Pre-anesthesia bloodwork before spay?

[russian blue]

Originally Posted by abbycats

I think that Ketamine is the worst drug in the world to give to animals for anesthetic. I have talked to other people who have lost their animals to that particular drug. After what happened to Tommy I will never let the any vet use that drug on one of my cats again. I have them use ISO on all my cats when they have to be put under. There is probably danger in that drug too, but not as much as ketamine. I notice a big difference when they come back from the vet, they are not as drugged up.

Not to hijack this thread, but here is my ketamine experience when Nakita went to the vet to get spayed. Plus, the vet who did the surgery barely mentioned the pre-surgery bloodwork option.

I posted this thread on TCS when I first joined:

http://www.thecatsite.com/forums/sho...light=ketamine

 

[catnapt]

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?

 

[semiferal]

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.

I've induced many cats with straight Iso by mask and it's not all that pleasant an experience for either one of us. Iso burns the throat and the cats fight tooth and nail. I usually end up having to wrap the cat in a towel, hold the mask in place with one hand, scruff the cat with the other, and lean over to use my upper body to keep the cat from trying to run off the table when half anesthetized. No cats have ever been hurt (knock wood), but all it would take would be a momentary lapse of concentration on my part. As it is, losing focus for just a second or two has caused me to be shredded by back claws a couple of times.

I respect this clinic's desire to use only iso, but I honestly think the benefits of routine use of a small amount of a ketamine cocktail would outweigh the risks.

 

[petnurse2265]

Originally Posted by semiferal

I've induced many cats with straight Iso by mask and it's not all that pleasant an experience for either one of us. Iso burns the throat and the cats fight tooth and nail. I usually end up having to wrap the cat in a towel, hold the mask in place with one hand, scruff the cat with the other, and lean over to use my upper body to keep the cat from trying to run off the table when half anesthetized. No cats have ever been hurt (knock wood), but all it would take would be a momentary lapse of concentration on my part. As it is, losing focus for just a second or two has caused me to be shredded by back claws a couple of times.

I respect this clinic's desire to use only iso, but I honestly think the benefits of routine use of a small amount of a ketamine cocktail would outweigh the risks.

Your brave,

we have an induction box so we don't have to do that.

 

[plebayo]

Originally Posted by semiferal

I've induced many cats with straight Iso by mask and it's not all that pleasant an experience for either one of us. Iso burns the throat and the cats fight tooth and nail. I usually end up having to wrap the cat in a towel, hold the mask in place with one hand, scruff the cat with the other, and lean over to use my upper body to keep the cat from trying to run off the table when half anesthetized. No cats have ever been hurt (knock wood), but all it would take would be a momentary lapse of concentration on my part. As it is, losing focus for just a second or two has caused me to be shredded by back claws a couple of times.

I respect this clinic's desire to use only iso, but I honestly think the benefits of routine use of a small amount of a ketamine cocktail would outweigh the risks.

We have a box! But it's equally as stressing. They thrash around and freak out. Thank goodness I'm not asked to make a kitty burrito and hold them down! I agree with the cocktail, it's WAY less stressful on the cat.

 

[jcat]

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.

Your post has made me question the usual veterinary practices here. Generally, cats aren't intubated, as it's considered risky, while dogs normally are. I haven't encountered any vets here in the last 20 years who don't use as injection, generally ketamine, I believe, and then a mask to anesthetize cats.

 

[semiferal]

Cats go into laryngeal spasms when intubated. It's not an easy thing to do. We give Lidocaine in the throat once they're unconscious but even then, some cats do have trouble with the tube. Male cats and very small females are usually just masked the whole time.

 

[dr. doolittle]

I know a veterinarian with lots of experience that has written a book on anaesthesia that refuses to intubate cats...

She says that it is too risky

I intubate hundreds of cats a year and I have never had a problem. We too use a lidocaine spray prior to placing the tube, and I always watch my cats recovery closely. Once and awhile a cat will have some laryngospasm but it is treatable. Usually just a little oxygen with a mask and some time is all that is needed. In a really severe case more induction agent may be needed to replace the tube so that the cat can breathe. But like I said, out of hundreds of cats only a few will have this problem.
Aspiration pneumonia is much more serious and harder to treat. It is also much more likely to happen if the animal does not have an endotracheal tube in place.
Edited to add: even feral cats are intubated at my clinic.

 

[dr. doolittle]

catnapt:

I have performed dentals on 18 year old CRF cats before. If your vet is not comfortable then look for a feline practitioner, board certified anaesthesiologist, or board certified dentist. They should be willing to help your kitty. One thing I would definately recommend is bringing your cat to the clinic the night or even day before. They can hook your cat up to an IV and hydrate her for 24 hours prior to her anaesthetic. This will help her kidneys through the procedure. Using a board certified dentist will also reduce the amount of time she is under- they are very fast and have all the right tools!

 

[petnurse2265]

Not to mention that if you are doing a dentistry, or anything involving the mouth, it is really hard to work around a mask. Also with intubation if there is a problem during the surgery and the cat stops breathing you already have an established airway. Dentistry's are another good place where an an injectible anesthetic is very helpful, it is really hard once you have gassed a cat down with ISO to very quickly place an endotracheal tube before the cat starts waking up especially when you are dealing with laryngospasms.

 

[gayef]

*This thread is temporarily hijacked*

Dr. Doolittle, Semiferal, Plebayo, Petnurse and all our other Veterinary Care Professionals,

You guys are just awesome. I learn something new each and every time I read one of your posts. Thank you so much.

I know I tend to be a bit ... um ... *blush and sputter* ... one-way hardheaded about things a lot of the time and I don't mean to cause any of you offense.

Dr. Doolittle, thank you for being respectful of my feelings regarding my preference of anesthesia, it meant a lot to me to have that acknowledged by a pro. It is true that many Siamese bloodlines carry genetic issues which can predispose them to cardiac/renal issues and that really is why I am so stubborn about it.

Thanks again to all of you who truly do the best you can to edu-ma-cate us numptys. *smile*

*We now return you to your regularly scheduled thread*

 

[dr. doolittle]

Anytime Gaye!

Anaesthesia is my favorite subject!

 

[rosie0708]

By posting my original question, I didn't know it could become so intense...lol

 

[xocats]

My complements to all of the people who shared their knowledge & experience about general anesthesia on this thread.
I bookmarked it so that I can refer to it when my kitties need anesthesia.
It will help me ask some very important questions.

Exellent thread Rosie.

 

[charcoal]

Originally Posted by rosie0708

Hi All,

I am getting my healthy 5 month old kitty spayed next month. When I called the vet to make the appointment, they said the vet likes to do pre-anesthesia bloodwork on all the cats just in case. The bloodwork, of course, would cost extra ($45).

Do you all think this would be a good idea to get the bloodwork or just an unnecessary cost?

I would get the bloodwork done. I did for my little girl.

 

[abbycats]

My compliments to all who replied, it has been a great learning experience! I do have to question the medical community on the treatment of abyssinian cats, because I did not learn about the problems abyssinian cats can have with ketamine until my breeder told me. The medical people who deal with all cats should be more aware of what breeds have what problems, than the layman who has to be subjected to a death because the vet and techs did not know that that particular breed was a sensitive breed to ketamine. In all due respect to all the vets and techs on this board it is your job as medical professionals to tell me....... You mention siamese cats but have no mention to the purebred abyssinan cat, I did say Tommy was purebred abby when I posted. So do I trust you with my cat, or do I learn on my own what I have to on my particular breed?????. Unfortunalty I learned from Tommys death. I know why Tommy died, he died because I was not notified of the underlying medical conditions abyssinians have also to ketamine. So in the future on Tommys behalf always include the abby cat as a risk behind ketamine!!!!!!!! I felt like I murdered my cat thru the veterinary medical field. When I went to purchase another abby cat, and learned from my breeder that ketamine can be very deadly to abyssinians, I felt horrible.

PLEBAYO
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.

PLEBAYO
Granted, if you are going to a reputable clinic, they use VERY safe anesthetic

I would never take my cat to an unreputable clinic..

In all due respect are you going to tell the person with a abyssinian kitten/cat, or a siamese kitten/cat, ketamine is the drug to use on this particular breed when they come into your office????? I hope not.

Thats my other half of the story.....

With your knowledge on what they teach you in school, you should know this as a medical professionals. If you were not taught the negative use of ketamine in certain breeds, possibly in the future it should be a part of the medical training you recieve so as to bring you in to the 21st century.

 

[plebayo]

In all due respect are you going to tell the person with a abyssinian kitten/cat, or a siamese kitten/cat, ketamine is the drug to use on this particular breed when they come into your office????? I hope not.

I'm not saying it's the ONLY thing to use. No, I wouldn't necessarily offer it to particular breeds of cats.

However, you weren't THERE when they altered your cat. I was just saying, the results you are saying your cat had could be related to a number of things. It's just really hard to judge things on a forum. We all give our oppinions which are based on personal expiriences, so there's no way to really judge an anesthetic, based on someone else's expirience. Every cat is different, and every vet is different. I guess I mostly posted to point out that you shouldn't drop your vet if they use ketamine, because a number of vets do. ISO has its own ill effects, and that no anesthetic is going to be 100% safe. You just have to rely on the fact that your vet knows what they are doing, and are doing all they can to keep your pet safe.

That's all I am saying.

 

[rosie0708]

Hi All,

I am so glad I started this tread and I hope people learned a lot.

So my little furbaby is getting spayed on Wednesday and I am going to get the pre-anesthsia bloodwork done for her. I'm just very nervous and will be thinking about her ALL that day wondering how she is doing and how the surgery went.

I'll just think to myself that this is better for her, so she can lead a quality life...

 

[gayef]

You are a good kitty mom and are doing what is right for your baby - that is a good thing!

I'll be thinking of you and of your little girl on Wednesday! Let us know how it goes.

~gf~

 

[dr. doolittle]

Originally Posted by abbycats

My compliments to all who replied, it has been a great learning experience! I do have to question the medical community on the treatment of abyssinian cats, because I did not learn about the problems abyssinian cats can have with ketamine until my breeder told me. The medical people who deal with all cats should be more aware of what breeds have what problems, than the layman who has to be subjected to a death because the vet and techs did not know that that particular breed was a sensitive breed to ketamine. In all due respect to all the vets and techs on this board it is your job as medical professionals to tell me....... You mention siamese cats but have no mention to the purebred abyssinan cat, I did say Tommy was purebred abby when I posted. So do I trust you with my cat, or do I learn on my own what I have to on my particular breed?????. Unfortunalty I learned from Tommys death. I know why Tommy died, he died because I was not notified of the underlying medical conditions abyssinians have also to ketamine. So in the future on Tommys behalf always include the abby cat as a risk behind ketamine!!!!!!!! I felt like I murdered my cat thru the veterinary medical field. When I went to purchase another abby cat, and learned from my breeder that ketamine can be very deadly to abyssinians, I felt horrible.





I would never take my cat to an unreputable clinic..

In all due respect are you going to tell the person with a abyssinian kitten/cat, or a siamese kitten/cat, ketamine is the drug to use on this particular breed when they come into your office????? I hope not.

Thats my other half of the story.....

With your knowledge on what they teach you in school, you should know this as a medical professionals. If you were not taught the negative use of ketamine in certain breeds, possibly in the future it should be a part of the medical training you recieve so as to bring you in to the 21st century.

Once again, with all due respect, I understand your fear of anaesthesia after the experience you have had. We routinely use Ketamine (not by itself but in small amounts) at our hospital. We use it for pain control and anaesthesia. It is certainly not the only drug we use and we always keep a variety of drugs in stock so that we can tailor an anaesthesia protocol to the individual patient. We regularly attend continuing education seminars and consider ourselves to be a very progressive hospital. The board certified veterinary anaesthesiologist in my area is a big fan of ketamine. She has numerous doses and combinations for this drug and uses it in many situations. Another vet that I saw lecture in Las Vegas at a huge conference also had great things to day about it.

There is absolutely no evidence to prove that abbysinians have adverse reactions to this particular drug. I assure you that if a study had been done I would know about it. From what I understand your cat had a pre-existing medical condition that caused him to die under anaesthetic. The condition must not have been found on his pre-anaesthesia exam. As I mentioned earlier some conditions are very difficult to detect. The early stages of Hypertrophic cardiomyopathy for instance.

We have a breeder of Abby's that is a client. I have anaesthetized plenty of abby's and siamese using ketamine. I have never lost a patient. If I thought that abby's and siamese were at risk, I would choose a different protocol.