If you have any other questions or concerns, your specialist will only be too happy to help.
Q: “Is there anything that I should do before the anaesthetic?”
A: Evening before the appointment: Most animals need a period of fasting prior to their anaesthetic. You will be told if this is not the case for your pet. They can have their usual evening meal the night before, but no food should be given the morning of the hospital appointment. Cats should be kept indoors overnight. This means that you can be sure they have not found any extra food elsewhere. It also prevents them from using their sixth sense and hiding away from home when the cat basket appears the following morning! Your pet can still have free access to water right up until the point that you arrive at the hospital. This is particularly important on hot days.
Morning of the appointment: Dogs should be allowed a short lead walk before their appointment to allow them to go to the toilet. If your pet is currently receiving medication they can have their usual morning dose, unless told otherwise. These should be given without any food. If the medication specifically requires food when it is administered let the practice know and we can provide advice on how to proceed.
Please make a note of what your pet’s usual medication dosing regime is. The vet or nurse admitting your pet will ask you details about this. It is likely that we will continue this while your pet is in hospital so it can sometimes be useful to bring a small supply of the medications with you. You do not need to bring anything else with you unless asked. We have a large supply of bowls and comfy bedding for our patients and would hate to lose any of your pet’s beds or toys. We also stock a large variety of diets, so it is often unnecessary to you to bring any of your own. However, if your pet is receiving a special diet, you can ask the admitting vet or nurse whether we any in stock; if we have none available then you may leave a small supply with your pet.
Q: “Could my pet have a bad reaction to the anaesthetic?”
A: As with any medical procedure, there is a small risk when an animal is given either a sedative or anaesthetic agent. The chance of a bad reaction is greater if your pet is especially sick. The risks can vary in severity. Examples of relatively minor risks include a prolonged recovery with excessive “sleepiness” for a period or a temporary reduction in body temperature. More serious risks can include regurgitation of stomach contents and subsequent aspiration pneumonia, anaphylactic reactions or even death. Although these risks can never be eliminated they can be minimised. Our dedicated, skilled anaesthesia team will oversee all phases of your pet’s anaesthetic. We ensure they receive a tailor-made anaesthetic technique that takes into account all aspects of their medical history and current problem. Combining the experience of our team with use of a wide range of monitoring equipment allows close monitoring of your pet throughout their procedure and the recovery period. This means that if a problem should occur it will be noted and treated as early as possible.
Q: “My pet had an anaesthetic at my own vets yesterday, is it safe to have another one so soon?”
A: This is a relatively common scenario for our anaesthesia team. Multiple general anaesthetics or sedations are sometimes unavoidable when treating your pet. However, providing your pet has fully recovered from the previous anaesthetic, this should not be a problem. Each anaesthetic event is independent and the risk is not cumulative over multiple anaesthetics. In some instances, it is actually better for your pet to have several short general anaesthetics rather than one long one. This is because the risks of anaesthesia tend to be greater the longer a patient is anaesthetised. It is for this reason that in elective cases we often perform diagnostic procedures under a different sedation or general anaesthesia than any surgery which may be required.
Q: “Is my pet too old to have an anaesthetic? Will there be more risk?”
A: Studies have shown that anaesthesia of cats and dogs older than 12 years of age does carry a slightly higher risk than anaesthesia of younger patients. However, it is not the case that we shouldn’t anaesthetise your pet if they are over this age; some older dogs and cats still look and act like puppies and kittens!! What is important to consider is balancing the risk associated with the required anaesthetic and procedure with the benefit your pet will gain from having the procedure performed. If you are finding this a difficult decision to make, it is something that can be discussed with your pet’s clinician.
One of the reasons that there is a greater anaesthetic risk with older pets is that there is a higher chance of an animal having problems in addition to the reason why they are at the hospital. If a potential problem is picked up on your pet’s pre-anaesthetic assessment we may suggest that extra tests are performed, for example blood tests or a heart scan. This will ensure we have the maximum amount of information possible before the anaesthetic. This allows us to identify potential risks and prepare an appropriate plan to help avoid and treat any problems should they arise.
Q: “What is the difference between sedation and general anaesthesia?”
A: During your pet’s time in hospital they may have to undergo a number of procedures either to diagnose or treat their problem. In order for the procedure to be carried out safely and to minimise stress to your pet, we may need to be give a sedation or general anaesthetic. Unlike when we go to a hospital as a patient, unfortunately we cannot explain to our animals what is happening during the procedure and that we need them to lie still, or in a particular way.
All sedations and general anaesthetics are tailored specifically to your pet and their needs, overseen by our team of anaesthetists. Additionally, all patients are constantly monitored during the procedure and recovery by one of our experienced veterinary nurses. For all general anaesthetics and most sedations your pet will have an intravenous catheter placed in one of their legs. This means a small patch of hair needs to be clipped from the leg. The intravenous catheter allows us to give additional drugs or fluids easily if they are needed.
If your pet needs a sedation, we will give them a combination of drugs by injection to make them more relaxed and “sleepy”. Sedated animals are often still aware of their surroundings and may even be able to walk to and from the procedure room. Sedation is used for simple, short diagnostic procedures which are not painful such as x-rays and ultrasound scans where we may need your pet to lie still, or in a special position. If your pet needs surgery this would be performed under general anaesthesia, not sedation. If your pet is very sick or has a complex medical history we may recommend that a general anaesthetic is safer than a sedation, even for the more simple procedures; general anaesthesia may allow us to perform more in-depth monitoring with fewer drugs compared to sedation.
When we give a general anaesthetic, your pet will become unconscious while the drugs are being administered. This is often described as “sleeping” and your pet will not be aware of anything that is happening during the anaesthetic. They will also not remember what has happened once they have woken up from the anaesthetic. We use a combination of drugs during the general anaesthesia, which may work in slightly different ways, providing an individual approach specific for your pet. Some drugs may be administered by injection while others are a gas that your pet breathes into their lungs. In order for the anaesthetic gas to be given a tube will be placed into your pet’s airway. This also helps us to prevent anything from passing down into the airways during the anaesthetic as your pet will not be able to cough it back up like they would do normally. Occasionally the airway tube can result in some irritation when your pet recovers from the anaesthetic and they may have a very mild cough for a day or two.
A key part about any sedation or general anaesthetic plan is to ensure that we provide appropriate pain relieving drugs should there be any chance your pet experiences discomfort. This ensures your pet is as comfortable as possible.
Q: “Will my pet be painful?”
A: Some procedures, particularly surgery, inevitably result in some degree of discomfort and pain. Although it is necessary to carry out these procedures for the best long term outcome, we need to reduce the immediate negative impact that this may have on your pet. Therefore, we always use techniques and drugs to minimise the pain that your pet will feel. Often the best results are obtained through using a number of different techniques. This may include:
- Medications given by injection such as the morphine-type drugs
- Oral medication such as anti-inflammatories
- Nerve blocks similar to what the dentist performs when you are having a filling
- Epidural anaesthesia – similar to what is commonly used during childbirth
- Physiotherapy and specific exercise plans if appropriate
- General care including soft bedding, warm environment and regular toilet breaks
The specific anaesthetic plan will depend upon your pet and the procedure they need to undergo. The process of managing potential pain starts before any procedure has begun with all animals receiving “pre-medication” before general anaesthesia. This is a combination of drugs given by injection often including a sedative to help relax your pet and morphine type pain relief. It is well recognised that administration of pain killing drugs before the procedure will help reduce the amount of pain a patient experiences in the post-operative period.
Unlike with people, it is not possible for your pet to tell us when they feel any pain. Therefore, in order to make sure your pet continues to be as comfortable as possible throughout their hospital stay, we will regularly assess their behaviour using recognised pain scales. This allows assessment of comfort levels and rapid treatment of any pain.
Sometimes animals arrive at the hospital and are already experiencing a level of discomfort due to their underlying problem. You may already be giving your pet pain relieving drugs that have been prescribed by your own vet. As part of your pet’s assessment we may give additional drugs to complement their pain management during their hospital stay. Our anaesthesia team are also often involved in managing pain in hospitalised patients who are not undergoing an anaesthetic or sedation. A number of our team also offer “pain clinics” for patients who may require long term pain management.
Q: “I have heard about using nerve blocks or epidurals; what are these and how may they benefit my pet?”
A: Depending upon the necessary procedure, we may ask your permission to perform either a nerve block or an epidural. These are both ways in which we can help manage the pain which the procedure might induce. Nerve blocks and epidurals use local anaesthetic drugs to prevent transmission of a painful stimulus to the brain. This means that the patient will not be able to feel any pain associated with the surgical site while the local anaesthetics are working. They are some of the most effective ways in which we can manage pain.
A nerve block is when local anaesthetic is administered around the nerves associated with the surgical site. It is what your dentist performs before you have a filling placed. An epidural is when local anaesthetic, possibly combined with other strong pain killers such as morphine, is deposited in the space around the spinal cord. We have put together an information sheet on local anaesthetic techniques which gives more details.
Q: How will you look after my pet during their anaesthetic?
A: Before your pet is anaesthetised they will have a full assessment with one of our members of the anaesthesia team. All of our anaesthetists have many years of experience and a number are recognised specialists within their field. Your pet’s assessment will allow an individualised anaesthetic plan to be devised to ensure they have the best experience possible.
All anaesthetic protocols start with a “pre-medication”. This is the administration of drugs by injection and often includes sedative agents to help relax your pet and analgesic agents, which provide pain relief for any procedure that your pet is about to undergo. This helps make sure your pet is calm when we need to place intravenous catheter which allows us to give further drugs and fluid as needed. General anaesthesia is induced through an injection of drugs through the intravenous catheter into your pet’s vein. Your pet will have the sensation of falling asleep and will not be aware of anything that happens until they wake up from the anaesthetic. A tube is then placed in their airway to allow us to continue delivering oxygen and gaseous anaesthetic.
During their anaesthetic, your pet will be constantly monitored by one of our experienced veterinary nurses, overseen by an anaesthetist. If they are very ill a member of our anaesthesia team will remain with your pet at all times. We use multi-parameter anaesthetic monitors for all patients undergoing anaesthesia, which include the ability to assess:
- Heart rate and rhythm (electrocardiography or ECG)
- Respiratory rate and levels of carbon dioxide being breathed out (capnography)
- Levels of oxygen in the haemoglobin in blood (pulse oximetry)
- Blood pressure
- The concentration of anaesthetic gases being breathed in and out (agent monitoring)
When combined with the “hands-on” monitoring that our skilled staff members provide, this equipment allows us recognise and act upon any potential abnormalities quickly. If your pet is particularly sick, or they have a higher risk of complications, we may also use additional pieces of equipment to ensure that we provide an exceptional level of care. We have asses to a technique to assess cardiac output directly, called trans-oesophageal Doppler (ODM) – this sophisticated technique is rarely available to veterinary surgeons and we are pioneering its use in some of our sickest patients.
Recovery from anaesthesia has been shown to be one of the higher risk periods surrounding anaesthesia. We therefore continue to monitor your pet closely right up to the point when they are back to their normal selves. We also have an intensive care facility (ICU) for those patients who are very sick. This is manned 24 hours a day by our dedicated team of veterinary nurses, closely supported by anaesthetists and clinicians. This allows close monitoring to be extended well into the post-anaesthetic period for those patients that require this.
Q: “What should I expect when my pet comes home from hospital after they have had an anaesthetic? What do I need to do?”
A: Whenever your pet is discharged from hospital you will receive detailed discharge instructions from the clinician who has been looking after your pet. These will provide information as to what has happened to your pet during their stay and what you need to do in the immediate future.
Sometimes your pet may come home the same day after they have had an anaesthetic. This can be the case if they have undergone diagnostic procedures only. If your pet has undergone surgery, it is likely that we will recommend they stay in the hospital for a short period of time to allow us to provide the best management, including pain killing drugs to manage any degree of discomfort they may have.
If discharged on the same day as their anaesthetic, expect your pet to be a little quieter than usual. You may find that they want to sleep more than normal. It is a good idea to make sure your pet has a warm, quiet place where they can rest during this time. We would advise that cats stay in the house overnight and that dogs are allowed only a short lead walk to go to the toilet. You can offer your pet a small bland meal (e.g. chicken) when they get home, but do not worry if they don’t want to eat too much; their appetite should improve as any after-effects of the anaesthetic wear off.
If your pet has had any procedure which may cause discomfort, they will have received pain killers while in hospital. These may last quite a long time. The need for further pain medication and what to give will be detailed in the discharge instructions. If you are worried that your pet is still uncomfortable despite receiving pain medications then you can contact us here at Davies Vet Specialists where we can offer further advice and support.
Davies Veterinary Specialists, Manor Farm Business Park, Higham Gobion, Herts SG5 3HR 01582 883950
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