We understand the concerns that you may have regarding your pet undergoing anaesthesia.
However, at VetDentist, we know that proper diagnosis is often only possible under sedation or general anaesthesia. We also know that treatment usually requires anaesthesia – even if follow-up home care is going to be an integral part of the complete treatment.
In general terms, anaesthesia will always carry some risks. VetDentist takes precautions to make those risks (which are generally small already) even smaller. However, the potential benefits to your pet of undergoing investigation and treatment under anaesthesia far outweigh the potential hazards. This is why we recommend proceeding.
This short video outlines the steps we take to make anaesthesia as safe as possible:
Prior to the anaesthetic, a detailed history will be taken from you. This will not only describe the presenting problem (- for example, a tooth fractured 2 weeks previously) but other more general conditions. Things like increased thirst, or increased urination will be noted and may suggest further tests prior to the anaesthetic.
A detailed physical examination will be performed. Whilst our focus is on the mouth and dental issues – a fuller examination is essential for the safety of the anaesthetic. For example – the abdomen will be palpated for signs of liver enlargement or other problems, the heart and lungs will be listened to for signs of abnormalities.
Pre-Operative Blood Samples:
We do recommend that most anaesthetic cases have pre-operative blood samples analysed. Liver and kidney problems can be detected far earlier on a blood sample, rather than waiting until more advanced physical changes are apparent. We are able to run many of the laboratory tests in-house and so analysis can be done that day – prior to the anaesthetic.
Using a "pre-med" will usually provide some pain relief, in addition, it will often dramatically reduce the dose of anaesthesia that is required. Pets will become sedated and then the anaesthetic can be given in a minimal stress environment.
Usually, we induce the anaesthesia using a short-acting intravenous agent. Pets gently fall asleep and we can then intubate them. The agent itself is then quickly removed from the bloodstream, allowing for a more controlled anaesthetic and recovery.
For the vast majority of our dental procedures, a tube is passed into the airway. Most importantly this allows gas anaesthetics to be used, together with suitable monitoring. It also ensures that no debris is allowed to pass into the lungs to cause damage.
Intubation means that gas anaesthetics can be used. These have far greater control (an injection cannot be pulled back out – but the anaesthetic gas can be switched off to simply provide oxygen allowing a patient to quickly wake up.) At every breath, the anaesthetic concentration can be varied – providing the sort of control we aim for. In addition, patients can be aspirated with Oxygen should the need arise.
Every anaesthetised patient is allocated a dedicated member of the nursing team to monitor their anaesthetic. Reflexes, responsiveness, eye position, mucous membrane colour and capillary refill time, respiration and cardiac rates are all assessed to provide guidance as to the depth of anaesthesia. This is then varied by the veterinary surgeon and changes constantly monitored. In addition, we have invested in an array of sophisticated monitoring aids. These monitors are available PER ANAESTHETIC PATIENT – not simply one machine serving the whole practice.
- Respiration Monitor
- Heart – ECG - Monitor
- Pulse Oximeter – indicates oxygen levels within the blood
- Capnograph – indicates expired CO2 levels and the pattern
- Blood Pressure monitors
- Temperature monitors (both skin surface and internal – with the difference being noted)
- Inspired Anaesthetic gas concentrations
Body Temperature Support
Under anaesthesia, our patient’s temperature control is not as effective as when they are awake. So we use heated tables and mats. In addition, we also have heated air blankets to provide excellent support for higher risk patients or longer procedures.
These can be indicated by the results of the pre-operative blood tests, but are also sometimes used for additional support for higher risk patients or for longer procedures. Our IV Fluids are all delivered by dedicated IV Fluid pumps – providing controlled, measured fluid volumes directly into the veins.
Local anaesthetic techniques can be employed to assist in pain relief and in reducing the overall need for a higher depth of general anaesthesia.
This is usually continued from the premedication prior to pets waking up from anaesthetics. Our aim is to provide as smooth a transition as possible. Pain control medication will usually be continued at home with tablets or other medications.
Pets are transferred to the recovery ward – where their kennels have been individually heated. They are closely observed until they are fully conscious again.
Sometimes pets may need to be bathed, or their faces cleaned again before they are ready to go home. We also try and trim their nails and make sure that they are comfortable. Occasionally we may need to fit an Elizabethan collar (or similar) to prevent any self-harming.