Having an anesthetic procedure performed can be a scary experience for both you and your pet, but it doesn’t have to be. If you know the right questions to ask your veterinarian or RVT (registered veterinary technician) that will be performing the anesthesia, it will help alleviate some of your anxiety and give you peace of mind.
Why do we perform blood work or an ultrasound prior to anesthesia at Encina Veterinary Hospital and how does this influence our anesthetic plan for your pet? Blood work and sometimes ultrasound aids us in looking for abnormalities within your pet’s organ systems. Some blood abnormalities we look for are low red cell counts (anemia), elevated kidney or liver levels, electrolyte abnormalities (electrolytes are things like potassium, sodium, chloride etc) or decreased protein levels in the blood. In addition, ultrasound helps us diagnose the severity of heart disease if your pet has a murmur or a mass/tumor in the body. These are just a few of the abnormalities that will help us determine your pet’s anesthetic plan. The medical history (previous medical problems or history of hospitalization) of your pet also aids in determining our anesthetic protocol. Anesthesia is NOT a one size fits all. We will choose the anesthetic drugs for your pet depending on its blood work, ultrasound results and medical history. Species and breed type can also influence our anesthetic plan. Sight hounds (Greyhounds, Whippets etc), brachycephalics (Pugs, English Bulldogs, Boxers etc) and cats, in general, can have different reactions to certain anesthetic drugs that differ from the majority of the pet population. Pets that are overweight, old (usually 9yrs or older) or very young (4 months or younger) also have anesthetic issues that can alter their anesthetic plans. All of this is taken into account when deciding on what anesthetic drugs will be safest for your pet.
Your pet will have many monitoring devices placed on it during anesthesia. The monitors help us make sure your pet has the safest anesthetic experience possible. We monitor your pet’s heart rate with an ECG as well as its blood pressure. Blood pressure is a VERY important vital sign to monitor. It tells us whether your pet’s organs and tissues are getting enough blood and therefore oxygen (blood carries oxygen that is vital in keeping your pet alive). The cells that make up tissues and organs can die if not enough oxygen is delivered to them. Initially this may not be a big deal, but if your pet has multiple anesthetic procedures and blood pressure is not monitored or is low your pet can start showing signs of organ disease. If blood pressure continues to be low during anesthesia we will administer fluids and sometimes drugs to help increase it. Low blood pressure is usually a side effect of most anesthetic drugs. Usually blood pressure returns to normal once anesthesia is discontinued. Carbon dioxide levels are also very important to monitor. If carbon dioxide starts increasing in your pet it can lead to very serious complications and eventually may lead to death. If carbon dioxide levels do start to increase during anesthesia, we will place your pet on a ventilator (a machine to assist your pet in breathing better). This DOES NOT mean that your pet has developed a breathing problem. Most of the drugs that we use for anesthesia cause respiratory depression i.e. breathing depth and frequency become decreased causing carbon dioxide to build up. Once your pet is recovered, breathing depth and frequency will usually return to normal. Oxygenation of the blood is monitored which aids us in making sure that enough oxygen is being transported by the red cells to your pet’s body. Your pet’s temperature is continually monitored with a temperature probe (like a big thermometer you use at home). This probe is placed in your pet’s throat or rectum depending on the surgical operation – don’t worry, the probes covers are changed after every surgical procedure. Usually your pet will have a warming device that blows warm air placed on top or under them to keep their temperatures normal. If your pet is small or sick, we may place two of these warming devices on them as these patients get cold quickly.
After your pet’s surgical or dental procedure is finished at Encina Veterinary Hospital, they will usually receive another dose of pain medication upon recovery. Again, this pain medication is chosen depending on their medical history. If you know that your pet has had a certain anesthetic or pain drug in the past and has not done well on it let the doctor or staff know so we can chose another drug. There are many newer anesthetic and pain drugs that are available to us. Your pet will recover in our ICU or preoperative area depending on the severity of their medical condition or surgical procedure. Patients that recover in ICU have many things that need to be monitored post operatively by our ICU nurses such as IV fluids or constant pain medications. Patients with moderate to severe organ disease will also be placed in ICU along with older healthy patients. Younger and healthier patients will recover in the preoperative area where they are watched by our surgical staff.
Anesthetic complications, though rare, can occur in any pet because ANY patient can have drug reactions that we can not predict. Some drug reactions can be reversed by using drugs that are specifically made for this purpose. Unfortunately, reversal drugs are only commonly available for opioids (morphine type drugs) and certain sedation drugs (Dexdomitor). Most other drugs can not be reversed so if a reaction occurs we can only support the patient with IV fluids and other drugs to minimize the reaction. Unfortunately, sometimes this is not enough and the patient may die, although this is EXTREMELY uncommon. We try to minimize all potential anesthetic complications by obtaining current medical history from you the pet owner as well as having current blood work on your pet. Records are reviewed by the surgical doctor as well as the RVT anesthetic staff the day of anesthesia. Again, once your pet’s history and blood work has been reviewed we will develop an anesthetic plan specific to your pet to minimize all potential complications and risks.
In addition, our anesthetic staff is the only staff in the entire Bay Area that is overseen by an RVT with a specialty in anesthesia (avta-vts.org). This allows our staff and doctors to be current on all anesthetic and pain drugs that are available including being current on new recommendations for their safe use.
Susan Burns BS, RVT, VST (Anesth)