Addressing Hesitancy Around Anesthesia
February 23, 2023
A concerning recommendation for a pet owner to hear from their veterinarian is that their pet needs treatment that requires general anesthesia. We have all read/heard stories about pets going under anesthesia for a routine procedure and not going home afterward. While that fear is understandable and anesthesia is never without any risks, the veterinary profession has made many advancements to improve the quality and safety of anesthesia for our patients. At 4 Paws, we recognize the hesitancy around anesthesia as a legitimate concern (we have all had to put our own pets under anesthesia before) and do everything we can make the experience as positive as possible.
Some pet owners may feel that other than an initial spay or neuter procedure, their pet will never have to go under anesthesia again, especially as the pet gets older. The fact is, general anesthesia will likely be necessary for every pet at some point whether it is for a routine dental cleaning or to extract a painful tooth, remove an abnormal growth or surgically repair an injury. At 4 Paws, we have several anesthetic safety standards and protocols in place to meet the needs of all of our patients regardless of age or underlying medical conditions. Every pet is examined by a doctor initially and bloodwork is performed to be sure they are a good anesthetic candidate. This means listening to their heart and lungs, assessing their circulatory system, checking their liver and kidney function and looking for other underlying conditions that may pose a risk to an anesthetic outcome. If a potential risk is identified such as a heart condition, the procedure is put on hold and additional testing is done to be sure we are safely proceeding with anesthesia in the future.
So what happens once a pet is checked in to the clinic for an anesthetic procedure? Each patient is examined again by the doctor, the procedure is verified, the medical history is reviewed, bloodwork is reviewed again and the pet’s temperature, pulse and respiration is taken. Once we are sure the pet is safe to continue with anesthesia, the pet is given 1-2 injections of sedation to help keep them calm and lower the amount of other anesthetic drugs that are needed to keep them asleep. An intravenous (IV) catheter is placed so that injectable IV medications and fluids can be administered as needed. Once the pet is sedate we check their temperature, pulse and respiration again as an additional safety measure before giving an injection of a medication that will make them fall asleep. This allows us to safely place an endotracheal tube that will help to protect the pet’s airway and deliver oxygen and gas anesthesia to the patient during the procedure. Every patient is connected to IV fluids to maintain blood pressure, hydration and circulation. The pet is kept on a heating pad and covered with warm blankets. Each patient is closely monitored by a veterinary technician using our state of the art monitoring equipment that checks heart rate and rhythm (EKG), respiratory rate and quality, temperature, blood pressure and blood oxygen saturation. These parameters are monitored by the technician every 5 minutes and the doctor is present at all times to address any variances if they arise. At 4 Paws, we always assign two technicians to assist the doctor with monitoring our patients throughout their stay with us.
The recovery process is just as important as the anesthesia itself. We use gas anesthesia as it is metabolized quickly by the body. This allows for a quick recovery once the procedure is complete and the gas anesthesia is turned off. We recover our patients as gently as possible and continue to monitor their vital parameters such as heart rate, respiratory rate and temperature. The endotracheal tube is only removed once we are certain that the pet is able to breathe efficiently on their own. We place the patient in a warmed recovery area in view of all other hospital staff and continue to monitor their vitals for the next few hours. This ensures that we are sending each pet home in stable condition and as comfortable as possible.
So what happens if something goes wrong? As stated before, anesthesia is not completely without risks, no matter how many safety procedures we have in place. This is why the doctors and staff are trained to monitor the pet’s vital signs closely while under anesthesia so that we can intervene and correct any abnormalities before they become a problem. In some cases, adjusting the gas anesthesia or IV fluid amount is all that is needed to keep the pet’s vital parameters normal. In other cases, injectable medications can be used to help increase heart rate and blood pressure safely. If our patient is still not doing well under anesthesia, meaning that we are not able to keep their vital parameters in an acceptable range despite our efforts, we will wake the patient up as soon as we can safely do so as not to compromise our patient’s safety. Our number one goal is always to provide responsible treatment for our patients so that they can return to the owner happy and healthy.