Modern anesthesia is very safe. The risk of a pet dying under anesthesia while undergoing an uncomplicated spay, neuter, dental or mass removal is extremely low, but this risk can be affected by the anesthetic drugs used and the monitoring of the patient as well as any underlying health condition that is not detectable on an exam. Can you imagine an anesthesiologist in a human hospital using ether or chloroform in the 21st century? Of course not! But, unfortunately (and surprisingly), there are no standards of care for veterinary anesthesia, and some clinics are still using out-of-date techniques. Here is a list of questions to ask your veterinarian the next time your pet is scheduled for an anesthetic event:
1) Is pre-anesthetic blood work performed?
We recommend all patients, not just the old or sick, have pre-anesthetic blood tests performed prior to anesthesia. These tests check the major organs for undetected disease and check cell counts for anemia or infection. Many animals will require more extensive pre-anesthetic blood work or additional tests. Even in animals under one year of age, blood work will occasionally detect abnormalities that could affect anesthesia.
At Austinburg Veterinary Clinic we offer several pre-anesthetic testing options for all pets.
2) Are intravenous fluids administered during anesthesia?
Many drugs used for general anesthesia tend to cause blood pressure to decrease. Intravenous fluids will combat this decrease. In addition, if there are any adverse reactions under anesthesia, an intravenous catheter allows immediate administration of emergency drugs. IV catheters and IV fluids are routinely used in our patients. We an IV pump to accurately deliver the correct amount of fluids. We also use a fluid warmer to keep our patients comfortable.
3) Is the pet’s body temperature maintained during and after anesthesia?
All pets, especially cats and small dogs, lose a lot of body heat under anesthesia. The resulting hypothermia can slow the anesthetic recovery. Anesthetized pets should be placed on a recirculating warm water pad and/or under a warm air blanket. Conventional heating pads are risky because they can cause severe burns. Our surgical table is heated and we have a warm air blanket, just like human hospitals, to keep our patients warm during surgery as well as in recovery.
4) Is the patient intubated, and what anesthetic gas is used?
Intubation means that the patient has an endotracheal tube placed through the mouth and into the trachea, through which gas anesthetic is administered. The endotracheal tube allows controlled respirations if the patient is not breathing well on his or her own, and prevents accidental inhalation of stomach contents if the pet vomits under anesthesia. Virtually every surgical procedure done in dogs and cats requires intubation and gas anesthesia. The modern gas anesthetics are isoflurane and sevoflurane. Halothane and methoxyflurane are out-of-date. We use isoflurane gas inhalant on all our anesthetized patients.
5) What pain control is used?
Surgery hurts! It doesn’t matter if the patient is a human, a dog, or a cat. Analgesia is the relief of pain, and in modern anesthetic protocols, we strive for pre-emptive analgesia (blocking the pain pathways before the painful procedure starts), and balanced anesthesia (trying to block the pain pathways from as many directions as possible). At our hospital, we are very aggressive about pain management. Our patients are given pain medication before, during and after a surgical procedure. Research has shown that if pain medication is given before surgery that the patient will have less discomfort after.
6) What monitoring techniques are used?
It is critical to monitor the patient’s vitals while under anesthesia to ensure that the respiratory and cardiovascular systems are functioning well, and to ensure that the patient is not under too lightly or too deeply. Most important is that someone besides the surgeon (who is occupied) is monitoring the heart rate, respiratory rate, and anesthetic depth at regular intervals. At Austinburg Veterinary Clinic, we exceed most clinics by providing:
- An electrocardiogram (EKG or ECG) to monitor the heart rate and rhythm looking for arrhythmias.
- A pulse oximeter/SPO2 to monitor the percentage of oxygenation of the blood, which should be close to 100%
- Blood pressure monitor because many patient’s blood pressure drops during surgery. If the pressure drops too low, organ systems such as the kidneys can suffer.
- Body temperature monitor so that the patient stays warm and comfortable during the surgical procedure.
- Veterinary Technician (CVT) or trained assistant that is dedicated to monitor and stay with your pet throughout the anesthetic procedure and after surgery.
- Observation during recovery one of the most critical times for a pet is while they are recovering from anesthesia. Where is your pet being recovered and how often are they checked upon. At our clinic, our patients stay with us in the pre-op area until they are able to keep themselves steady and walk. We use pads and blankets to keep them warm, comfortable and secure. Once they are returned to their cage, they are checked on frequently throughout the day.
As you can see, modern anesthesia involves a lot of equipment and expertise, and this unfortunately costs money. Cutting corners by not intubating patients, not keeping patients warm, or skimping on pain medications and monitoring can save money, but the price is decreased comfort and safety for your pet.
Although anesthesia is very safe, because of the unpredictability of the patient, we take anesthesia very seriously here at Austinburg Veterinary Clinic. We feel that performing pre-surgical blood work, using state-of-the-art anesthesia and anesthetic monitoring equipment along with trained veterinary staff is not a compromise that we would make with our own pets and you shouldn’t either.
If you have any questions about an anesthetic procedure for your pet, please speak with one of our doctors. We want you to feel as confident as we are when your pet has his or her next surgical or dental procedure.