Fortunately, anaesthetics these days are extremely safe – especially compared to the “bad old days” of ten to twenty years ago, when monitoring equipment was less widely used and anaesthetic agents were less advanced. All anaesthesia carries risk; there is no escape from that fact, even for us humans! However, the risk is very minor, and adverse anaesthetic reactions are extremely rare, especially in young healthy patients.
Owners of older pets are often concerned about having them undergo anaesthesia. This is where modern anaesthetic agents, monitoring equipment and indeed the skill of the veterinarian come into their own. Anaesthetic risk does increase with age and ill-health, but the risks are very minor nevertheless. We will run through the basic anaesthesia protocol that is normal for most patients, then we will discuss the various extra options that are available for clients that wish to provide additional care to their pets, and especially for aging or ill patients.
Standard Quality Protocol
The above regime describes very modern and safe anaesthetic practice which ensures very little risk of adverse reactions, even in old and sick patients. There are however, extra precautions that can be added to this regime for concerned clients, and especially for old and sick patients. We will describe these options, then explain the actual advantages of each.
Pre-Anaesthetic Blood Screen
A blood test prior to surgery may detect underlying conditions that don’t necessarily cause visible symptoms, but can affect an animal’s response to anaesthetic. Hence, a pre-anaesthetic blood screen is important in either sick patients, or geriatric patients. In young to middle aged patients who are well, we feel this screen is extremely unlikely to be rewarding, therefore we tend not to recommend these in such patients. The analogy we often use is one from head veterinarian Dr Marcus Hayes who cites: “I’ve had 10 anaesthetics in my life, and not once been offered a pre-anaesthetic blood screen”. So either us humans are not as important as our pets, or pre-anaesthetic blood screens they are largely over rated. We do feel these are a little on the retail marketing side of upselling items unlikely to be rewarding in 99.9% of cases. For our clients who still wish to have them however, you can ask on the day and they will be done ($110).
Intra-operative fluid therapy has a two-fold benefit. Firstly, it helps to counteract the drop in blood pressure that tends to occur during anaesthesia. Maintaining blood pressure reduces this risk factor and can help to protect against potential organ failure in sick and elderly patients. Secondly, young and old patients alike generally experience a better recovery from surgery if they are not in a state of dehydration. It’s amazing how patients that have had fluids are often quite bouncy and active even a few hours after anaesthesia.
For older and sick patients, don’t be scared of anaesthesia to the point that a patient’s health may be more compromised by not performing a surgical procedure. Consider fluids as the main extra, and we, as clinicians, will advise whether a pre-anaesthetic blood test should be considered more strongly, but the choice is still there for you if costs are of no concern.