Pre-anesthesia bloodwork before spay?

[gratefulbear629]

We always highly recommend pre-op bloodwork.. except on cat neuters and especially on older pets. We used to use ketamine but had one incident so now we give buprenix pre-op, mask down with iso (sevo for dentals and older pets) or give rapinovet and (depending on the procedure) possibly metacam for pain.

Originally Posted by semiferal

Assuming you can afford the $45, you will be much happier to have spent $45 unnecessarily than to lose your kitty when a $45 blood test could have prevented it.

Well said. The one incident that we did have.. the owner was in a rush to work and didn't want to be bothered to have anything explained to her and denied any work up prior to sx. Unfortunately, the cat passed away.

So, I definitely voted yes.

 

[xocats]

Originally Posted by gayef

The added benefit of having the bloodwork drawn now is that you will establish a "normal" baseline for your kitty in the future - as she ages there may be health issues that come up and by having a baseline of "normal" values in her bloodwork, you will instantly be aware of anything abnormal.

I also vote to have the bloodwork drawn, but I think I would go the extra mile (and to the extra expense) of having a complete organ function panel drawn.

 

[rosie0708]

Hi All. I am definately going to get the blood work done for my kitten.

My vet actually just called me back and I asked him about the different anesthesias (I mentioned that I was concerned with Ketamine, etc.). He said that they only use a tiny bit of Ketamine (paired with something else that escapes my mind right now) for pre-anesthesia, so he can get the breathing tube down her trachea. Then he uses the Isoflurane gas while she is in surgery and that they have her hooked up to several machines that monitor different things during surgery.

As far as the blood work, he tests for a variety of things for liver/kidney function, glucose, anemia, and some others.

Thank you for all the input...I know I learned a lot!! I'm crossing my fingers and hoping everything turns out okay!

 

[xocats]

You made the right decision.

Be sure to remind us, a day before her spay in a new thread, so we can give support to you both.

 

[dr. doolittle]

I just have to mention that Ketamine is not the big bad scary drug that everyone is making it out to be. Unlike any other anaesthetic drug, ketamine can actually increase heart rate and blood pressure. Most drugs lower heart rate and BP forcing the anaesthetist to struggle to keep the cat alive and well perfused during surgery. Ketamine also has good pain control. In cats (and dogs) ketamine is usually used with valium to induce anaesthesia and place an endotracheal tube. Then the cat would be placed on isoflurane or another gas anaesthetic. Using ketamine with other drugs allows the anaesthetist to use less of each drug which lessens any negative side effects those individual drugs may have. This is called "balanced anaesthesia" and is the gold standard in good veterinary practices. Any Vet that only ever uses one drug, or anaesthetizes all animals the same way is taking a big risk. Every animal is different and should be treated as such.

On the bloodwork topic- a very good idea if you can afford it. Occasionally, young "healthy" animals are born with congenital defects that cannot be picked up with a physical exam. Sometimes a blood panel will detect this. Even if the results are perfectly normal, you will have a baseline profile of your animal when he/she is healthy which will give your vet something to compare future results to.

 

[jeanor]

All of the vets we've ever gone to strongly recommend it. I've only done it once, with a Siamese that needed his teeth cleaned. Turned out, the bloodwork determined a kidney problem. Unfortunately we ended up having to have him PTS.

I haven't ever done it with my kittens spays or neuters - as long as they appear healthy. I know it's probably not the best, but it's usually what I can afford. I think there are three levels of vet care... OK, Better and Best. Unfortunately I can't always afford the best - I usually aim at least for 'better'

 

[semiferal]

Another advantage of ketamine is that it inhibits the gag reflex. That means an animal is much less likely to vomit while under anesthesia.

There are specific medical conditions that would contraindicate the use of ketamine but for the most part it is an extremely safe drug.

 

[abbycats]

Maybe there is advantages to ketamine... But when you watch your loved cat go thru 3 days of in and out of drug induced coma to death due to that drug, you will definatly think about another option! I still remember his crys before he fell to the floor.

I loved Tommy so much, he was my first abyssinian who was given to me from a breeder, he had a sad story behind him. I felt like I let him down so bad.. If I can do anything in his behalf, it would be to tell other cat owners what happened to me because of that drug.

From my personal experiences with ISO vs ketamine. The cat who got the ISO is home the very same day without acting all drugged up. The cat who gets ketamine is messed up for days, and is not released from the vet until at least the next day...

 

[petnurse2265]

We use ketamine and valium regularly, and all our patients go home the same day. I am very sorry to hear about your cat, but what happens if you have a cat die under straight ISO (and it can happen)? are you going to swear off ISO? We always try to do what is right for the animal, but there is always a percentage that will die under anesthetic no matter what is used. There are people who still die under anesthetic, and doctors try to be very careful so they don't get sued. It will never be a perfect world and there will never be a 100% drug, someone or something will always have a reaction to it.

 

[abbycats]

I understand what you are saying, It's just that the ISO is not metabolized through the cats kidneys and liver. It is a better option to take. I have had long talks with my vet about this. and he totally agreed with me. Also an older cat would probably be better off with the ISO because as they get older we all know that there kidneys start to go.. Yes, they may pick that up in a pre blood work test but what if the older cat is just a little above normal, using ketamine could push their kidneys over the threshold, since it is metabolized through the kidneys. I understand the risks we take with anesthetic, but I would like to lessen the risk.

 

[gayef]

With nothing but the utmost of respect for our members in the Veterinary Care field, I have to agree with abbycats. I have lost several cats to Ketamine use (the post-mortem examination findings confirmed that) and will never allow it to be used in my cats ever again, for ANY reason. The fact that gas is metabolized in the lungs (out of the system more quickly) and the fact that it does not in any way stress the renal system (which can already be compromised in many cats - bloodwork analysis/interpretation issues notwithstanding) gas is, IMO, the better alternative if one is looking to minimize risk. The fact is that until very, very recently, ketamine was not even labeled for use in cats - it was labeled for use in canines only.

 

[kiaira]

Originally Posted by semiferal

It's "unnecessary" unless your cat happens to have a previously undetected medical problem. The problem is that only the bloodwork can detect such a problem.

If you can afford the bloodwork, then it is wise to have it done. Chances are overwhelming that the bloodwork will be normal and your kitty is just fine. But if your cat does have a medical issue that could complicate anesthesia, the bloodwork can be lifesaving. Assuming you can afford the $45, you will be much happier to have spent $45 unnecessarily than to lose your kitty when a $45 blood test could have prevented it.

Well said!
Although the majority of spay surgeries run smoothly, and pre-op blood is almost always normal on young cats....there will always be that one with a medical problem...and I would hate to lose her when (like you stated) it could have been prevented by running some blood tests.
We always recommend it before every surgery and most of our clients opt to have it done. I always have pre-op blood work done on all of my animals

 

[plebayo]

I just have to mention that Ketamine is not the big bad scary drug that everyone is making it out to be. Unlike any other anaesthetic drug, ketamine can actually increase heart rate and blood pressure. Most drugs lower heart rate and BP forcing the anaesthetist to struggle to keep the cat alive and well perfused during surgery. Ketamine also has good pain control. In cats (and dogs) ketamine is usually used with valium to induce anaesthesia and place an endotracheal tube. Then the cat would be placed on isoflurane or another gas anaesthetic. Using ketamine with other drugs allows the anaesthetist to use less of each drug which lessens any negative side effects those individual drugs may have. This is called "balanced anaesthesia" and is the gold standard in good veterinary practices. Any Vet that only ever uses one drug, or anaesthetizes all animals the same way is taking a big risk. Every animal is different and should be treated as such.

We use this combination, and use ISO. In the 3 years I've been working at this clinic [my sister has been there for 20+ so I dunno what she has seen] I have never seen a cat or dog spay die under anesthesia.

From my personal experiences with ISO vs ketamine. The cat who got the ISO is home the very same day without acting all drugged up. The cat who gets ketamine is messed up for days, and is not released from the vet until at least the next day...

I wonder what they put with the ketamine. We release our spays and neuters same day, the pets are fairly lively when they wake up. It depends on the individual, some of them are still kind of groggy, while others are up and alert. I've only seen the "messed up for days" reaction when we give the patients morphine. Are you sure the vet who used ketamine didn't use a morphine injection afterwards? We recently spayed my dog and gave her morphine, she was wiped out for the next two days.

My biggest things with stuff like this is we're only hearing one half of the story. I'm sorry for the loss of your cat, however, it was only ketamine related? I just have a hard time judging things like this, when I am unable to talk to the veterinarian to know exactly what went on.

 

[catnapt]

one quick note, while having pre anesthesia blood work done is a good idea, it does not guarentee that something will go wrong during the surgery and your pet may die.

another thing that is equally important to ask about is, what kind of monitoring is done DURING the surgery (or dental, or whatever)

every cat is unique, and you need a vet who appreciates this. it is dangerous to put ALL cats on an IV during surgery, just as it is risky to not use IV fluids for a cat with compromised kidney function (although subcutaneous fluids may be safer)

does the vet use pulse oximetry?? this is so rare in this area that a vet who does use it makes a big point of letting you know.

for spays and dentals, at some clinics there is one anesthesiologist, one vet and several technicians- the techs do the dentals and the vet over sees them. the anesthesiologist is supposed to be monitoring up to six cats at the same time.

thats not what i want for my cats!!

getting answers to questions about how surgeries are done and what sort of monitoring is done may be more difficult, but i think its just as important as having pre anesthesia blood work.


studies i have read say that most deaths occur during low risk spays- are sudden and unexpected heart failures that no pre anesthesia blood work could have prevented.

 

[pat]

I would never skip pre-anesthesia blood work..I like having as much information as possible before any surgery on my pets. I continually see that imo, for my cats, the thorough and conservative route has been best, since my darlings continue to do things differently...the phrase, I've never seen that/seen that happen in a cat, is now a joke with my vet, and was uttered as recently as this week

 

[petnurse2265]

One thing I thought I would also bring up is it depends how ketamine is given. When I first started at the clinic I am at the one doctor (an older doctor) would use ketamine IM (intramuscular) on cats, when used this way it does leave them groggy for a couple of days. We now only use it IV with valium as an induction anesthetic (meaning long enough to intubate them and put them on ISO). Ketamine is a short acting drug when used IV, the Valium last much longer than the ketamine which helps the animal to wake up a little more slowly and calmly. Also if a pre-op pain med was used that tends to make them more groggy for awhile afterwards more than the ketamine. also having an animal a little groggy after a spay is a good thing because it is a way to tell them to take it easy. I am allergic to acetaminophen, but does that make it an unsafe drug, millions of people take it every day.

 

[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.

 

[rosie0708]

Originally Posted by xocats

You made the right decision.

Be sure to remind us, a day before her spay in a new thread, so we can give support to you both.

I'm definately going to be worried for her that day...I'm thinking of taking the next day off of work so I can monitor her and make sure she will be okay.

 

[xocats]

I think that it is a great idea to take the next day off, if you can do so without jeopardizing your job.

 

[rosie0708]

I have plenty of vacation days plus 2 "floating" holidays...