Dr. Phil Zeltzman is a mobile, board-certified surgeon in Allentown, PA. Find him online at www.DrPhilZeltzman.com. He is the co-author of “Walk a Hound, Lose a Pound” (www.WalkaHound.com).
Kelly Serfas, a Certified Veterinary Technician in Bethlehem, PA, contributed to this article.
Whether because of a bad personal experience with another pet, or lack of information, many pet owners are scared of having their pets put under anesthesia. Surely, there’s always a risk with anesthesia, for any pet. As the saying goes, there are routine surgeries, but there is no routine anesthesia. Fortunately, veterinary anesthesia has become very safe thanks to better protocols, safer drugs and sophisticated monitoring.
A scientific study led by Dr. Brodbelt, a British, board-certified anesthesiologist, showed that the death rate under sedation or anesthesia is around 0.15% on average. Meaning 99.85% of patients survive anesthesia and sedation, clearly an overwhelming majority. The research is exceptional as 98,000 dogs participated, an unusually large sample for a veterinary study. Anesthesia lasted for an average of one hour, for a variety of procedures performed by general practitioners as well as specialists. Patients were 8 years old on average.
Patients fell into three categories: healthy, ill or very sick. Anesthesia risks were slightly higher with:
• Sick patients (up to 7 times more risk)
• Emergency anesthesia (up to 3 times more risk)
• More involved surgeries (up to 5 times more risk)
• Older patients (up to 7 times more risk for patients over 12 years of age)
• Small patients (up to 8 times more risk for patients under 10 pounds)
• Use of halothane anesthesia gas (up to 8 times more risk compared to isoflurane)
• Brachycephalic breeds (dogs with a flat face, such as Bulldogs and pugs)
The study also revealed that most patients die after anesthesia, and not during anesthesia. The study considers a death to be related to anesthesia when it occurs within the following 48 hours, and especially when it is within the first 3 hours. In fact, over half of the deaths occurred within 3 hours of recovering from anesthesia.
Take Away Points
This should lead you, as your pet’s best advocate, to talk openly with your family vet, no matter how uncomfortable it may seem. How will your pet be monitored during anesthesia? How will your pet be recovered from anesthesia? Who will do that? Where will your pet be recovered, and how, and by whom?
Ideally, pets should be recovered from anesthesia in a specifically-designated area, away from boarding, barking or sick animals. This provides a quiet, relaxing environment. Also ask what will be done to keep your pet warm during and after surgery. (Is It Cold In Here, Or Did Your Pet Just Have Surgery?)
If, in spite of it all, you’re still concerned about your pet’s recovery, and (s)he needs to stay overnight with no supervision, you may want to consider transferring him or her to a referral hospital that provides medical care overnight. Sure, transportation may be annoying, but you will achieve peace of mind, knowing that your best friend is being pamperedand spoiled all night.
If you have any questions or concerns, you should always visit or call your veterinarian – they are your best resource to ensure the health and well-being of your pets.
Anesthesia in Your Pet: What You Need to Know
One of the scariest situations for many pet owners is the thought of putting their beloved companion under anesthesia. But, most pets will require general anesthesia at least once in their lifetime, such as during a spay or neuter, or a dental cleaning. When your pet is under anesthesia, we control her consciousness level, to ensure she does not feel pain and does not move, which are crucial elements of surgery. Pet owners often fear general anesthesia when, in fact, the risk to your pet’s health if you fail to have an important procedure performed can be much more dangerous than anesthesia itself.
If your pet needs to undergo anesthesia, we take every precaution possible to ensure your furry pal remains healthy, and pain-free, and recovers well from an anesthetic procedure. To accomplish this potentially challenging task, our Pet Emergency Clinic and Referral Center team takes steps to help ensure your pet’s health and safety.
Step #1: Keeping your pet safe before anesthesia
Before we begin creating an anesthetic protocol for your pet, we first run preanesthetic blood work. A complete blood count can tell us if your pet is anemic, battling infection, or dehydrated. A chemistry panel checks your pet’s organ functions, glucose level, and electrolyte balances. If your pet’s kidneys or liver aren’t functioning properly, we need to take special precautions, and ensure we tailor her anesthetic protocol to account for decreased organ function.
In addition to preanesthetic blood work, we place an intravenous (IV) catheter in pets undergoing anesthesia. This direct port to your pet’s vein provides many benefits, including:
- Stabilization of blood pressure by administering IV fluids
- Aiding the kidneys in metabolizing anesthetic drugs
- Providing instant access to your pet’s bloodstream, in case of an emergency, and we need to administer life-saving drugs
Once we have completed your pet’s preanesthetic blood work and placed her IV catheter, we formulate an anesthetic protocol based on her organ function, health status, and the procedure we are performing. After we have calculated her pain medication, sedation, induction agent, and emergency drug doses, we administer her premedication cocktail of pain medication and sedation, allowing the pain medication to take effect before putting her fully under general anesthesia.
Step #2: Keeping your pet safe during anesthesia
Once your pet’s pain medication has taken effect, and the sedative has relaxed her, we inject the induction drug, closely monitoring her heart rate and rhythm, respiratory rate, and blood pressure. During your pet’s procedure, we connect her to monitoring equipment, to evaluate her pain, anesthetic depth, temperature, heart function, oxygen level, and blood pressure.
After administering your pet’s induction agent, we place an endotracheal tube (i.e., breathing tube) down her trachea. This tube allows us to provide pure oxygen and anesthetic gas, to help her breathe and remain unconscious throughout the procedure. Correct placement is critical for your pet’s safety and respiratory function, which is why our skilled team has been trained extensively in every anesthesia step.
Step #3: Keeping your pet safe after anesthesia
We continue to closely monitor your pet’s vital signs after our surgeons have completed her procedure. Your pet naturally loses some body heat while under anesthesia, so we ensure she is kept warm and pain-free during her recovery period, as we evaluate pain indicators, such as an increased heart rate, increased respiratory rate, and vocalization. We stay with your pet every moment of her recovery until she is alert enough to pick up her head on her own, and we then follow up with periodic checks of her vital signs and comfort level.
How you can help make anesthesia safe for your pet with at-home changes
While we do everything we can to keep your furry friend safe under anesthesia in our hospital, you can help to ensure your pet is in excellent health for anesthetic procedures. By following these steps at home, together we can make anesthesia as safe as possible for your four-legged pal:
- Withhold food and water from your pet before anesthesia — Follow our team’s instructions, which will vary, depending on your pet’s age and species, and also on the procedure being performed. Many of the pain medications we give your pet can make her vomit, so she cannot have a full stomach while undergoing anesthesia.
- Give your pet’s medications appropriately — If your pet is on chronic medications for heart disease, diabetes, or arthritis pain, ask us what you should give her the morning of surgery.
- Maintain a regular preventive care schedule — Schedule routine wellness visits with your family veterinarian, who will perform baseline blood work to monitor your pet’s normal values, and administer year-round parasite prevention.
- Keep your pet at a healthy weight — Each additional pound over your furry pal’s ideal weight makes anesthesia and surgery more difficult—for example, the heart and lungs must work harder to function properly in an overweight pet, and maintaining an appropriate body temperature is more difficult. Recovery from surgery can also be slowed if your pet is overweight.
We understand that the thought of putting your beloved pet under anesthesia can be frightening. Rest assured that we will take every precaution possible to eliminate risks and keep your best friend safe. If you have any questions regarding anesthesia and the potential risks for your pet, contact our clinic .
Is Anesthesia Safe for Your Pet?
A few weeks ago, I had a client who had a cat with severe dental disease. This client initially declined my strong recommendation for oral surgery because he was afraid of sedating his 14-year-old-cat, Bob. He told me that his friend’s cat died under anesthesia and he would not be able to forgive himself if Bob died while having his teeth cleaned.
To convince him to follow my recommendations, I had to educate Bob’s father and address his fears. First, I told him that not only is Bob suffering from dental disease that could aggravate his kidneys, liver or heart, but he is also in chronic pain. This pain is adversely affecting his quality of life and will only get worse over time. Second, all anesthetic procedures have risks, but they can be greatly minimized with proper pre-anesthetic workup and careful selection of your anesthetic team. After a lengthy discussion, Bob’s father realized the risk of an anesthetic complication was lower than he feared and the value of having oral surgery performed on his best friend was greater than he had thought.
I believe an educated client makes the best health care decision for their pets. I recommend that you ask your veterinarian the following questions to help minimize your pet’s anesthetic risks:
- Does your veterinarian require a pre-surgical examination and blood work before surgery? I believe strongly that every pet should receive a thorough physical examination prior to sedation. In addition, a complete blood cell count (CBC) and comprehensive blood chemistry panel should be performed to make sure that there are no hidden medical problems prior to sedation. For instance, if your pet has kidney or liver issues, an adjustment can be made in the anesthetic protocol. Or, if a heart murmur is discovered, a chest radiograph or ultrasound may be recommended.
- How does your veterinarian monitor your pet’s vitals during the anesthetic procedure? Anesthesia today is much safer than it was five to 10 years ago. Many years ago, veterinarians would monitor their anesthetized pets by looking at their mucous membranes (gums) and listening to their chest. Today, we have sophisticated monitoring equipment that detects small changes in your pet’s blood oxygenation (pulse oximetry), carbon dioxide levels (capnograph), blood pressure, body temperature and electrocardiogram (ECG). Closely monitoring these parameters help prevent small abnormalities from becoming catastrophic event. Make sure your veterinarian has the proper monitoring equipment available for your pet.
- Who monitors the pet when it is under anesthesia? Not only should your veterinarian have the appropriate monitoring equipment, but make sure there are competent people watching it. For instance, at Animal Medical Center of Chicago (AMCOC) a surgical nurse and certified veterinary technician will monitor Bob’s vital parameters while the doctor evaluates his pet’s teeth and performs oral surgery. My technician can detect subtle changes in Bob’s monitored values and make appropriate adjustments before detrimental events occur. For instance, if Bob’s blood oxygen level drops slightly, my technician will quickly adjust his anesthetic depth or increase his rate of respiration to circumvent a problem.
- Who calculates and delivers the anesthetic drugs? Every anesthetic patient must be treated as an individual. The anesthetic drugs may initially be calculated based on your pet’s weight, but they should be given based on your pet’s response to the drug. Most importantly, the person who administers these drugs should be a certified veterinary technician or a veterinarian.
- How does your veterinarian sedate the pet? No dental procedure should be performed without proper sedation. This means all pets are intubated with a tracheal tube and placed on an anesthetic gas machine. In addition, at AMCOC, all anesthetized pets are placed on a mechanical ventilator to ensure your pet breathes regularly and at a proper depth. A proper dental procedure can never be performed on an awake pet.
- Who is with your pet when it wakes up from anesthesia? An anesthetized pet should never be left alone in a cage to recover. During the anesthetic protocol a tracheal tube is inserted down your pet’s trachea and is attached to an anesthetic machine so that anesthetic gases can be delivered to your pet’s lungs. Only when your pet is alert and swallows should this tube be removed. The likelihood that your pet would aspirate fluids on recovery is virtually eliminated with this protocol. In addition, the recovery nurse is there to respond to your pet’s needs, such as pain or anxiety.
Bob was sedated this week and his teeth were cleaned and evaluated. Unfortunately, numerous teeth were surgically extracted but Bob recovered beautifully. Within hours of his anesthetic recovery, Bob was happily eating chicken flavored baby food.
Anesthesia can be scary, but your fears can be minimized with knowledge. Before you sedate your pet for any other surgical procedure, make sure the right people are there with the right monitoring equipment. Please don’t sacrifice quality care because you didn’t know your veterinarian’s anesthetic protocol. Ask your veterinarian how they prepare your pet for his/her anesthetic procedure, who is present, what’s monitored and how the pets recovered. Anesthesia needs its proper respect and don’t ever let anyone convince you otherwise.
Anesthesia is definitely safe in the right hands and with the proper precautions. If not, it can be very dangerous. In conclusion, know your pets true anesthetic risks and choose your veterinarian and anesthetic team wisely.
- At Home: How to teach pets house rules
- Got a sick fish? Call the Bay Area’s fish vet
- Peninsula Humane Society & SPCA’s Pet of the Week: Suzi
- Critter Corner: How to potty train a new dog
- Moles, voles or gophers — what’s destroying my yard?
East Bay SPCA’s entry is “Oaktown Pup,” a parody of Bruno Mars’ “Uptown Funk.” It features Oakland’s SPCA staff and volunteers, and Mayor Libby Schaaf makes a cameo appearance, but the real stars are lots and lots of incredibly cute and adoptable dogs and cats.
You can vote here and, unlike the presidential election, you can vote once a day until 9 p.m. Thursday. The winner will be announced on Nov. 17.
This election won’t decide the next leader of the free world, but it will make you smile and perhaps forget some of the past 18 months of human campaigning.
Safe Anesthesia for Pets
For most pet parents, the thought of their pets having to undergo anesthesia instills fear and worry. This is often caused by a lack of knowledge about what questions to ask your veterinarian, and what constitutes safe anesthesia. This article by Dr. Louise Murray explains in great detail what you should look for to ensure that your pet’s anesthetic procedure is done safely.
Guest Post by Dr. Louise Murray
As you can tell, my mission is to give pet owners the information they need to protect their pets’ health and to wisely choose the best veterinary practice to help achieve that. I believe that knowledge is indeed power and have seen too many pets suffer because their owners did not have the tools they needed to advocate for their animal companions.
Today I suddenly realized (duh!) that just talking about ways you can protect your pet isn’t enough I need to show you. It’s one thing to babble on and on about safe anesthesia and having your older pet’s blood pressure checked and ensuring your pet receives safe and adequate pain control. It’s another to let you see for yourself. If nothing else, pictures are a lot less boring then listening to my nagging.
So, today let’s talk about, and take a look at, what is required for safe anesthesia. Safe anesthesia requires monitoring equipment, so that when your pet’s oxygen level or heart rate or blood pressure drops, someone knows about it and can do something to fix the problem before your pet actually stops breathing or her heart stops and…well, you know. Pets can die under anesthesia, and proper monitoring vastly reduces the chance of that.
At a minimum, your pet should be hooked up to a handy gadget called a pulse oximeter. This little gem monitors the animal’s blood oxygen level and heart rate, good parameters to keep an eye on if you want to make sure someone keeps living.
Here’s a picture of a kitty having his blood oxygen level and heart rate measured with a pulse oximeter. I think you’ll agree he seems quite happy about it.
You’re right, he’s not under anesthesia. You can also use a pulse oximeter in awake animals when you are concerned about their breathing, such as animals in heart failure or those with pneumonia. If the oxygen level is too low, the vet needs to do something about it rather quickly, such as place the animal in an oxygen cage.
Another component of safe anesthesia is called intubation. This means placing a tube in the animal’s trachea (windpipe) to deliver oxygen and anesthetic gas. If an animal under anesthesia is not intubated (if the anesthesia is delivered with a mask, or just by injection), there’s not much anyone can do if that animal start to crash or stops breathing. But if the animal is intubated, the vets or technicians can ventilate the animal (breathe for her).For example, if the pulse oximeter shows the animal’s oxygen level is dropping, the folks doing the anesthesia can give the animal a few oxygen-rich breaths by sqeezing on the oxygen bag a few times. Or, as I mentioned above, if the animal stops breathing completely, they can use the tube to breath for the animal. Can’t do that with a mask and certainly not for an animal who just got an injection. Then it’s rush rush rush to try to get a tube in before the pet dies. Not good.
Here’s a kitty who is under anesthesia and intubated.
See that little black bag on the lower left? If the kitty’s oxygen level drops or she stops breathing, the vets or techs can breathe for her by squeezing the bag.That way they can keep her cute little tongue nice and pink like it is in the picture.
The other thing I want you to notice about the cat above is that she has in IV catheter in her leg. This is also super important for safe anesthesia. If this little cat’s heart slows down, she can be given a drug to speed it back up through the catheter. If her heart stops, she can be given epinephrine to help re-start it. If her blood pressure drops, she can be given a bolus of IV fluids or medications to correct this.
OK, gotta run to work now. Now you know all about safe anesthesia don’t let your pets receive anything less!
Dr. Louise Murray is an experienced and highly regarded authority in her profession. During her ten-plus years as a practitioner, she has lectured frequently on a wide range of topics, gaining her the respect of her colleagues. She has also been honored with several prestigious awards and has had her research published in the Journal of the American Veterinary Medical Association.
Dr. Murray is also the author of Vet Confidential: An Insider’s Guide to Protecting Your Pet’s Health. For more information about Dr. Murray, please visit her website.