Dr. Phil Zeltzman’s Blog

Vets have been able to dramatically decrease the death rate under anesthesia thanks to better anesthesia drugs and better monitoring.

What does monitoring mean?

Let’s review some techniques we use at our hospital to reduce the risks.

Please understand that not all practices have this equipment, for financial reasons mostly. As a general rule, we perform higher-risk and longer anesthesia and surgery, so we have an obligation to provide the best equipment available.

Vital signs

One of the many roles of the anesthesia nurse is to record the pet’s vital signs and numbers indicated by the devices described below: body temperature, blood pressure, heart rate, respiration rate, temperature etc.

This is critical to determine if there is a trend.

For example, is the blood pressure slowly dropping?

The surgeon is then alerted, and decisions can be made in a timely manner.

ECG

Most people have had an ECG (aka EKG), so most are familiar with the concept. An ECG measures the electric currents generated by the heart. It helps monitor the heart rate and rhythm. It allows early recognition of heart issues, such as arrhythmias (extra heart beats), which can then be treated appropriately.

Blood pressure

Blood pressure measurement is probably the earliest indicator of problems with anesthesia in pets.

Pulse oximetry

This is a way to estimate how much oxygen is being carried by red blood cells.

You may have been connected to such a device at the hospital.

This is the clip that is usually placed on your finger.

In pets, the probe is usually placed on the tongue.

Temperature

Anesthesia commonly reduces the body’s temperature.

We are obsessed with maintaining pets’ temperature, especially small ones.

Opening a body cavity (chest or belly) leads to losing even more body heat.

So we use several modalities to keep the temp up.

For example, every single patient gets a “Bair Hugger,” which is a warming blanket, in addition to a heating pad under their body.

It is important to warm patients up after surgery as well.

Capnography

This is a fancier machine, not routinely available in general practices.

It monitors the amount of CO2 (carbon dioxide) in the patient.

If it becomes too high, it means that the patient is not breathing enough to “blow off” the toxic CO2.

The anesthesia nurse would then help the patient breathe.

Such equipment undoubtedly helps us greatly improve the safety of anesthesia.

By far, my favorite way to monitor my patients is my skilled nurses.

The risk obviously depends on the patient and the type of surgery.

For example, spaying a healthy 6 month old Lab puppy is less risky that removing a 1 pound cancerous tumor from the liver of a 14 year old diabetic, seizure-prone poodle with heart and kidney disease!

That said, the OVERALL death rate under anesthesia is:

. 0.06 to 0.43% in cats;

. 0.11 to 0.43% in dogs

according to several studies conducted in the late 1990s.

As you can see, careful monitoring makes the anesthesia as safe as possible, so that we can reach our ultimate goals: a healthy pet and a happy pet owner.

If you would like to learn how we can help your pet with safe surgery and anesthesia, please contact us through www.DrPhilZeltzman.com

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Phil Zeltzman, DVM, DACVS, CVJ, Fear Free Certified

I can’t even imagine what veterinary practice would be like without our veterinary nurses. Actually, I can: Pure chaos.

I’ve long referred to them as veterinary nurses because I think it’s a better description of the role they play in animal health practice than the current official “veterinary technician.” It turns out I was just ahead of the curve, because the National Association of Veterinary Technicians in America (NAVTA) has officially come out in favor of a national program for registered veterinary nurses, RVNs, to replace “technician.”

Whatever you call them, without a shadow of a doubt they are the main reason I am able to do what I do. They are lifesavers — and not just pets’ lives, but vets’ lives, too!

If your pet is one of my surgical patients, or if you’ve been to any vet recently, I want you to consider this:

• A nurse started the consultation
• A nurse admitted your pet for tests or surgery
• A nurse drew and analyzed blood work
• A nurse took x-rays
• A nurse provided sedation, anesthesia, and pain relief
• A nurse monitored anesthesia
• A nurse assisted in surgery
• A nurse cleaned surgical instruments
• A nurse fed your pet
• A nurse changed your pet’s bedding
• A nurse applied a bandage and managed wound care
• A nurse discharged your pet after surgery

In fact, a veterinary nurse did so many things it would take two pages to list them all. I routinely see nurses hand-feed finicky patients, carry them around (granted, more often with cute fur balls than 80 pound Labs), pet and spoil the patients, give them kisses, talk to them in a funny voice, and more.

Did you know all that was happening behind the scenes? How about these real-life examples from the work of the best tech I work with?

• She buys a fast food meal with her own money and feeds it to dogs who are going to be euthanized (with the owner’s permission), saying, “They might as well go over the rainbow bridge with a stomach full of junk food!”
• She runs has her own mini-rescue organization
• She’s been known to pay for veterinary care a pet’s owners can’t afford

It’s National Veterinary Technician Week, so if you happen to be at a vet clinic, or if you are particularly grateful to a nurse or a group of nurses, this week would be a great time to express your gratitude!