Breed Specific Anesthesia

I thought it might be a good time to discuss a recent article that pertains to an issue I know many pet parents worry about. Anesthesia.

Every so often I see a pet who still isn’t spayed or neutered. Many of these pets have developed problems because they haven’t been "fixed." Some of these problems are prostate issues, mammary tumors, pyometras, and even some behavioral issues. Many people haven’t spayed or neutered their pet because they are so afraid of the risks of anesthesia.

I understand how scary it can be. To love your pet and worry and try as hard as you can to avoid ANY and ALL unnecessary risks. I get asked all the time about the dangers of anesthesia. I tell my clients that we don’t recommend a surgery unless the very small risks associated with general anesthesia far outweigh the risks of not doing the surgery. I also try to re-assure them that we are very, very careful with every aspect of the entire procedure. I carefully examine every patient, I think about their specific disease, problem, surgery, and post-operative concerns. There is a great deal of time, care, and concern that goes into every aspect of every patients care, especially when it pertains to surgery and anesthesia. I do not ever take my responsibilities lightly and I remind my clients that I have been in their shoes before, so I understand their turmoil, trepidation, and reluctance.

Wren, my newest kitty, was a very sick, very challenging case from the beginning. She came to me as a 6 week old pathetic mass of infection, fleas, disease and death loomed over her for months. It was four  very intensive, nail biting months of caring for her. It really was four months before I even let myself believe that she would live through all for her seemingly insurmountable obstacles. At seven months old I knew it was time to spay her. I dreaded that day for a month. I treated it like a stop smoking deadline.


This little sad puff of fur is Wren. At day 2 or 3 of ICU care at my house. She went everywhere with me.
Here she is blind because her eyes are so full of puss, she can't lie down because her lungs are full of fluid, and she can barely breathe. I had just removed more fleas from her than is imaginable. She is anemic, has pneumonia, and is dying from them.



You know the advice that the quit smoking experts give you. You are supposed to pick a date in the near future, circle it on your calendar, prep yourself for that date, and then when the date arrives you commit to it. When that morning arrived I was sweating with fear. I was so afraid to lose my little precious Wren. I thought to myself that I hadn’t slept for one full night in the last four months, because I had to check to make sure that she was still breathing, that she was warm enough, I had to  feed her, give her her fluids in her femur bone catheter, and now I couldn’t bear the idea that I might still lose her. I had actually waited an extra month to spay her because I wanted her to be big enough to take the insult of anesthesia and have a tiny bit of belly fat to cushion the blow.

That day I headed to work with a hungry, upset, meowing, terrified, "just big enough to be spayed but almost a full three months older than most kittens" Wren in a carrier under a blanket in my back seat. Every cry seemed a desperate plea to turn the car around and go home.

I arrived at work, told my staff to give me a full hour of no interruptions, questions, or drama so that I could get my little Wren spayed with the minimal amount of stress possible.

At first I thought about driving an hour away to my friends specialty service practice and ask him to do Wren's spay for me. He is an excellent surgeon, and I thought to myself "He  won’t mind if I asked him to do a little old cat spay?" Then I thought, “Huh, he probably hasn’t done a cat spay since vet school? I have waay  more practice then him." And then there is the  whole humility and embarrassment of having to admit why I am asking him to do this for me.

What would I say, “Well, because I have gotten so emotionally attached to her that I can’t do her spay surgery.” Seems like a plausible reasonable conundrum, doesn’t it?

So you see I understand where my clients concerns come from. I get it? I empathize, understand, and that’s why I am so careful with anesthesia.

I was reading a very interesting article in the last months NAVC Clinicians Brief on “Breed Specific Anesthesia.” This is a very informative article that lists specific breeds and their own particular anesthetic concerns.

Cooper’s quick mass removal was my most recent anesthetic plan that didn’t go exactly as planned. But for every plan that doesn’t go exactly as planned you have to have a back up plan, a good monitoring system and open lines of communication. Life rarely ever goes as planned but that’s why you have 4 years of training, and a lifetime of skill to build upon.

Here are some of the breeds the article gives recommendations on;

1.       Brachycephalic breeds. WOW! I talk about these guys a lot and they are listed first! For good reason.

2.       Sighthounds.

3.       Boxers, of UK origin. I found it interesting that the US Boxers don’t seem to have the same sensitivities as the UK guys do.

4.       Herding breeds (collies, shelties)

5.       Toy breeds

6.       Dobies

7.       Giant breeds.

The article also mentions to know which breeds are predisposed to have heart conditions (cardiac disease). So if you suspect heart disease have the patient visit the cardiologist before surgery.

The entire article can be found at http://www.cliniciansbrief.com/journal

P.S. Wren did fine with her spay. And she is the light in my day, everyday.

Puppy Mills Cruelty

Puppy Mills

I got a call from Grace at Animal Rescue asking me if I would look at a 7 year old Golden Retriever that they had rescued from a shelter. Animal Rrescue takes in so many dogs abnd cats that they provide spays and neuters to all of the pets that they adopt out at their shelter. When they were preparing to spay this dog they injected her anesthetic and proceeded to try to pass an endotracheal tube into her esophagus to provide her the oxygen and anesthetic gas to keep her under general inhalant anesthesia. For the Veterinarian we approximate what size endotracheal tube to use on the pet based on their size, weight, and breed. I have seen some toy breed dogs take a tube used routinely for cats. And I have had to use a tube three sizes smaller than I estimated on a bulldog.

As a side note: There are a lot of helpful anesthesia tips for brachycephalic dogs. I always have a long discussion with these owners prior to placing these guys under sedation or anesthesia. You should expect to pay more and be asking questions if you are not.

In the process of trying to pass the endotracheal tube the Veterinarian noticed that her vocal cords were abnormal. She also noticed that the size of the lumen (the opening of her airway) was significantly smaller than it should have been. As I have said before your body will respond to an insult (fancy medical term for damage) by scarring. Scarring in a tubular structure is called stricture. A stricture causes the tube to narrow. Her vocal cords were unable to open normally, (they open like drapes around a window) because she had been brutally de-barked.

When Grace called to ask me about this dog she was calling to ask if I could use our laser to try to remove the scar tissue that was like a webbing holding her vocal cords together. It is always very difficult to give an opinion on a case over the phone. I need to see a pet and understand not only the condition about which they have come in, for but also assess the pet, and in many cases the owners ability to follow through with any post operative care. I told Grace that I needed to better understand this dog’s condition by seeing her. I also told Grace that I wasn’t sure what she was talking about when she explained to me that she had a 7 year old dog that had been de-barked at the puppy mill. I had never heard of a de-bark being done by anyone other than a veterinarian. (This is a procedure that used to be done pretty routinely in the “old days,” thankfully it has fallen out of fashion).  Grace sent me a drawing of the dogs larynx as the Vet had described. She also went on to say that the way puppy mills de-barked was to “shove a pipe down their throat, to break the vocal cords.” I wanted to vomit. I couldn’t believe that people could be so cruel. I also couldn’t believe that I had been doing this for as long as I had and never heard of this. (Something about ignorance being bliss ran through my head).  I told her that I was appalled to hear about this girl but I would be happy to see her.

Thankfully she did well under anesthesia and recovered without any problems. It was decided that based on her age, her lack of clinical signs and how well she seemed to be doing that we would take a “watch and wait and see” approach.

My hope is that she will never need another surgery and that she will be with a family that loves her. She may have started out with a terrible cruel person who didn’t care about her, but hopefully she will end up with the exact opposite.

Puppy mills only stay in business because there are people willing to buy a pet from them. If you don’t know the breeder and you haven’t met and visited their facility personally please don’t support them by buying a pet from them. They will only stop abusing when there isn’t someone buying their product.

There is not much information available on de barking, but here is an interesting debate;
http://tinyurl.com/3rdfugb