We have been booked with a lot of surgeries and dental cleanings lately, so it seemed like the perfect time to revisit anesthesia. Anesthesia and surgery can be a scary thing for pet owners. One of the most common fears that I hear about procedures is putting pets under anesthesia. I think that because this is such an unknown for people, it can bring a lot of fear. The good thing is that anesthesia has come a long way, and most veterinarians monitor very closely. Hopefully hearing about our protocols in depth will make you more comfortable for your pet’s next anesthesia.
Many veterinary hospitals have optional, but recommended, support systems for pets during anesthesia. These aren’t all optional at some clinics, and a few clinics don’t offer them. Feel free to speak to your veterinarian about their protocols, but today I will just discuss ours. One very important example is the placement of an intravenous (IV) catheter. IV catheters allow pets to receive fluid support during anesthesia. This means that we give them an exact amount of fluids to account for not eating before surgery and any losses during surgery. Keeping a pet’s hydration status stable helps all of the medications we use to be metabolized correctly. Many of the medications are processed by the kidneys, so this means that if our pets are perfectly hydrated their kidneys will work more effectively. Fluid balancing helps us control blood pressure as well. Also, an IV catheter allows us to have immediate access to a vein in the rare case of an emergency. This time-saving step can make a huge difference during emergency situations.
IV catheters are optional for procedures at many clinics because sometimes that difference in cost can make the difference between doing a necessary procedure or not. However, they are always recommended. The longer an anesthetic period will be, the older or more unstable a pet the more important having a catheter placed is.
Next, a pre-anesthetic blood work panel is recommended. On younger dogs, it allows us to establish their baseline values and make sure they do not have any inherited problems. As a dog ages, their organs undergo changes. Bloodwork to detect these changes allows us to change our anesthetic protocol to better suit the individual patient’s needs. If your dog gets annual bloodwork for medications and monitoring anyways, this is a great time to do it.
The first thing that happens before any surgery is a physical exam. Even if a pet has just been in, their heart and lungs should be listened to for any changes or abnormalities. Bloodwork is drawn at this time as well (unless it was done recently.) Once bloodwork is run and evaluated, pets are given a small dose of “pre-anesthetic”. These medications usually help in advance with surgical pain and also help the pet become slightly sleepy and relaxed. At this point, we place an intravenous catheter. After this, pets are given a medication that puts them under anesthesia. The length of the procedure and the health status of the patient will determine the medicine used.
In general anesthesia, an endotracheal (ET) tube is placed. This is a tube in the trachea (windpipe) that delivers pure oxygen and anesthetic gas to the pet. This is how we maintain the appropriate plane of anesthesia. It also ensures proper ventilation and prevents anything in the mouth from entering the lungs. While under anesthesia our swallow reflex is reduced, so we take care to make sure nothing from the mouth can go down the trachea instead of the esophagus. This is especially important during dental cleanings since we are removing bacteria from the teeth and do not want it to access the lungs at any point. Intubating is not optional, but in very short anesthesias (for example, a small cut being sutured) it is not always necessary. Your veterinarian will determine this. Some dogs benefit greatly from breathing pure oxygen during any procedure, especially pets with lung compromise or brachycephalic breeds (like pugs, boxers, and bulldogs.)
We keep pets on a heated air blanket. Since they are not able to control their own temperatures, keeping them at a consistent, warm temperature helps them metabolize the medication correctly, helps them wake up better, and keeps them more comfortable. We also recover pets in warmed cages for the same reason.
Up to this point, everything is almost exactly the same as would happen to you if you underwent surgery. The only difference being, that things are not optional for humans. Anesthetic protocols are very well studied in both humans and pets, so while circumstances may vary they are incredibly safe.
Of course, if you have specific questions about your pet’s anesthesia or surgery your veterinarian can elaborate. These are things that we do every day and that have been done for as long as veterinary medicine has existed. Protocols are always being updated, and we stay current on the best medications and safest way to anesthetize your pet. While the thought of pets undergoing anesthesia can be concerning to owners, know that everything is very well controlled and safe. Your veterinarian would not recommend a procedure if they didn’t feel your pet was healthy enough for it, and in most cases, they are much better off undergoing short anesthesia to help prevent a long term problem.