Monday, February 18, 2013

Straight Talk: Anesthesia & Your Pet

...and the questions YOU need to ask!

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Monday Medical Dental Health Series: Part 3
Previous:   2/4/13: Overview
                2/11/13: Interview with Dr. Huber, part 1
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If you've ever had your pets teeth cleaned, you know that feeling of anxiety that comes with knowing your pet is being given anesthesia for this procedure.

Maxwell examines Faraday's teeth up close & personal.
"Dood, you need to start flossing!"
Some people worry less about it, others more. There's always the tale about the friend of a friend who unexpectedly lost their beloved pet from complications due to anesthesia. And it's not just with animals - a friend who volunteers at our local shelter told me one night recently that she lost a very close [human] friend to unexpected complications under anesthesia, too.

I have to admit, my concerns ramped up a while back when a vet tech at our shelter informed me that cats need to be monitored closely as they often stop breathing while sedated.

So I asked our veterinarian about it. You met Dr. Sara Huber last week during part 1 of this interview on dental health. Now she answers my concerns about anesthesia. First up: do cats stop breathing under anesthesia?

Dr. Huber:  Certain drugs that we use to intubate patients can cause what we call a transient apnea. This means that they will hold their breath for several seconds. But in 99% of cases, these patients will spontaneously begin to breathe again on their own.

For the other cases, we will use a bag on our anesthetic machine to administer a few breaths for the patient until their own respiratory center takes over and tells them to breathe again.

In very rare cases, the animal will not breathe on his own. Should that occur, a technician will administer breaths for them throughout the procedure.

I personally have never had a patient that had to be 'bagged' the entire time, but it is a remote possibility. This is just another reason why we have continuous electronic and hand monitoring of the patient throughout the procedure. If a patient does stop breathing for whatever reason, we have many ways to help them return to spontaneous respiration.

Green bag allows a technician to breathe for your pet
(this unit from shopmedvet.com)
As I mentioned last week, we tailor our anesthesia protocols for each patient, taking into account such things as their age, any underlying disease, or tendency toward respiratory distress.

The entire time he's under anesthesia your pet’s breathing, pulse, oxygen level, and heart activity is being monitored, and a blood pressure is taken every 3-5 minutes.

This way we know we’ve taken every possible precaution to keep your pet safe and healthy while anesthetized. And this is standard procedure in most veterinary practices.

A Tonk's Tail: We've heard that cats have more trouble coming out from under anesthesia than dogs do. We've also heard that some breeds are more prone to respiratory distress than others.
Do you do anything differently in these situations?

DH: I think it's far more important to base our care on an individual basis rather than a breed basis. Yes, some dog and cat breeds may have shortened nasal passages. Of course we take that into account, but any veterinarian will tell you that it's far more important to know an animal's specific medical history and current state of health.
Champion Persian (GNU Free License)

During recovery, all animals are monitored by a technician for any distress and a veterinarian is always nearby to address any emergent issues.

Every anesthetic procedure comes with some degree of inherent risk (and by the way, this goes for human beings as well!). So I emphasize again the importance of pre-anesthetic testing and continuous monitoring to give your pet the best chance for a routine procedure and a healthy recovery.

The only cat I've ever seen lost to complications post-anesthesia was a cat whose owner refused to give permission for a pre-dental blood screening.

Thankfully, our practice refuses to perform a procedure like this without a full blood panel. These tests tell you so much, and give warning for conditions that can be life-threatening where anesthesia is concerned. 

ATT: Are there any actions a pet owner should take prior to a dental cleaning?

DH:  I would say that before you agree to any procedure, you should have a detailed discussion with your vet.

If your veterinarian does not offer up the following information, here are several important questions that I think should be raised:
  1. What pre-anesthetic blood testing do you perform prior to the procedure?
  2. What monitoring equipment is used during and post procedure?
  3. Will the doctor be present for the entire procedure?
  4. Do you have dental radiography?
    This is a very important question! Dental x-rays can help diagnose suspected disease definitively and often will uncover disease we did not know was present. It can also help the doctor to assure that the entire root was removed after an extraction - an invaluable tool.
  5. What kind of home care do you recommend following the procedure?
ATT: Do you have any last words of advice you'd like to leave us with?

Quite the under bite! (Photo: public domain)
DH: The longer you wait to get a dental procedure done, the higher the risk your pet will need to have other procedures such as teeth extractions. These will ultimately end up costing you more money and causing your pet more pain.

So I would strongly advise all pet owners to heed the recommendations of their veterinarian and have routine dental cleanings performed on their pets.

I understand that they can often be somewhat expensive, but truthfully it saves the pet a lot of possible pain and illness down the road.

Many thanks to Dr. Sara Huber for her time answering these questions on pet dental health!

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Additional sources:

Understanding Anesthesia in Cats
Pet Meds Online: Cat Health
Trupanion Breed Guide Health Concerns

25 comments:

  1. Have a magnificent Monday. Clean teeth, happy feet we say.
    Best wishes Molly

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  2. Thanks for posting this. Anesthesia does worry Mom for us kitties.

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  3. I worry a lot if Eric has to be anaesthetised, as 3 or so years ago he had a very bad reaction to the anaesthetic (Domitor) which is now marked in red on his records to be avoided. He had come round and appeared ready to come home with us. About an hour after getting him home he collapsed and went limp. We thought we had lost him, but thankfully he made a full recovery. He may need a liver scan after his next round of blood tests and will have a light anaesthetic, so that will be another worrying time.

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    1. Domitor looks to be an induction agent - which is often used as step 1 in a standard 2-step anesthetic process. There are other induction agents that your vet can use, and some of them metabolize a lot more quickly than Dormitol. Also, you may not need an induction agent at all for a dental. Our vet decided to stop administering it to Ryker when they did his dentals, and just opted for the isofluorine - which is step 2, the inhaled anesthetic.

      You might be interested in reading the first link under "sources" at the end...the article entitled "Understanding anesthesia in Cats". It has a link to another article as well that you might find interesting.

      As I mentioned before, for dental procedures where pain management is not really an issue, the first stage of anesthesia, known as the induction agent, may not be absolutely necessary, and so our vet decided to stop giving Ryker the induction agent after he had such a hard time shaking off its 'loopy' effects. And he did fine just with the inhaled anesthetic - isofluorine.

      But this is just my layman's understanding - it sounds as if your vet is definitely aware of the situation and on top of it, which is good! I'm the kind of person who needs to know everything I can about a procedure before it occurs, which is why I'm so very appreciative of Dr. Huber's time in answering questions on this subject!

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  4. Great information. We had a scary experience with anesthesia years ago with our cat Tutu. She almost died during a dental, but fortunately was brought back and went on to live a long life.



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    1. We can identify with the scary experience! A local shelter (which cannot afford to do blood panels before every spay or dental) recently lost a cat from anesthesia complications. It's quite possible they might have found a heart or kidney issue had they done that... We're not coming down on the shelter, we understand that they often have limited resources and must do the best with what they have.

      We're so glad Tutu made it and lived a long happy life!

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  5. Whisky took a pretty long time to get back to her normal self after her last dental (several years ago). Thankfully, she is pretty cooperative when it comes to getting her teeth brushed so we've been able to avoid another dental for some time now. We'll have her teeth checked in her next annual check up. Cosmo is the only one with some plaque build up so we'll be getting it looked at soon.
    Thanks for this post. Very informative!

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  6. Luckily Alfie has only been put to sleep once when he had an operation. We never thought of the anesthetic, we just wanted him well. This was a great post guys :) xx00xx

    Mollie and Alfie

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  7. We've only been "fixed" and our teeth are apparently fine, but we're sure our human will try to be in the surgery with us if we every need to go under anesthetic. She can be so embarassing.

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  8. Very interesting and worthwhile information here. I've always known there is some risk with being put "under." But so far all our pets have handled it well.

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  9. Another great post! We actually used a very fancy ventilator at our clinic that would breath for the patients during the whole procedure. The machine was a little scary to use at first. I honestly don't think it was completely necessary for most procedures and more of a hassle to use. But the management wanted it to be used for everything so we did.

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  10. Excellent post! Thanks for that information. I had my teefs cleaned a few months ago and I didn't have to have any extractions!

    Wally

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  11. Great post, friends! We worry about anesthesia with Sammy, because he's so old and has other issues like a heart murmur. But as Dr. Huber said, there is always some inherent risk.

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  12. Oh wow, Im sposed to have my teefs cleaned next week. How worried should I be about that? ~ Ayla

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    1. Ayla, you's had your teefies done before, right? We're assuming you sailed through last time. Does your V-E-T do blood work? If so, your human has done everything right! We'll still be crossing our paws for you though!!! Crossed paws are always good things to do!

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  13. This series is very helpful especially by giving what questions should be asked if these procedures are needed. Thank for going to this trouble to really give all of this information out its very useful.

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  14. You have a pawsome Vet! I've really enjoyed reading your posts with her. In particular on this post, the questions that she recommends asking about prior to a procedure are invaluable. Thank you for this!
    : ) GG

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  15. Great info, says the Human! Me, I don't want to even THINK about the Stabby Place. Puts paws over ears--lalalalalalalalalalalalalala

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  16. What a great vet you have and what great information....

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  17. Thank you for this great article. I think the bottom line is that medicine is the art of compromise. You have to figure out what benefit you are getting from something (the dental, for example) versus what the risk is (anaesthesia in this case). And that takes some thinking, discussing it with your vet and finally making a decision that's right for you and your pet.

    Remember, each case is individual. You are not an "average," you are you and only you can finally decide what's right for you (with your vet's help, of course.)

    Purrrrrrrrrrrrrrs.

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  18. and DON´T forget to brush your teeth´s ( say´s my mom )
    Pawsome interview with your Vet !
    XOXO

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  19. Excellent post. We don't have any reactions but a before cat did, Mommy is extra special carefuls and has had us all tested first.
    Kissses
    Nellie

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  20. This is very informative, thank you. I always worry about the anaesthetic for sure.

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