Main News (June 2, 2006)
Anesthesia safer today for senior dogs and
cats
By Kelly J. Kaczala
Press News Editor
Not long ago, older pets had a higher risk of dying
from general anesthesia. Today, medical advances have improved their
chances of survival.
"The safety of anesthesia has been drastically
improved," said Jeff Ko, a board certified veterinary anesthesiologist
and professor at Purdue University.
Newer anesthesia allows pets to wake up more quickly,
and free from pain, he said.
"The standard of care has been raised. Anesthesia
in veterinary medicine is relatively safe, though we still have
fatalities," he said. "But owners should not worry about
it as much."
More caution is used when treating older pets,
he said, because underlying health conditions can cause complications.
"There are more situations that tend to make
anesthesia a bit more complicated, in a sense, because geriatric
animals have liver and cardiac conditions, are diabetic, or have
other problems associated with the aging process, just like humans.
They do carry higher risk than younger patients," he said.
Pre-screened blood tests are important to determine
if pets have underlying health problems, which help veterinarians
choose appropriate drugs.
"It's a very vital tool for us to have, to
get an important clue about how well the animal is doing. If we
detect some problems, it may demand further evaluation," said
Ko.
Most university teaching hospitals require blood
work within two weeks prior to a general anesthetic procedure, he
said.
"Especially if there would be surgical trauma,
we prefer to have bloodwork to prevent complications," he said.
Pre-screened blood tests are important to determine
if a pet has liver or heart disease, "the two main organs that
metabolize drugs."
Most veterinarians offer the tests, said Ko. If
not, owners should request them.
Dr. Michael Stone, of Oak Harbor Veterinary Clinic,
agrees. He conducts pre-screened blood tests on all dogs and cats
over eight-years-old.
"It's part of the costs of surgery and treatment,"
said Stone. "It really scares me to go into an older patient
without blood work. If we have compromised health, we're definitely
not going to do that animal any justice without it."
Older animals require careful selection of anesthesia
or sedation that don't have serious side effects, such as respiratory
depression, said Stone.
"I don't want to condemn a dog just because
it's 10-years-old - that it can't have its teeth cleaned or a lump
removed because of age. It isn't fair and it's not appropriate,"
he said. "With the anesthetics we have now, I usually tell
people to let the animal do the talking. Our aged patients are evaluated.
We do a short blood panel, look at their liver, kidney function,
total protein, glucose, while cells, clotting ability, and an electrocardiogram."
"Geriatric patients present special concerns,"
said Dr. David Boudouris, of Country Squire Animal Hospital in Oregon.
"The first step is to assess their health. They many need blood
tests. We have a variety of anesthetics which can be administered
to best suit the patient."
Some drugs are "friendlier" than others
on the liver, heart and respiration rate, said Ko.
"It boils down to how familiar the veterinarian
is with the drug, and does he know how to use it effectively,"
said Ko.
Owners have a right to know about the possible
side effects of anesthesia, he said. "But you also have to
trust that the surgeon picked a drug that is suitable for your pet."
Monitoring an animal's condition after surgery
is just as important as during surgery.
Recovery
Geriatric pets are more prone to complications
and should be more closely monitored in recovery, said Ko.
"They take longer to wake up," he said.
Seniors are also more susceptible to lower body temperature.
In recovery, preventive measures, such as heating
blankets, are provided to geriatric and pediatric patients.
Seniors, defined as those that are at least eight-years-old,
or five-years-old for giant breeds, should have their vital signs
monitored more frequently, particularly during a difficult recovery,
whether or not they're experiencing pain, said Ko.
Some breeds with short noses, such as boxers or
pugs, require special attention because they tend to have upper
airway obstructions during recovery, said Ko.
"Fatalities can happen during recovery if
precautions are not taken," he said.
Animals should be waking up in recovery within
a couple hours of surgery, he added.
"And if there are some potential complications,
vets should call the pet's owner to let them know that some situation
happened," he said.
How well a hospital communicates with pet owners
is a measure of its "quality of care," he said.
"That shows their compassionate care through
the patient. They communicate with the owners so they feel comfortable.
I'm pretty sure that's a hospital you want to go back to,"
he said.
"We believe very strongly in communicating
with our pet owners," said Boudouris. "We make ourselves
very available to them to address their questions and concerns.
We are dealing with pets that can't communicate with us and we rely
on their owners to be advocates for them so we have the best outcomes.
We are a team with the owners and they need to be informed so that
we can work together."