by Paul Skellenger
As pet owners, we are all concerned about the risks associated with anesthesia and surgery. Anesthesia and surgery is a more exact science than you might expect. The safety of general anesthesia is dependent upon the anesthetic agent, the equipment used, the methods of patient monitoring, patient status, and the expertise of the people involved. In fact, the safety of general anesthesia is dramatically improved by giving adequate attention to each of these areas.
To the doctors and staff of Research Pet and Bird Hospital, nothing is more important than taking steps to maximize the safety of a procedure. In fact, our core values demand that we use only the safest anesthetic agents, precise delivery systems, intense patient monitoring, and all measures available to improve the patient’s status to make the procedure a success. For us, it is a mission. Our focus and intensity does not wane until the patient is fully recovered and ready to go home. Anything else is a complete failure in our minds and hearts.
If you are planning to have your dog spayed, cat neutered, your bird’s broken leg fixed, the mass in your ferret biopsied, or the teeth in your rabbit floated, these procedures are performed under general anesthesia. Your pet’s safety is our greatest concern.
Our goal is to minimize the risks associated with anesthesia. In order to make anesthesia as safe as possible, we use some of the safest anesthetic agents available. The use of precision vaporizers allows a constant and exact amount of anesthetic to enter the patient and allow rapid adjustments of anesthetic depth and rapid elimination of the anesthetic agent permitting quick recoveries. Our anesthetic machines also deliver 100% oxygen to provide adequate oxygen delivery to the tissues.
Our surgical nurses are the best in the business. They are hand picked to take on this profound responsibility. They understand this tremendous responsibility and they take it very seriously. We charge them with caring for the most important animals on the planet, your pet. To them, guiding your pet through the procedure to a successful conclusion is their single most important task. We train them to be the best. They are so good, our doctors ask for their assistance on their own pets. Our surgical nurses are intensely trained and care so much that often it may seem they are making too many recommendations. The reason is simple, your pet’s safety is their responsibility and they want every advantage.
If you have ever seen us working on your pet under anesthesia, you would notice all the devices connected to your pet. We use state of the art monitoring equipment to provide up to the second information about patient status. Continuous cardiac and respiratory monitoring is performed and adjustments in anesthetic depth are based on objective measurements such as pulse rate, respiratory rate, % saturation of hemoglobin with oxygen (pulse oximetry), blood pressure, and electrocardiographic tracings. These measurements are balanced along with our assessments of patient status.
We take into account variables such as patient age, size, weight, and health as well as the nature and expected duration of the procedure and make adjustments according to changing observations or expectations during the anesthetic period. Without a doubt, one of the most important keys to the safe conclusion of an anesthetic event is understanding patient status. What we learn during your pet’s history and physical help us identify the three greatest risk factors: the presence of pre-existing illness, organ dysfunction, or sensitivity on the part of an individual to a particular anesthetic agent. In addition, we strongly recommend pre-surgical blood screens or profiles for all patients for all anesthetic procedures. In some cases, we are already aware of a pre-existing condition that should be monitored by these tests. In other cases, these tests may reveal a hidden illness or problem that could increase the patient’s anesthetic risk. Complications to anesthesia are rare, but some are serious and may result in patient death. Under no circumstances do we want to jeopardize your pet’s health if we feel the risk is too high.
Pre-surgical testing decreases the overall risk of anesthesia and helps prevent unexpected complications to anesthesia and surgery. This helps to decrease the risk of anesthesia by identifying problems before the procedure, instead of finding out about them afterwards. Typical tests are a complete blood count (CBC) to identify hidden infection, anemia, potential bleeding problem, or immune suppression. It also includes chemistry tests to avoid stumbling into situations where inadequate organ function impairs anesthetic elimination or increases the likelihood of complications. An EKG is a simple way to screen patients for heart disease and potentially life threatening heart rhythm abnormalities. The testing is designed to complement the doctor’s assessment of patient status and risk of the anesthetic procedure. It is used to uncover undetected illness or to monitor known problems. It provides valuable information that may prevent us from unnecessarily endangering our patient. The likelihood that the findings will impact our decision to perform a procedure in healthy adults is small, but this does happen and there is no question those patients will be better off in the long run with that information. In some cases, a decision is made to postpone the procedure and try to resolve the problem first. In other words the pre-surgical testing decreases the overall risk of anesthesia and helps prevent unexpected complications to anesthesia and surgery. This type of testing is needed and is extremely important for any patient that will be anesthetized.
Intravenous catheters are always recommended to provide immediate access should emergency measures or other medications become suddenly necessary during the procedure. The administration of intravenous fluids during anesthesia is known to improve patient recovery and is a wonderful way to improve patient status.
If we made the recommendation for your pet to have something done with general anesthesia, you can be sure the benefits outweigh the risks and that we will do everything possible to bring about an uneventful recovery.
Some of the agents we use for anesthesia are Sevoflurane and Isoflurane (anesthetic gases) and Propofol (an intravenous induction agent to take the patient from awake to anesthesia).
Some of the other medications we use before and during surgery are sedatives, tranquilizers, and pain medications may be given alone or in combination. We use tranquilizers such as valium or acepromazine; pain medications such as buprenorphine, morphine, butorphanol; and non steroid anti inflammatory drugs such as Rimadyl or Metacam. Patients are maintained on anesthesia by driving the anesthetic agent with oxygen through an airway tube known as an endotracheal tube.
Species of animals we perform anesthesia and surgery on include dogs, cats, birds, ferrets, rabbits, guinea pigs, rats, mice, gerbils, hamsters, hedgehogs, prairie dogs, and chinchillas, lizards, snakes, and turtles.
Common procedures include spay, neuter, endoscopy, lump removal, tumor biopsy, intestinal biopsy, liver biopsy, pancreatic biopsy, intestinal obstruction, foreign body removal, mass removal, tumor removal, fracture repair, bone plating, knee surgery, ACL repair, tracheoscopy, esophagoscopy, rhinoscopy, nasal biopsy, lymph nod biopsy, radiography, contrast studies, dewclaw removal, abscess surgery, urethral obstruction, bladder stone removal, fustula removal, resection and anastamosis, intussusception, perineal adenoma, perineal urethrostomy, perineal hernia, abdominal hernia, diaphragmatiac hernia, inguinal hernia, dentistry, dental cleaning, dental prophy, tooth extraction, oral surgery, periodontal therapy, root planing, gingivoplasy, external fixation, vaginoscopy, urethroscopy, cystoscopy, cysotomy, gastropexy, gastrotomy, feeding tube placement, jejunostomy, mast cell tumor removal, bile duct surgery, gall bladder surgery, corneal and eyelid surgery, enucleation, bulla osteotomy, lateral ear resection, total ear canal ablation, pelvic surgery, correctional osteotomy, and surgical sexing of birds.
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