Anesthesia - What happens

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Hayley92
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Anesthesia - What happens

Post by Hayley92 »

Hi guys My name is Hayley and I am a student veterinary nurse from RVC, England. I am troubled by the ammount of anesthesia posts I see on this forum and would like to try and put a reassuring 'guide' to what happens when your dog goes in for surgery. This will be a general overview of a more routine procedure as less routine procedures sometimes require administration of extra drugs before (removing mast cell tumours etc)

When your pet is scheduled for surgery you should be given infomation on starving your dog. Starving is important as like humans, dogs and cats can vomit during surgery.
On the arrival, a vet or nurse will go over the consent form, making sure the dog was starved and making sure telephone numbers are correct. They will also give you the option of pre op bloods. If you consent to these during the primary physical examination a small amount of blood is taken, these are usually run in two separate machines. Biochemistry which checks levels of hormones released by organs for example high level enzyme and hematology which measures the amount of separate components of the blood, this can show things such as infection or anemia.
On arrival your dog will be put into a kennel with a bed and appropriate temperature control (heat pads if its cold, fans etc if too hot) and allowed to settle. Once settled the dog will have a physical examination, weight check and if appropriate blood taken and are returned to the kennel. The bloods will be run, the vet will decide from the results if they are safe to go ahead, some older dogs are placed in IV fluids before surgery. If the vet gives the go ahead the dog will receive a pre med, these can vary on practice, species and other factors. They are worked out according to weight and usually seen administered intramuscularly. The premed relaxes the dog using mild sedation and will usually contain an analgesic. the first stage of monitoring will begin just before the pre med is administered with heart rate, resp rate and capilary refil time being noted just before.

Once the pre med has taken affect the dog is taken into prep. A final physical exam is carried out to ensure nothing has changed. If the vet is happy an anesthesic induction agent is administered in the cephalic vein (vein running down the forelimb) some dogs require the area to be clipped slightly in order to see the vein clearer. Although the agent is worked out again on weight, the agent is injected slowly while the vet monitors the dogs reaction, sometimes not all is needed to achieve a high standard of induction.
Very quickily after, a tube is placed in the trachea, this administers anesthetic gas and oxygen. Before anything else is done a nurse will monitor the patient for a while. Commonly the things checked are heart rate, resp rate, CRT (capilary refil time, done on the gums), eye position, jaw ton and blink reflex although the dog is monitored constantly which means any abnormalities will be picked up. After monitoring for a minute or so the dog will be clipped and scrubbed according to the procedure and taken into theatre. The procedure will take place and the dog will be constantly monitored throughout while the vet operates.
After surgery the anesthetic gas is turned off and remains on oxygen. Pain relief and antibiotics will be administered here and the dog will be monitored further until he/she can swallow and has a good blink reflex. This stage depends alot on the dog so some may remain on the oxygen longer. Once the dog is concious enough the tube is removed and the dog remains on the table for another 5-10 minutes being monitored. usually until the dog starts trying to move/lift head/whine. Then the dog is returned to kennels where a kennel nurse completes regular checks on the dog.
Usually within half an hour or so dogs will become aware of there surroundings again, may sit up and stand up etc.
Once the dog is fully aware of his/her surroundings they will be taken out to relieve themselves and be offered food and water.
Monitoring continues until the dog is sent home again.

I am happy to awnser any questions to my best ability or try and find the correct awnser for you.
I do not believe all chows are 'allergic' to anesthetic. Although intolerance is possible I think chows problem with anesthetic comes more down to there anatomy. It is important to realise the difference between general anesthesia and sedation. Ive seen tv programmes for other countries sedate dogs for castrates etc whereas in england dog castrates are always done under general anesthesia as sedation doesn't stop the dog kicking and twitching particularly when in pain, ive seen people nearly bitten by sedated dogs.

Every practice is different and may use different drugs but the general protocol should be the same, if your unhappy with your dogs diagnosis seek second opinion. My advice does not constitute veterinary advice, if you're worried about your dog seek veterinary attention immediately. Conditions such as bloat(GDV) which ive read is common in chow chows are life threatening but usually fairly easy to treat for a vet. If in doubt do not waste time posting on a forum and take them to a vet. Its beneficial for both the dog, the vet and finances to take a dog in and get diagnosed early than a emergency call out when the dog has taken a turn for the worst.
siewchingan
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Re: Anesthesia - What happens

Post by siewchingan »

Hi, your post is so much in details , learn a lot. I recently took my chow to have his tear duct flushed, wasn't impress ! No thorough explanation about what involve and aftercare ,well he still have watery eye :( . Thinking to go to eye specialist , what do you think? I live in uk.
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Merlin
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Re: Anesthesia - What happens

Post by Merlin »

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I do not believe all chows are 'allergic' to anesthetic.
\
It's more than likely that the word: "allergic" is a very missed used term amongst everyone, for lack of an understand of what can go wrong during a surgery.

There are studies out now proving that brachycephalic dogs who react poorly to specific agents used for anaesthesia, need to be anaesthtized <sp> with an agent that is reversible, and apparently not all of them are.

Ourselves we will only use Isoflurane now and never Ketamine, and to date we have experienced a very good success rate whereas we did lose dogs on Ketamine.



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Hayley92
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Re: Anesthesia - What happens

Post by Hayley92 »

Hi guys, sorry I havn't been on here in a while, been abit busy.

Siewchingan - I know this is abit late and you might of already taken him elsewhere but I would deffo recommend taking it to a referal practice, I'm currently training in one in Hertfordshire and its amazing, the care given is 110% and every care is taken, we have an ICU unit were we recover high risk patients which means somebody is constantly with them monitoring them, some are even put on ecg machines aswell to give that extra bit of care. they also have alot more diagnostic machines, MRI, CT scanners and endoscopes which most practices dont have which perhaps would be of use to identifying the underlying cause

Merlin - Ketamine is usually used as a pre med but I've never seen it used in dogs other than in low doses for analgesia. Its used with caution in any species as if its reversed too quickily the effects you seen in human drug users can be seen and its like being on a massive trip for them which is very distressing. I've seen it used for procedures with rabbits and used in cats in general practice in severe pain (had a cat hit by a car, couldn't get hold of the owners for a while so the cat was on alot of pain releif til we could get permission to fix it) Isoflurane is used for matienence of anesthesia, fractious patients sometimes recieve it with oxygen to relax them pre surgery but an induction agent should always be used (propofol) which is injected IV. Iso is the only matienence of anesthesia I've ever seen and that itself isn't strictly reversible as no injection etc will reverse the affects, patients should always be given oxygen for a while when the surgery is finished, this starts to wake the animal up - I personally have never known it to be a case of inject to put under and inject to wake up, if sedation or drugs used in sedation have been used they are usually reversed in recovery so the dog doesn't wake up fully, too quickily and end up distressed.
Brachycephalic dogs at risk are mainly animals such as bulldogs, boxers, pekes, pugs etc. I wouldn't count a chow and truely brachycephalic but would say its dependent on the individual, some have longer muzzles and some have shorter but I have never come across one with the same degree as the animals commonly receiving problems. Brachycephalic dogs are at higher risk as the soft tissue before there windpipe can swell in recovery usually due to excitement/stress which is why most are brought round slowly
I would say its better to investigate the chows anatomy further, one concept I have heard is the chow having a small heart in relation to its body which I would say is perhaps a better reason for deaths post surgery, anesthesia suppresses both the heart and lungs and perhaps they aren't as good as getting it going again as other dogs.
Hayley92
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Re: Anesthesia - What happens

Post by Hayley92 »

Just adding on - Noticed from your profile that you're from Canada, the procedures there from what I know are a lot different, I remember seeing a tv programme where a dog was being castrated under just sedation once, nasty :(
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