The following information explains our Practice Policy about general anaesthesia. When you go into hospital you naturally expect the best and very latest treatment; we believe that your pet deserves a similar approach.
This Practice routinely weighs and examines all patients prior to anaesthesia. It may be appropriate to carry out other tests, such as a blood screen, blood pressure assessment or electrocardiogram prior to anaesthesia. These can be performed in the Practice - the veterinary surgeon will advise you accordingly. These pre-anaesthetic investigations will help us to decide the timing of the procedure, the type and dose of premedication & anaesthetic agents, the requirement for intravenous fluids (or blood products) and the estimated duration of hospitalisation before and after the procedure.
A premedication is routinely administered to each patient soon after admission and is a combination of drugs tailored to the requirements of the individual patient. Please report all recent drug treatments and suspected sensitivities or allergic reactions during the admission procedure. The premedication reduces anxiety, produces mild to moderate sedation, pain relief during and after the procedure, decreases the required dose and side effects of subsequent anaesthetic agents, increases muscle relaxation, plus suppresses vomiting and regurgitation. Most commonly three agents are administered by injection – a sedative, a short acting opiate analgesic and a long acting non steroidal antiiflammatory pain reliever.
Your pet is to undergo an investigative, medical or surgical procedure which requires a general anaesthetic. We routinely use the modern anaesthetic agents propofol and isoflurane, although under some circumstances other agents or combinations may be selected. In most cases intravenous access is gained by introducing a cannula into a vein in either of the forelimbs. The haircoat on the forelimb(s) will always be clipped short, the skin will be cleansed and local anaesthetic cream may be used prior to cannulation. The induction agent propofol, and any other drug or fluid requirements, are administered through the pre-placed intravenous cannula. In the majority of procedures isoflurane gas, the maintenance anaesthetic agent, is administered through an endotracheal tube, even in rabbits. This combination is commonly used in human anaesthesia. Animals anaesthetised with these agents go to sleep in a smooth and well controlled manner, and wake up quickly and quietly, with very little "hangover" effect. Furthermore, it has fewer deleterious or long lasting effects on the vital organs including the liver, kidneys and heart. We know that by using these anaesthetic combinations the procedures are as safe as possible. This combination is thus especially suitable for out-patient procedures - where patients undergoing surgery are discharged on the same day as the operation. Your pet should return to you in a brighter and more alert condition than if older and cheaper drugs are used, even following anaesthesia just a short time before.
Not surprisingly, these anaesthetic agents are more expensive than older drugs, and we recognise that for the more routine operations and procedures, the extra cost appearing on your bill may not be particularly welcome. However, we hope you are reassured that we are committed to the very safest anaesthetic practices. Please feel free to question us about the forthcoming procedure.
Qualified veterinary nurses will continuously monitor each patient from admission to stable recovery. Anaesthetic charts will be annotated during the course of the procedures. The VN will gain information from visual parameters (mucous membrane colour, capillary refill time, respiratory rate and depth, muscle tone, various reflexes); tactile parameters (pulse rate and volume) and audible parameters (heart rate). She/he will also use monitoring equipment to assess the arterial oxygen saturation (pulse oximetry), heart rate and rhythm (oesophageal stethoscope) and body temperature (thermometer). Heat loss is reduced by the use of a heated mat, aluminium ‘Mediwrap’ blankets, warm blankets, baby socks and even warmed intravenous fluids when necessary.
A dedicated kennel nurse will monitor the recovery of each patient on return to their individual cage, if necessary further annotating the anaesthetic chart. The patient will often have a heated mat and an infra-red heat lamp if necessary, and will be turned as required. Further short acting opiate analgesic may be administered and in some circumstances slow release patches may be applied (three days duration pain relief). A timed alarm is set on each cage, this will sound at gradually increasing, though adjustable, intervals during the recovery as a further precaution.
All anaesthetics carry some risk. We strive to reduce that risk to the smallest possible degree.
What we would like YOU to do before bringing
your pet along for its treatment:
- Please ensure that your dog or cat has had nothing to eat from 9 pm the night before the procedure. Water should be available until 7 am on the day of the procedure.
- Please try to ensure that your dog has gone to the toilet before admittance and is clean - no muddy walks before coming in!
- Arrange for transportation home as your dog will be unable to walk home following an anaesthetic.
- But rabbits should be allowed to eat and drink as normal before admission. In some circumstances we may even syringe feed rabbits prior to procedures.
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