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Anaesthesia

Is Anaesthesia safe?

vets-auckland-clinic-veterinarian-pet-vaccinations-vet-IMG_7358Veterinarians anaesthetise animals on a daily basis. At least once per week in any clinic, a pet owner expresses concern about anaesthesia: is it safe? Will my pet survive the procedure?

Modern anaesthesia is very safe. The risk of a pet dying under anaesthesia is less than 0.01%. The rare patients that are lost under anaesthesia are generally emergency surgeries, when the patient’s condition is extremely critical. The risk of a pet dying under anaesthesia while undergoing a routine spay, neuter, dental or mass removal is extremely low, but this risk can be affected by the anaesthetic drugs used and the monitoring of the patient.

Can you imagine an anaesthesiologist 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(and surprisingly,) there are no standards of care for veterinary anaesthesia, and some clinics are still using out-of-date techniques.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 anaesthetic event:

1. Is pre-anaesthetic blood work run?

All patients , not just the old or sick, should have basic pre-anaesthetic blood test performed checking the blood sugar, kidney and liver values, and red and white and blood cell count. Many animals will require more extensive pre-anaesthetic blood work. Even in animals under one year old, blood work will occasionally detect abnormalities that could affect anaesthesia.

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2. Are intravenous fluids administered during anaesthesia?

Many drugs used for general anaesthesia tend to cause blood pressure to decrease and there will be fluid losses from surgery and evaporation. Giving intravenous fluids will combat these losses and the decrease in blood pressure. In addition, if there are any adverse reactions under anaesthesia, an intravenous catheter allows immediate administration of emergency drugs.

3. Is the pet’s body temperature maintained during and after anaesthesia?

All animals, especially rodents, cats, and small dogs, lose a lot of body heat under anaesthesia. The resulting hypothermia can slow the anaesthetic 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 burns.

4. Is the pet intubated, and what anaesthetic gas is used?

Intubation means that the patient has an endotracheal tube placed through the mouth and into the trachea, through which gas anaesthetic is administrated. 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 anaesthesia. The modern gas anaesthetics are Isoflurane and Sevoflurane.

5. What anaesthesia do we use for small rodents

We use the newest “triple anaesthesia” for our rodent patients, which is a fully reversible injectable anaesthesia composed of 3 different drugs. All 3 of these drugs are fully reversible once the diagnostic or surgical procedure is finished. During the anaesthesia we provide additional oxygen supplementation.

6. What pain control is used?

Surgery hurts! It doesn’t matter if the patient is a human, a dog or a guinea pig. Analgesia is the relief of pain, and in modern anaesthetic protocols we strive for pre-emptive analgesia (blocking the pain pathways from as many directions as possible).

7. What monitoring techniques are used?

It is critical to monitor the patient’s vitals while under anaesthesia 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 anaesthetic depth.

Additional commonly used monitoring techniques include:

– An electrocardiogram (EKG) to monitor the heart rhythm for arrhythmias.

– A pulse oximeter to monitor the percentage oxygenation of the blood, which should be close to 100%.

– A machine to monitor the blood pressure.

– A machine (apnoea monitor or capnograph) to monitor the respiratory rate and carbon dioxide level.

Another concern many pet owners have is the cost of anaesthesia: Why is it so expensive? Why does Dr. X charge $375 for a dental while Dr. Y down the street only charges $100? As you can see, modern anaesthesia 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.

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