procedures. There are only safe anesthetists."-Robert Smith, MD

You may find the entire article online at: https://www.aaha.org/graphics/original/professional/resources/guidelines/anesthesia_guidelines_for_dogs_and_cats.pdf.

Next month I will take you through a typical anesthetic procedure case from the initial exam through induction and the anesthetic process to recovery.

John Haddock, DVM

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