CH Kitty and anesthesia

So in dealing with all of DeeJay's issues I have put Mini Dee's teeth extractions (3 possibly 4 fangs/canines) on the back burner.  But I have decided it is time to have the procedure done.  I swear that I remember reading somewhere that Ketamine affects the same part of the brain as is affected by the Cerebral Hypoplasia or something along those lines as to why Ketamine shouldn't be used in CH kitties.  Does anyone know anything about this?  Would like to take something concrete to my vet as this is the first time they have dealt with a CH kitty.  At my vet they use the Telazol, Ketamine Xylazine combo for sedations. 

OK - Dr. Scarlett doesn't explain WHY, but see this - and read down to her answer: http://www.justanswer.com/cat-health/3qh4t-anesthesia-safe-kitties-cerebellar-hypoplasia.html

And this may be helpful: http://lifewithchcats.com/2013/04/12/ch-cat-parent-the-spayneuter-clinic-wouldnt-neuter-my-ch-cat/

And here's where the information came from. No references. http://chcat.org/faq/

I should have included: our Ming Loy has CH. She just had her dental a few months ago - but our vet doesn't use ketamine, they use the gases.

Thank-you!  I am just worried, Mini Dee DOES NOT handle handling very well, don't get me wrong she likes to be held etc  But she definitely will be a challenge to get blood from and put a catheter in.  I am just so worried.  I would have my dad do it, but he can't run bloodwork other than a CBC, and she is 7 & 1/2 years old.

Well, with this information (sorry I couldn't find anything more definitive or explanatory!), have a chat with the vet. If they normally use the ketamine combo, I don't know they'll be able to offer an alternative. But being aware of the after-effects, you might better be able to manage the situation (maybe keep her confined to one room for 24 hours, etc).

I do know we use Domitor on some patients as well as just using Telazol, but for sedations for surgery the TKX combo is the 'norm'.  But I am sure they will be open to changing that for her.

Not answering your question, but can gas be used for induction (presumably injectable induction is the heavy sedation to allow one to put on the mask and breathing tube for gas isoflurine)? I thought that vets use one injectable drug for induction - ketamine (or some combo) or I think sometimes propofol (presumably these are injected??) - and then use some gas anesthetic (isoflurine etc.) to keep the pet under. But they don't usually use the injectables these days to maintain the anesthetic, do they - or maybe some do but not sure why they would do this?

After my kitty Duncan had an allergic reaction to anesthetic (very rare), I now elect to have all of my surgeries done in a 24/7 clinic that is a regular clinic during the day, but does overnight emergencies. That way if things go wrong, I don't have to worry about how to transport the kitty from a regular clinic to somewhere they can get  24/7 care. Also, if they need an overnight IV before or after the procedure as senior kitties, then I can do that too. I could be wrong, but I think that ketamine has some pain relief properties, so I think that some vets like to use that for induction in dentals (??). 

Not sure how accurate the information is:

http://cats.about.com/cs/anesthesia/a/understanding.htm

http://cats.about.com/cs/anesthesia/a/understanding_2.htm

Feeling a little bit better about the procedure, talked with the tech manager and they don't use sedatives for cat dentals they just gas them down.  Much safer IMO so that makes me feel better.  I told them I am a paranoid mom and don't want anything to happen to my baby.  She also had a stricture in her throat and had to have her voicebox removed because of it so she has scarring so they will have to adjust the tube size too.  I talked with them about that too.  She said that for employees the bloodwork is optional, but she is 7 & 1/2 years old and hasn't had any ran since she was a kitten so I will be opting for that.  My hubby is gonna hate me for the costs but I'd much rather have her safe and out of pain.  I was trying to see if she needed a dental too and boy oh boy did she fight me touching her mouth so I know it's causing my girl some definite pain.  I have her scheduled on Tuesday. 

Tomorrow is the big day.  I have prepared a 'helpful hints about Mini Dee' paper for her cage.  They are as follows:

I have Cerebral Hypoplasia which makes me shaky and unsteady on my feet

I do not like to be restrained, so be aware of this when getting blood and placing catheter, I may fight you

Please no Ketamine for me, it is too scary for me to wake up from with my CH.

I have had surgery on my throat so you may need to use a smaller than you would expect endotracheal tube due to scar tissue.

That's excellent! SUCH a smart thing to do!!!!!!!!!!!!!

I'll keep up the vibes tomorrow, and PLEASE let us know how it goes!

cprcheetah said:

 
So in dealing with all of DeeJay's issues I have put Mini Dee's teeth extractions (3 possibly 4 fangs/canines) on the back burner.  But I have decided it is time to have the procedure done.  I swear that I remember reading somewhere that Ketamine affects the same part of the brain as is affected by the Cerebral Hypoplasia or something along those lines as to why Ketamine shouldn't be used in CH kitties.  Does anyone know anything about this?  Would like to take something concrete to my vet as this is the first time they have dealt with a CH kitty.  At my vet they use the Telazol, Ketamine Xylazine combo for sedations. 

Click to expand...

I have learned that Ketamine is a common but controversial anesthesia that can cause bad reactions is come cats. This anesthesia along with something else, was used on Thomas when he was neutered and he had a very bad reaction. We almost lost him at the vets but he miraculously snapped out of it on the drive home. Thank God! A truly scary and bizarre experience. Needless to say there is an alert on his chart to not use this drug. I have read that Isoflurane and Sevoflurane are safer types and will be asking my vet if they can get or use this in future.

I found the following page which you may have seen, which discusses Cerebellar Hypoplasia and different aspects regarding care and medical information. One of the topics is the type of anesthesia (Gas) that is recommended for a CH Kitty and how it is important to monitor breathing during surgery, so great that this is being used for Mini Dee's surgery. It also mentions Ketamine and how it should be avoided due to the long recovery time, but not much else : http://chcat.org/faq/ ..

The helpful hints list that you put together about Mini Dee is a very good idea! I hope everything goes really well with the surgery.

today! :cross:

oneandahalfcats said:

 
I have learned that Ketamine is a common but controversial anesthesia that can cause bad reactions is come cats. This anesthesia along with something else, was used on Thomas when he was neutered and he had a very bad reaction. We almost lost him at the vets but he miraculously snapped out of it on the drive home. Thank God! A truly scary and bizarre experience. Needless to say there is an alert on his chart to not use this drug. I have read that Isoflurane and Sevoflurane are safer types and will be asking my vet if they can get or use this in future.

Click to expand...

Obviously you won't use ketamine on Thomas or on DeeJay. And I talked to cprcheetah about the following already while she was making decisions.

But on Tanya's CRF web site, she does state her opinion that ketamine or propofol are safer for *inducing* anesthesia than using gas for the actual induction (in either case, you of course then use the gas isoflurane etc. to maintain anesthesia) - I think it has to do with blood pressure issues and kidneys or something like that. Obviously in certain situations like your situations above, inducing with gas is the best option - but as for myself, I would like to do more homework on using gas for induction vs. the other options for induction since Tanya's CRF web site usually has good information.

Thanks everyone for your vibes.  Mini Dee came through with flying colors.  Her bloodwork was great, she was pretty well behaved (she HATES being restrained) we only ended up pulling her 2 broken fangs.  We decided to leave the smaller one that is probably a kitten tooth as her adult tooth never came in.  She was induced with gas anesthesia.  I consulted with a Veterinary anesthesiologist who recommended that for CH kitties so that is what we did.  She is on pain meds and antibiotics.  I got her home, brought her into the office which is 'her' room showed her food, she got a drink and then marched back into the living room and climbed back in the carrier.  LOL  She LOVES that carrier, it is soft sided but has a firm frame, she likes to climb on top of it, I think it gives her a sense of accomplishment.  About 4:00 the Tech manager came and got me and wanted to know if what Mini Dee was doing was normal or if she was having a hard time waking up, she was unsteady but 'flopping' in her curled up ball in the cage.  So I grabbed her out of the cage and put her on the ground and she walked a few steps, yep that's pretty much normal for Mini Dee to act like she is drunk.  So they got a lesson on what CH was again and how it affected Mini Dee.  She is the first CH patient they have seen. 

 Good news!!

Scarlett 001 said:

 
Obviously you won't use ketamine on Thomas or on DeeJay. And I talked to cprcheetah about the following already while she was making decisions.

But on Tanya's CRF web site, she does state her opinion that ketamine or propofol are safer for *inducing* anesthesia than using gas for the actual induction (in either case, you of course then use the gas isoflurane etc. to maintain anesthesia) - I think it has to do with blood pressure issues and kidneys or something like that. Obviously in certain situations like your situations above, inducing with gas is the best option - but as for myself, I would like to do more homework on using gas for induction vs. the other options for induction since Tanya's CRF web site usually has good information.

Click to expand...

Hi Scarlett : Vets and practitioners will have different opinions about Ketamine, its true, as in general, Ketamine is a fairly safe anesthetic apparently which is widely used but can be cointradicted in cats with heart, kidney and liver issues, and as has been noted, for cats with CH. I think dosage and what ketamine is combined with is an important consideration. I can't recall the mix that Thomas received but I have heard Ketamine mixed with Valium with good results. As all anesthesia drugs come with some risk, even isoflurane and sevoflurane, it is important to do some homework as you say, get the blood work done to check for any medical issues that may cause problems and then decide which feels right based on the information.

@cprcheetah: happy to hear that everything went very well. Love the anecdote 'she LOVES that carrier' which is surprising and funny as most cats don't I think. You have trained her well sounds like.  

Glad everything went well! 

My poor little baby.  She's not doing to hot today.  She hasn't moved all day.  Ate some temptation treats but didn't touch her breakfast.  She is on pain meds and antibiotics, but right now I just feel like the evil mommy who had her teeth pulled. 

ETA:  I got her to lick some diluted (about 50/50) canned food, she licked up maybe 1/8th of a can.  So I will keep trying that approach for her eating.  I know the kibble she has is odd shaped so it probably hurts a little when she tries to eat.  She normally will only lick juice off of canned food, so this is a good sign that she will at least eat it if I dilute it up for her. 

I'm hoping it's just a reaction to the antibiotic that's causing this lethargy and suppressed appetite.  Probably is .  (my Sven was so kibble addicted that even with 4 teeth pulled in one session,  he wouldn't even touch canned and continued to eat kibble the next day after that dental.  Didn't take any pain pills either, that I recall.  Just antibiotics, which did cause loss of appetite and lethargy, so much so that the Vet had us stop them early.  )