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Alternatives to ketamine?

post #1 of 16
Thread Starter 
I have a cat who's going to need a tooth cleaning and I'd like something else besides ketamine used to induce anesthesia. However, it seems all the vets around here use ketamine and are either reluctant to use another protocol or want to charge an arm and a leg. I'd appreciate any suggestions for alternate methods of anesthesia induction, particular something that would cost about the same. Thanks.....
post #2 of 16
Tim, my opinions on anesthesia are ummm ... controversial, at best. But I do not allow ketamine use in ANY of my cats, EVER. I request mask induction with either isoflurane or sevoflurane, continuous gas and oxygen during the procedure, IV fluids, including pain relief if necessary on board throughout.

I won't kid you, gas anesthesia is more expensive and it also carries risks - not as many as ketamine or ketamine cocktails though. But IMO, the increased cost and the increased amount of benefits far outweigh the risks.

Speak candidly with your vet about your concerns and ask him to go over the different varieties of anesthesia and induction as well as their risks with you.
post #3 of 16
I have a tribute I just posted to my Tommy, who passed away from ketamine 2 years ago. He went in for a teeth cleaning. He was only 5 years old.

My alternative to ketamine is ISO... Ketamine is a four letter word in my household
post #4 of 16
Thread Starter 
Gayef - I located one vet who was willing to do isoflurane induction, but he says that since the cat has to be put in a box, it's extremely stressful and he doesn't like doing it. What are your thoughts on that?

Abbycats - sorry about your Tommy.
post #5 of 16
Personally I would much rather my cats be put in a box for induction and be stressed for a couple of seconds over having them die on the table from a ketamine reaction. But you need to do what is best for your cats and for you.
post #6 of 16
Originally Posted by abbycats
I have a tribute I just posted to my Tommy, who passed away from ketamine 2 years ago. He went in for a teeth cleaning. He was only 5 years old.

My alternative to ketamine is ISO... Ketamine is a four letter word in my household
What a lovely tribute to a very sweet little Abby boy ... I am so sorry for your loss.

Even though many cats do fine with ketamine, I just think it is so not worth the gamble.
post #7 of 16
We use a ketamine and valium mixture for all dentistry's at our clinic and never had a problem. Gas induction is more stressful because it the animal goes through an excitatory phase which is stressful to them. Also with a gas induction (which does take 5-10 minutes for them to go down) for a dentistry you have to take them to a deeper anethesia plane to intubate them which is not very safe either. If you don't intubate them then you have to take them deep, clean the teeth till they start waking up some then gas them down some more so they are on an anethesia roller coaster ride which is not safe either. With ketamine /Valium it is a "twilight" anesthesia, they are not completely out, but enough that we can do what needs to be done, but the don't remember it. Talk to your vet and have him explain the different options open to you and the pro's and con's of each.

Here is a link you can look at too.
post #8 of 16
Thread Starter 
Thanks for the link...that's an awesome thread!!
post #9 of 16
I have also NEVER, in my 10 years as a tech, seen a ketamine reaction. I am not saying it isn't possible, but I've always used it in my own cats and thousands of cats in our clinic and have never had problems. I'd wonder about the vet saying it was a ketamine reaction and really it was maybe something else. I gas boxed my cat once due to the fact that he's fractious at the vet, and it's a horrible experience for them. I do not want to sound contradictory, just stating the facts as I see them.
post #10 of 16
I deeply respect the opinions of our veterinary care professional-members here at TCS - I am often humbled by their expertise and knowledge. A few of them have made wonderful suggestions here which, when employed in my own home, have made remarkable positive changes. However, when it comes to anesthesia preference, I am also stating the facts as they pertain to my own personal experiences.

I have lost cats due to ketamine use, confirmed by post-mortem analysis. Abbycats lost her beloved Thomas ... and I personally know 10 or more people in my own group of family/friends who have also lost cats from ketamine reaction. I do have to say that the majority of those people did not have any sort of confirmation of that other than what their vets told them, but the post-surgical symptoms those cats presented were all ... well, let's just call it 'indicative'. My dearest friend Tricia lost her sweet Toby and was told "Well, he must have had undiagnosed cardiomyopathy (which is prevalent in cats, by the way) - it wasn't the ketamine that killed him, it was the cardiomyopathy!" Ummmm, would it not make better sense then, since we know that cardiomyopathy doesn't always show up on most pre-surgical blood screens, to use an anesthesia which would be safe for ALL cats?

Please don't misunderstand me ... I am certainly not implying that gas anesthesia doesn't carry risks - it does. But IMO and for my cats, the risks of ketamine use are greater in number and severity.

It should also be noted that not all veterinary clinics use the box-induction method. My vet has used this method in the past, but prefers the mask. He just finds it easier on everyone - most importantly, the cats. But I still hold fast to my original thought on box-induction ... I would rather my cats be stressed for a few SECONDS than die from post-surgical complications of ketamine. If performed correctly, gas box induction should be almost immediate, no more than a few seconds at most. If your experiences are different, Petnurse2265, then in the sincere hopes of trying to be helpful to you, maybe a little tip I heard while in my own vet's office one day will assist in some small way ... my vet noted that in his experience, box induction seems to go a lot easier and more importantly, faster for the cat if you place a ~warmed~ blanket or other such material in the bottom of the box before inserting the cat - they don't resist as much and so the process goes quicker. I don't know if this will change your experiences, but it is offered in the spirit of trying to help.
post #11 of 16
The best response I ever heard to the anesthesia question (I have sighthounds also) is that the best anesthesia is the one the veterinarian is most experienced and comfortable using.
post #12 of 16
Thread Starter 
And that's another concern. If I convince a vet to use a non-ketamine induction, and it's something they haven't used before, then it adds another level of risk. I don't really want them learning on my cat, either.

I just wish there was some way of measuring ketamine's risk: is it one in a hundred, one in a thousand, one in ten thousand? What is it?
post #13 of 16
When my older cat ever needed to be sedated for procedures, they always used gas. I'm not sure what kind it was, but I was told that it was safer for him because if something went wrong, that the gas could be taken away and he'd wake up much faster than with other methods. Plus, when he came home, he wasn't groggy for hours afterwards and didn't have that goop stuff around his eyes from being under.

And looking back over the detailed vet bills, it didn't seem to be more expensive.
post #14 of 16
I also know of way to many cats/kittens who have passed because of Ketamine. When we began breeding it was essential for us to find a vet with experience in some other anesthesia than Ketamine. We have heard a lot of breeders with a success with Isoflourine. That is what we use on all of our pediatric spay and neuters, and for any other surgery's that require anesthetic.
There are also different anesthetics that have Ketamine in them, I don't remember all the different names, but Ketaset, was one that comes to mind. We haven't used it, although our vet said it didn't have as many negative effects as Ketamine did.
Although, I wouldn't think it wise to "talk" the vet into a different anesthesia than what he is familiar with. I called around and spoke to several vets, and those that I liked, I went in to talk with them further. It took us a few visits to find the right vet, but I can say that we love our vet now.
Good luck!!
post #15 of 16
Everytime I go to a petloss forum there is another cat who died from the anesthetic.

I never heard of Ketamine before Tommy died. If I could turn back the hands of time I would have had the vet use ISO on Tommy. I learned the hard way. Tommy didn't die right away. He never came down from the ketamine and he went in and out of a coma for 3 days. He died alone in a cage at the vets office. It was the most heart breaking experience. I wouldn't want anyone to go through what I did that awful week in March 2 years ago.

Ketamine seems to be a very dangerous drug. I would opt not to use it, rather than learn the hard way.
post #16 of 16
If your cat has had ketamine in the past and tolerated it well, then it would be the best way to go.

I've worked in clinics where they don't use injectable anesthesia at all for cats and clinics where they use injectable. Masking down a cat with ISO is a harrowing experience for both of us!

My experience with ketmine goes along with the statistics - 99.5% tolerate it without any problems. Unless the animal has a condition or history that specifically contraindicates the use of ketamine, I consider it as safe as any other anesthetic.

Bear in mind that it's not like vets are out to lose patients or will cut corners to save money or anything like that. Besides the fact that the vast majority of small animal vets are animal lovers and like all doctors, they certainly don't want to lose a patient - it's their licenses and their butts on the line if they make a questionable decision and an animal suffers a serious complication. If ketamine were not a very safe drug, it would not be routinely used as it is.
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