Originally Posted by Dr. Doolittle
Gaye- I respect your position on the ketamine. As a breeder of siamese you are probably aware that hypertrophic cardiomyopathy is more common in this breed. Ketamine is contraindicated in cats with this condition. Sometimes HCM can be hard to detect so I understand your concerns.
Isoflurane inductions have to be done with a mask on the cats face or with the cat in a sealed chamber. They are slow, stressful for the cat, have a prolonged excitatory phase, and have increased drug exposure for the staff. Yes the pet does wake up faster, sometimes this isn't a good thing because the pain medication given may not have had a chance to work yet. This can result in excited, painful recoveries, which as a tech I try to avoid at all costs.
The advantage to an IV induction is that it is fast, minimal excitement phase, and the animal can be intubated quickly- allowing us to protect its airway sooner. Ketamine/Valium is not the only IV induction agent. Propofol is a popular choice in sick or debilitated animals. It has some excretion throught the liver and some through the lungs. It is very short acting and animals wake up quickly with no hangover.
this thread has been very educational.
i have an 18 1/2 yr old cat who has CRF. she could really use a dental, but my current vet is not comfortable doing one on her.
i understand the concern about her kidneys, and as far as i know, she would be best off having an IV during a dental (and may need different induction agents than what was just used on my grandkitty- the ketamine/valiuim combo)
but i am wondering if she had a cardiac ultrasound and it looked ok, could she possibly be a candidate for a dental at a vet who was more experienced doing dentals on older/sicker cats?
i know many people who have cats with both diabetes and CRF who have gotten their cats teeth done.
it was important because diabetics are more prone to infections.
there were given IV fluids during the dental- i do not know what anesthesia was used,
and i do not know if they had a cardiac ultrasound first.
my thinking is that if her heart is ok, an experienced vet would be willing to go ahead.
she has always been a very healthy cat until she got the CRF (followed by IBD)
she does not look like an 18 1/2 yr old cat- she could easily pass for 12 to 14 (and then only because of the muscle wasting in the hind quarters)
are there other diagnostic tests that would be important for an elderly cat with CRF?
her CRF is stable now- her BUN has been running above normal but with regular fluid therapy, her creatinine is now high NORMAL
its so hard to know what to do- i think a dental could add a year or so to her life,
as long as she can survive the anesthesia..............
she will be going in to have her blood pressure checked, so maybe i should ask about the cardiac ultrasound?