When King, a 22-year-old cat, came into my office with a broken leg, his owner said she felt his case was hopeless. She had been to another vet who had refused to anesthetize him to set the leg, fearing he would not wake up from the procedure.
After evaluating his X-rays, I told his owners that King would suffer greatly with his fractured hip and likely die from complications related to his age, inability to stand to use the litter box and bed sores. I encouraged them to have the leg set under anesthesia and to apply a custom-made, lightweight cast.
King had the procedure, and recovered well from the anesthesia. His fracture healed, and he lived comfortably until passing in his sleep at age 24.
Sofie, a 15-year-old poodle, had very bad gingivitis, tartar and a heart murmur. I encouraged her owner to get necessary dental care so she could have more comfort eating and fewer bacterial infections.
Bacteria from her gum disease was silently damaging internal organs: the heart, liver and kidneys. Sofie's owner was afraid she would die under anesthesia, so she delayed a dental cleaning. A little over two years later, Sofie tripped on the stairs and hit her chin. Chronic infection caused Sofie's jaw to break from the fall.
When she came to the office, I anesthetized her, pulled diseased teeth and wired her jaw back together. Her owner was amazed that she survived. She was even more amazed when she took Sofie home. She was more active than she had been in years. Her owner realized how greatly the dental infection had impacted Sofie's daily life and wished she had her dental care done sooner.
Both Sofie and King are good examples of cases in which emergencies forced us to anesthetize high-risk pets. Both had very good outcomes.
These steps can make anesthesia safer for all pets:
1. Assuring your vet knows all risk factors prior to surgery. A thorough physical exam is just the start.
2. Running pre-anesthetic blood tests. A blood count and chemistry panel, in addition to heartworm, Lyme disease testing for dogs, and viral tests for cats, are important. Some pets should have additional tests such as clotting profiles, Von Willebrand disease testing, blood typing, and urinalysis prior to anesthesia.
3. Having a variety of anesthetic plans, depending on health status. Some drugs are cleared through the liver versus the kidneys. Some prevent seizures and some are better for heart patients. The same considerations apply for pain medications. When deciding about testing before a procedure, know that 20 percent of young healthy pets and 80 percent of pets over 6 years have an abnormal test result that causes our vets to modify the anesthetic or pain control plan. Having a vet who provides for and understands these options is advantageous.
4. Running a pre-anesthetic EKG.
5. Monitoring by a trained technician, in addition to a heart rate, respiratory, oxygen levels, CO2, EKG and blood pressure monitor are excellent in preventing anesthetic emergencies. A machine which provides all this info costs $8,000, so not all clinics offer all these monitors.
Pet owners can help their pets have fewer risks by providing your vet with as complete and thorough a health and medication history as possible. Disclose all prior drug, vaccine and other reactions before the procedure. Follow all fasting instructions, and be honest if you forget and feed your pet.
Read the consent form information and answer all questions thoroughly. Ask about what monitoring devices and procedures will be used to improve the safety of your pet's anesthesia. Learn about risk factors for your pet's breed and condition; research additional tests that your pet may need. Don't assume he will be tested for everything possible. Ask before the procedure.
Newer and safer anesthetics are available. Don't be afraid of having a procedure for your pet; be informed.
Dr. Cynthia Maro is a veterinarian at the Ellwood Animal Hospital in Ellwood City and the Chippewa Animal Hospital in Chippewa Township. She writes a biweekly column on pet care and health issues. If you have a topic you’d like addressed, please e-mail firstname.lastname@example.org.