Anesthesia Myths and Urban Legends in Veterinary Medicine
Describing the risks and benefits associated with an anesthetic event is not an issue that’s alien to companion animal veterinarians. It’s something I tackle every, single, day. In fact, I’d count it among my top five speeches. Yep, it’s right up there with allergic skin disease, weight management, parasite control and periodontal disease.
And it’s no wonder it bears discussing. After all, most pets wouldn’t tolerate deep ear ablutions, careful dental cleanings, and routine sterilization procedures without complete anesthesia. So we exercise our anesthetic muscles a lot more than most general practitioners.
But that doesn’t mean it’s easy on the patients’ parents (AKA, owners). This is obviously something veterinary surgeon and newsletter author Dr. Phil Zeltzman has been thinking a lot about lately. Otherwise he wouldn’t have dedicated a whole weekly installment to this concept. Here’s what he has to say:
Scheduling surgery or dental work for your pet can be a scary proposition. Every procedure carries some measure of risk, so it’s tough to think about your loved ones under anesthesia. But before you panic, talk to your veterinarian to determine what’s best for your pet and discuss your concerns. And don’t hesitate to do a little research of your own. Here’s a guide to some of the most common myths about anesthesia:
Myth 1: Anesthesia complications are common.
Fact: Don’t let horror stories prevent your pet from receiving necessary veterinary care. Complications do occur, but deaths are rare. Studies suggest that for normal, healthy dogs and cats, the risk of death is approximately one in 2,000. For pets with a preexisting disease, that number increases to about one in 500. But a well-trained veterinary team will take every reasonable precaution — including having a knowledgeable staff, appropriate patient monitoring procedures, and proper patient evaluation and preparation — to minimize these risks.
My take: So the risk of dying, all pets combined, is a fraction of 1 percent. Still too high, but pretty amazing, don’t you think? In fact, the new trend among anesthesiologists is not to reduce the risk of dying under anesthesia, but to lower the complications related to anesthesia. For example, we can perform anesthesia on pets who have heart, liver and kidney disease, without damaging these organs some more.
Myth 2: Certain anesthetic drugs could harm my pet.
Fact: In most cases, monitoring a pet’s condition (for example, monitoring anesthetic depth, blood oxygen level, respiration, blood pressure, body temperature and heart electrical activity) during a procedure is much more important than which drug protocol is selected.
It’s more important for your veterinarian to tailor a protocol to each patient’s needs and provide an appropriate level of supportive care — seldom is one drug better or worse than others since they all have benefits and risks.
My take: Tailoring a protocol to each patient’s needs means that, for example, there are some drugs that we will simply not use in certain breeds or specific pets or with certain diseases. In the anesthesia world, one size does not fit all. "Every pet is different," as I keep repeating.
Myth 3: Most complications occur during a procedure while my pet is asleep.
Fact: Almost half of anesthetic deaths occur after the delivery of anesthetic drugs during recovery.
Ask your veterinarian for a rundown of how your pet will be cared for after a procedure and make sure you’re comfortable with that level of care. Premium care will often cost a little more, but you can take comfort in the fact that your pet will be receiving an optimum level of attention and monitoring during a very critical period.
My take: I couldn’t agree more. Again, over half of anesthetic deaths occur during recovery, i.e., AFTER anesthesia or surgery is over. This is especially true with dogs and cats with a flat face (brachycephalic breeds) such as Bulldogs, Pugs and Bostons.
This is the reason why it is so critical to ensure that a nurse will stay with your pet until it is safe to leave their sight. Even then, periodic "rounds" to make sure everything is OK are critical.
Myth 4: The Internet is the most reliable source for information about potential anesthesia risks.
Fact: While some sites offer reliable and useful information, plenty of others contain inconsistencies or flat-out falsities. So don’t be fooled by misinformation, which can spread quickly from website to website. Do your research on anesthesia and its potential - but rare - complications, then discuss your findings with your veterinarian to make sure you’re getting the most accurate picture. This will allow you to do what’s best for your pet, and perhaps rid your mind of a few unfounded fears.
My take: What can I say? There is an enormous amount of junk on the Internet. It’s one of the reasons I started this crazy newsletter project, and my web site. Online, anybody can claim to have some knowledge. Just because someone has had Labs or Siamese cats their whole life does not make them anesthesia specialists. Just because someone has had the misfortune of losing a pet under anesthesia does not make them a reliable source of information. Clearly, your vet is the best source of information about your pet’s specific needs. Now, if you don’t trust your vet to do anesthesia on your pet, you have a real problem. You should find a vet you trust. It’s that simple.
Myth 5: Most veterinarians provide a similar level of anesthetic care and monitoring.
Fact: Every veterinarian has a different way of doing things. Some may refer cases to, or consult with a specialist for anesthetic procedures, while others may rely on their in-house team. If you have any questions or concerns, ask your veterinarian for details before your pet undergoes any anesthetic procedures, and then make an informed decision about what’s best for your pet.
My take: As a traveling surgeon, I work with many vets, and indeed I can attest, "every vet has a different way of doing things." I have to say that overall, the vets and the nurses I work with all do a great job. We hardly ever lose a pet under anesthesia these days, even some really, really sick ones, and it’s without any question thanks to safe drugs, great monitoring, and above all, doctors and nurses who care about their patients immensely.
So what’s MY take? My take is that I agree so wholeheartedly with what Dr. Z says here that I just had to take this opportunity to plug his newsletter yet again. 'Nuff said.
Dr. Patty Khuly