ASA Status

Scoring System

This is where ASA classification can help. An ASA risk is a 1-to-5 score adapted for animals from human medicine’s American Society of Anesthesiologists. The system is based on the patient’s overall health, not the procedure being performed.

The ASA scoring system is NOT an assessment of total perianesthetic or perioperative risk, since many things, including the surgical procedure planned, the skill & training of the anesthetist and the surgeon, as well as the the resources at hand, contribute to the entirety of operative risk. If you EVER have any questions or concerns regarding your pet and any upcoming procedure they may be having talk to your veterinarian/veterinary support staff immediately!

The pre-anesthestic phase includes NOT only the choice of preanesthetic sedatives & analgesics but also a full preanesthetic evaluation & stabilization of the patient, if necessary. Categorization of patients using the American Society of Anesthesiologists (ASA) provides a framework for evaluation of patient health & determination of stabilization requirements prior to anesthesia.

STATUSASA CLASSIFICATIONEXAMPLES
IHealthy Pet, No DiseaseElective Spay/Neuter
IIMild systemic disease or localized diseaseHealthy geriatric pet, mild anemia or obesity
III (Fair)Moderate systemic disease limiting activity but NOT life-threateningMitral valve insufficiency, collapsing trachea, poorly controlled diabetes
IV (Poor)Severe systemic disease, incapacitating; life-threatening; not expected to live without surgeryHemoabdomen from splenic rupture, severe traumatic pneumothorax, organ failure
V (Grave)Moribound; not expected to live >24 hours, with or without surgeryMulti-organ failure, severe shock, terminal malignancy

Meet “Bifford”

About “Bifford”

Bifford was born in Chicago, Illinois after his mother was rescued off the streets by a compassionate and patient animal shelter volunteer. Being one of four kittens he was categorized by animal shelter volunteers as “the worst” out of the litter in regards to his cerebellar hypoplasia. When Bifford was a mere 10 days old his mother rejected him thus withholding care and nutrition he so desperately needed when a devoted foster mother assumed responsibility for his around the clock care. When Bifford was transported to Youngstown, Ohio by a local cat shelter a note was enclosed with him:

“Born October 09, 2011, mother rejected at 10 days old. Tipsy [my brother] and I are the largest of the four kittens in our litter and most affected with CH. He will use a litter box 99% o f the time, will cry beside the litter box if he cannot get in or is having trouble. Sometimes falls/flips right out of the litter box and also sometimes lays on side to go [to the bathroom] and I will help hold him up until he finishes. Sometimes will take a nose dive in litter and will need cleaned off/bathed. Sometimes he will accidentally step in his own mess because he is unable to bury his potty. Will eat some from plate but will eat best when fed canned food by hand while holding him up under his belly with my other hand. Will cry for a bedtime bottle around 9-10 PM and gets canned food 3x/day.” 

Bifford was initially adopted in Fall 2012 but was returned after his family moved and could no longer take him with them. Upon being returned back to the shelter he was then adopted in Spring 2013 by a family who vowed to care for him but unfortunately bungled his care. When being returned (again) to the shelter in May 2014, Bifford’s former family admitted that they were unable to effectively care for Bifford and felt that he was “suffering” and wanted him to “die with dignity” to which they would contain him in an empty hot tub with the cover on it in order to “contain the mess”. Bifford was terrified and underweight but otherwise unscathed, though shelter life was no life for him. Living in such close proximity to other cats in a cage free shelter proved the theory of “survival of the fittest” in which Bifford was not as fast as the other cats and was often the subject of many bullies.

I agreed to foster Bifford on Mother’s Day, 2014 in which the situation was only to be “temporary” in order to spring him from the shelter and hopefully nurture him physically and emotionally. The first few nights were proving to be exhausting ones for both Bifford and myself — roaming the house and crying all hours of the night I can only speculate he was terrified being in a strange, new environment (again) and even more terrified that he was going to fall in love with a new family and ultimately get returned back to the shelter. Couple this with the fact that at that time I had no idea how to properly care for a “CH” cat (nor did I know much about them) I feared that I would not be able to arise to the labor of love that was Bifford.

Years have passed since those first few days and I still joke with Bifford that he is a “foster” though I can say without reservation that he is a “foster fail” because he took over my heart in so many ways. Come October 09, 2018 Bifford will be turning 10 years old to which he has a happy, healthy and spoiled lifestyle (what cat do you know that has their own bedroom and TV?!) and ultimately planted the seed of special needs animals advocacy and education due to all of the misconceptions and ill-information circulating about special needs animals.

Please enjoy the website, Bifford’s photos and overall shenanigans and information 🙂

Common Veterinary Anesthetic Medications Chart

DISCLAIMER: These are COMMON medications/adverse reactions to veterinary anesthetic medications, just like humans, pets also can have a variety of symptoms/reactions that are not listed or documented.

If you have any questions or concerns always speak to your veterinarian about the kinds of medications utilized and the potential side effects that may occur.

Anesthetic/Analgesic DrugCommon Adverse Effects
Dexmedetomidine Medetomidine XylazineBradycardiaCardiac Output ReductionHypertension/HypotensionVasoconstriction
NSAIDs SteroidsBleeding DisorderDiarrhea/VomitingGastrointestinal UlcerationLethargyRenal/Liver Failure
Diazepam MidazolamMinimal Cardiorespiratory EffectsParadoxical Excitement of Patients
Halothane Isofurane SevofuraneDecreased Cardiac OutputDecreased Myocardial Contractility Hypothermia/HyperthermiaMay result in hypotensionVasodilation
Diazepam/Ketamine Propofol Tiletamine/ZolazepamCyanosisOccasional Muscle Twitches/SeizuresProfuse Salivation/Airway SecretionsRespiratory Depression Transient TachycardiaVasodilation
Bupivacaine Lidocaine MepivacaineBradycardiaHyperthermia in some animals; hypothermia more likelyCardiac ArrestHypotensionSeizure
Buprenorphine Butorphanol Fentanyl Hydromorphone MorphineBradycardiaMydriasis/MiosisRespiratory Depression (hypoventilation, apnea)Vomiting

Meet Nilla Bean!

Nilla Beam is apart of Bifford’s Elite Team (which was put together by a group of nominated members of the specially-abled community to help further band together and raise awareness & understanding to specially-abled animals everywhere!). Our wonderful friends over at Meow as Fluff wrote this beautiful piece of Nilla Bean that we just HAD to share! Enjoy!

Be sure to “LIKE” Nilla Bean on Facebook & Instagram!

Bloodwork & Your Cat

Bloodwork is recommended yearly to monitor for any changes/potential concerns as well as prior to any surgeries or procedures requiring anesthesia! Talk to your veterinarian about having bloodwork completed on your pet or if you have any questions about having bloodwork ran on your pet!

GLUCOSE is a blood sugar.  Elevated levels can indicate diabetes mellitus, but in cats, mildly elevated levels can also just indicate stress.  Low levels can happen with insulin shock or malabsorption syndromes and can cause weakness, seizures, or death.

SERUM UREA NITROGEN (also known as Blood Urea Nitrogen) generally indicates kidney function.  An increased level is called azotemia, and can be caused by kidney, liver, and heart disease, urethral obstruction, shock, and dehydration.

SERUM CREATININE is a more specific indicator of kidney function in cats, although it can also be affected by dehydration and urethral obstruction.  An increased level without dehydration or urethral obstruction generally indicates kidney disease.

URIC ACID is a nonspecific value in cats, and does not indicate any disease processes.

ALT (Alanine aminotransferase) is a sensitive indicator of active liver damage but doesn’t indicate the cause.

TOTAL BILIRUBIN elevations may indicate liver or hemolytic (red blood cell destruction)disease.  This test helps identify bile duct problems in the liver and certain types of anemia. 

DIRECT BILIRUBIN elevations are another indication of liver disease and hemolysis.

ALKALINE PHOSPHATASE elevations may indicate liver damage or can also be a result of active bone growth in young kittens.  In adult cats, this is especially significant for liver damage.

AST (Asparate aminotransferase) increases are also very nonspecific, and can indicate liver, heart, or skeletal muscle damage.

INDIRECT BILIRUBIN is calculated using the total bilirubin and the direct bilirubin, and is not significant as a diagnostic test.

BUN/CREAT RATIO is calculated using the serum urea nitrogen and the serum creatinine.  In some cases, this result can help indicate if azotemia is from dehydration or kidney disease.

CHOLESTEROL is used to supplement diagnosis of hypothyroidism, liver disease, Cushing’s disease, and diabetes mellitus.  This is not a prognostic factor for heart disease such as in people.

TRIGLYCERIDES are not a significant value in cats.  They can be elevated if the cat has eaten recently, or in some disease processes, but are not a significant diagnostic factor.

CALCIUM deviations can indicate a variety of diseases.  Tumors, hyperparathyroidism, kidney disease, and low albumin are just a few of the conditions that alter serum calcium.

PHOSPHORUS elevations are often associated with significant kidney disease, hyperthyroidism, and bleeding disorders.

SODIUM is an electrolyte lost with vomiting, diarrhea, and kidney and Addison’s disease.  This test helps indicate hydration status.

POTASSIUM is an electrolyte lost with vomiting, diarrhea, or excessive urination. Decreased levels can be an early indicator of kidney insufficiency.  Increased levels may indicate Addison’s disease, dehydration and urethral obstruction. High levels can lead to cardiac arrest.

CHLORIDE is an electrolyte often lost with vomiting and Addison’s disease. Elevations often indicate dehydration.

SERUM PROTEIN indicates hydration status and provides additional information about the liver,kidneys, and infectious diseases.

SERUM ALBUMIN is a protein that helps evaluate hydration, hemorrhage, and intestinal, liver, and kidney disease.

GLOBULIN is calculated from serum total protein and serum albumin.  This is a blood protein that often increases with chronic inflammation and certain disease states.

OSMOLALITY CALCULATED is a calculated indicator of hydration status, and can help with interpretation of other blood values.

T4 (ANIMAL THYROXINE) is a thyroid hormone.  Decreased levels in cats do not signal hypothyroidism, rather, they can indicate an underlying disease process.  Elevated levels indicate hyperthyroidism.

Complete Blood Count (CBC)

WHITE BLOOD COUNT measures the body’s immune cells. Increases or decreases indicate certain diseases or infections.

RED BLOOD COUNT is the number of red blood cells per unit volume of blood.  Increases or decreases can indicate dehydration or anemia.

HEMOGLOBIN is the oxygen carrying pigment of red blood cells.  Increases or decreases in this number must be interpreted with other blood values.

HEMATOCRIT is probably the most important value of the red blood cells. This value measures the percentage of red blood cells in the blood to detect anemia, dehydration, and can help indicate some disease processes.

MCV (Mean cell volume) is the average red blood cell size. This value can help indicate some disease processes, but must be interpreted with other data.

MCH (Mean cell hemoglobin) is the average amount of hemoglobin per red blood cell.  This value can help indicate some disease processes, but must be interpreted with other data.

MCHC (Mean corpuscular hemoglobin concentration) is another value for interpreting hemoglobin concentrations in cells.

RDW (Red blood cell distribution width) elevations can indicate that there is an increased variety in red blood cell sizes.  This value should be interpreted along with other red blood cell values.

PLATELET COUNT measures cells that are used in blood clotting.

NEUTROPHILS are a type of white blood cells of the immune system.  An elevation or decrease in absolute or total neutrophil counts can indicate a variety of processes including stress, inflammation, infection, or other disease processes.

LYMPHOCYTES are another type of white blood cells of the immune system.  An elevation or decrease in absolute or total lymphocyte counts can indicate a variety of processes including stress, inflammation, infection, or other disease processes.

MONOCYTES are a less common type of white blood cells of the immune system that can indicate stress or chronic inflammation.

EOSINOPHILS are a type of white blood cells of the immune system.  An elevation in absolute or total eosinophils can indicate allergy disorders, parasitism,and some skin and intestinal disorders.

BASOPHILS are a less common type of white blood cells of the immune system. Elevations in these can indicate allergy disorders, parasitism, and neoplastic states.

“CH” Proofing!

Adopting a new CH baby or a new CH pet parent? Take a deep breath and remember that you “got” this! Remember that JUST like children each pet is different so “proofing” for one family may not be exactly like the next!

What do you need to purchase BEFORE your new addition comes home?

  • Food/Water Dishes (I always recommend a silicone based dish for safety and stability as pictured below – the photographed bowls you can remove the stainless steel dishes and strictly use the silicon portion for holding your new addition’s food & water!)
Silicone food/water dishes such as this one is dishwasher safe and catches any mess from your new baby!
  • Depending on the “severity” of your new special baby (Bifford is considered “moderate” and only needs certain accommodations) they may need ramps to help them into bed or furniture ! Again depending on the severity of your new baby you still may need to help them use the ramp/get onto the furniture to further insure their safety!
Ramp for the furniture such as this one has a carpeted/felt material on the ramp providing better traction for your special baby)
  • Low rise litter box (or in Bifford’s case a rubber maid container with a hole cut out!)
Low rise litter boxes such as this one are available online (such as Amazon or Petco)
  • Washable “pee pads” to use in the event of any “accidents” (or like we do with Bifford place them outside of his litter boxes to catch any mess he was attempting to bring with him!)
  • Spray Shampoo (our favorite is Burt’s Bees brand of feline spray shampoo — no water and it has a nice natural scent to it that is not overpowering!)

Pet Proofing — “Safety!”

  • Small and dangerous objects like paper clips, nails, staples, thread, pins/needles, rubber bands, tacks — basically anything that has fallen on the floor that shouldn’t be there.
  • Any electrical cords that are too long, suggest taping the cords to the floor (a tape which can be purchased online) or running the cords out of your pets way.
  • Intriguing things like plants, electrical cords, drapes, the pulls/cords on blinds, other cords.
  • Also consider if there are any objects (furniture/decorations) that could fall over if knocked-into, or if something could fall of the furniture.
  • Be mindful of sharp corners of furniture or fragile items that your new pet could accidentally fall into and cause them to break.
  • Don’t forget to check your window screens — they should fit securely and should not give way in case your cat leans against them.
  • Odoban! It comes in a spray bottle or a one gallon jug and it breaks up any enzymes in your pet’s urine or bowel movements that may be on the floor/blanket etc.!
Odoban can be purchased on Chewy or Amazon and even found at your local Wal-Mart!
  • Close closet doors and make sure you keep your room tidy. That means keeping laundry and shoes (consider shoelaces and loose buttons) in your closet or behind other closed doors.
  • Remove plants, if necessary.
  • Move all wires so they’re out of your pet’s reach.
  • Take a look at what you have on night stands, dressers, etc. If necessary, move the items into a drawer or cabinet.
  • Close all drawers entirely. You never know when a cat will crawl in.
  • Check your bed’s box spring. Cats and kittens are known to find their ways into them.
  • Be mindful of closed doors — make sure your cat isn’t in your closet or bathroom before closing the door.

  • Purchase trash cans that your pets can’t get in to (like those with lids), or hide your trash can in a cabinet. Don’t forget about small wastebaskets in the bathroom — cats can easily turn them over and rummage through the contents.
  • Use childproof latches to keep cabinet doors from being pulled open. (This is usually the case with cabinets that don’t have latches to keep them shut in the first place.)
  • Place all medications, cleaners, and chemicals on high shelves or in childproofed cabinets. Similarly, keep insecticides, rodent poisons and dryer sheets out of reach.
  • Look for small spaces your pets can squeeze into — behind appliances, between an appliance and the wall, etc. — and find ways to seal them.
  • Always keep the doors to your washer and dryer closed. Before doing each load of laundry get a visual on every furry member of your household.
  • Always put down the toilet seat lid. Cats can easily fall in and drown.

  • Again, look for small spaces your pets can squeeze into — under your couch, holes in furniture, etc. — and find ways to seal them.
  • Move wires and cords from lamps, entertainment systems and phones so your cat can’t access them. Petfinder.com suggests running the cords through PVC pipes to prevent pets from chewing on them. You can also purchase sprays that give the wires a bad taste, or run them under heavy rugs and carpets.
  • Watch your cat carefully when opening a front or back door.

In some severe CH cases your pet may benefit from you purchasing a “portable crib” for pets (found the one photographed below on Amazon) to help keep your baby safe (and the carpeted insert allows you to easily remove it to wash it in the event of any “accidents”!)

Have any suggestions/tips or tricks? Post them below and we will include them in our “Guide for New CH Pet Parents!”