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  Volume No. 16 Issue No. 8 August 2019  

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Dr. Jim Humphries

  Anesthetic risk in veterinary medicine
  By Dr. Jim Humphries
  Veterinarian

   Over four decades as a veterinarian, I have spoken with thousands of clients before a surgical procedure on their beloved pet. Most pet owners accept the risk with the understanding that everything possible is likely done to keep your pet friend safe.
   
   However, some people have had a personal experience with a terrible outcome either with their pets or perhaps even a human family member or relative, and this makes them afraid of anesthesia no matter how necessary it is.
   
   No anesthesia is completely without risk. Very often pets that need anesthesia are quite sick or have advanced years and present us with a greater risk of complications. However, it is a modern miracle of medicine and must be used to make life better, extend life or save a life.
   
   Today, anesthetic risks are increasingly small. Risks such as heart problems, brain dysfunction, aspiration pneumonia and blood pressure fluctuations are carefully monitored and managed. Sophisticated equipment and drugs make even major surgery a safe daily procedure in most veterinary medical facilities.
   
   Worrying about these risks can stress pet owners so much as to prevent a pet from receiving the care they need. What can you and the veterinary team do to make this less stressful and better understood?
   
   Here are a few communications tips to help you and your petís doctor discuss anesthetic risks, and help you become more comfortable with the process.
  1. Tell your veterinarian why you are concerned (or even afraid) about an upcoming anesthesia. This should elicit a frank discussion about this important matter. Your veterinarian should respect your concerns, and he or she should be able to explain everything the entire team does to minimize anesthetic risks. If they seem rushed or perhaps bothered by your request, maybe this is not the right veterinary hospital for you.
       
       Here are some key features to modern and safe anesthesia in veterinary practice; you want to see the use of the most modern anesthetic agents like propofol, sevoflurane, etc. Today, anesthesia should not be done without multi-level intra-operative monitoring including ECG, blood pressure and CO2 monitoring (capnography). All pets will benefit from circulating warm water blankets both above and below the patient, a well-trained staff to monitor without distractions; and backups for absolutely everything. The use of a safe surgery checklist is now considered essential. A trained veterinarian or technician should be monitoring the patient all the time ó including complete recovery.
       
  2. If it is possible, before a surgery, have someone on the team take you into the surgery room and see the equipment used to provide for a safe anesthesia. Veterinary hospitals are interesting places, and the staff should be proud to show you the facility and explain it. Of course, if they are busy, be respectful of their time.
  3. If you have some specific concerns that come from past experiences, then donít be afraid to speak up and ask what this hospital specifically does to prevent this from happening. Be frank as most veterinary doctors and staff are happy to share the technology they have in place for high quality anesthesia.
  4. If your pet is a senior or has a disease that makes them a greater anesthetic risk, ask what they can put into place to take extra precautions. Some cities, like ours for example, have a veterinary specialist in anesthesia that can be hired to take over and run the entire process (see peakvas.com). For a critical case, I would not hesitate to pay a little extra for this expertise.
  5. A technician can run the anesthesia only at the direction of the doctor, but they cannot do this by themselves. So with the doctor directing the anesthesia and doing the procedure means everyone must work as a team and know what to do in case of an emergency.
  6. And finally, the anesthetic is not finished until the patient has left the hospital on its own power; therefore, intensive monitoring and recovery are an essential part of this process. Find out what happens if there is a problem here and where your pet goes for overnight monitoring. There is a surgery record and an anesthesia record generated with every procedure. If there is a problem, ask for these records in case you need to prove there was a problem that was not handled correctly.
       
       I am a big believer in being direct and open. This is your pet and you are paying the bill. You have everything to say about what happens here. Do not just automatically trust or allow shyness to keep you from asking hard questions. Remember all along, you are advocating for your loved one, as they cannot do this themselves. Take this very seriously.
       
    Dr. Jim Humphries is a veterinarian in Colorado Springs and also serves as a visiting professor at the College of Veterinary Medicine at Texas A&M University. He lives in Falcon with his wife, horses and Great Danes. www.HomeWithDignity.com
  
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