Anesthesiology

Your pet’s anesthesia care begins well before their case is added to the anesthesia scheduling system.

All patients who undergo anesthesia are first evaluated by an admitting service, who is responsible for their overall care and communication. These initial evaluations and care oftentimes occur days to weeks prior to the anesthetic event and involve careful evaluation of a patient history provided by you – the owner – as well as supporting documentation from other veterinarians, analysis of previous bloodwork, and determination if further diagnostics or treatments are recommended prior to your patient arriving at the hospital for general anesthesia. The anesthesia service may be consulted during this initial evaluation to help determine any ancillary tests or treatments that may be recommended, as well as the best course of action on the day of the procedure. Occasionally, patients may have their anesthetic or sedated procedure performed on the same day as their initial appointment to the Lloyd Veterinary Medical Center.

If it is determined that your pet requires diagnostics or treatment under the care of the anesthesia service, their case is added to the anesthesia schedule. An anesthetist on the anesthesia team then evaluates all the information gathered by the service that admitted your pet for care, listens to your pet’s heart and lungs, if possible, and assesses their comfort level in the hospital to generate an individualized plan for their anesthetic management. These plans are then discussed with a veterinary anesthesiologist who is ultimately responsible for plan approval.

Anesthetic plans are generally split into three phases of anesthesia. Every individualized plan is designed to optimize these phases of the anesthesia experience for your pet:

1. Care and medications before general anesthesia.
2. Induction and maintenance of general anesthesia.
3. Recovery from general anesthesia.

Our goals during the anesthetic period are to minimize any stress your pet may experience while in the hospital – meaning we keep physical handling and restraint to a minimum, when appropriate – and to reduce the sensation of fear, anxiety, and pain with medications prior to induction of general anesthesia. Drugs and drug dosages are selected based on your pet’s unique needs and physical status, and requirements for supportive care and monitoring equipment for your pet are determined ahead of time.

Your pet’s anesthesia experience begins when the anesthetist first interacts with your pet. The anesthetist in charge of their case will review the medical record and ensure that proper identification is placed on your pet prior to administering any medication. If your pet does not already have an intravenous catheter, they will be brought to a quiet, clean anesthesia recovery area where they will typically be administered medication to provide a lower stress experience for intravenous catheter placement. Any pets provided with sedative medications are monitored closely until they are deemed relaxed enough to place an intravenous catheter.

Upon placement of an intravenous catheter, your pet is brought to the anesthesia induction room. The anesthesiologist and the anesthesia team operate out of the induction room, which allows for management of up to 10 patients at a time. Every patient is assigned a padded transport gurney, an anesthesia machine, and a cart with monitoring equipment and supplies for anesthetic management. If your pet is particularly stressed by commotion, a separate quiet room with a closed door may be utilized to improve their experience.

All patients undergo a pre-induction checklist, where the veterinary student and technician assigned to the case ensure that they have the correct patient and procedure information, to minimize the risk of medical errors. Your pet will then be administered general anesthetic drugs via their intravenous catheter. Once your pet is anesthetized, an endotracheal tube will be placed and secured to provide oxygen and respiratory support.

Monitoring equipment is utilized to monitor blood pressure, heart rate and rhythm, respiratory function (breathing) and oxygen status, and body temperature. Your pet’s anesthetists will monitor anesthetic depth and adjust drug administration under the guidance of an anesthesiologist to promote an ideal anesthetic state and minimize the side effects of any medications. Supportive care, as determined in the anesthetic plan, may be provided as needed to keep your pet’s blood pressure, body temperature, and respiratory function in the ideal ranges. Additional supportive care is provided as needed under the guidance of an anesthesiologist.

Recovery from general anesthesia is equally as important as the anesthesia itself. In this phase, we begin to reduce the anesthetic medications and wean the patient off of supportive measures used during the procedure. The goal is for your pet’s body to resume care of the normal life processes such as regulating its own blood pressure, body temperature, lung function, and reflexes. This process can vary between patients depending on the severity of disease, length and type of procedure, and medications used. Regardless, the same standard of care is applied to all pets, and no pet leaves the care of the anesthesia service until the team is happy with their status, or the service has confirmed transition of supportive care to the intensive care unit (ICU).

Some patients may leave the hospital the same day as their procedure (as ‘out-patients’) and some may need to spend one or more nights in the hospital to completely recover from the effects of general anesthesia and their procedure. This decision is made in part through a collaborative effort between the anesthesia service and the admitting service, after discussion with you – the owner – about how well the patient did under the care of the anesthesia service.

Patients who spend the night in the hospital can be monitored for side effects of general anesthesia (e.g., nausea), have their pain levels assessed and treated if required, and can receive supportive care such as intravenous fluids or injectable medications as deemed necessary by the service implementing their care.

Every individual recovers from general anesthesia differently. If your pet is headed home after having general anesthesia, they may be ‘groggy’ or tired for up to the next few days. During this time, we recommend gradual reintroduction of food and water and minimizing access to stairs or other areas where they could fall. Most pets are back to themselves by the following morning. If your pet is quiet for longer than you expect, or you have any concerns, do not hesitate to reach out to your veterinarian.