I would like to believe that I am not so cynical to not believe in signs from above but this one, this one was so blatantly obvious that one could not help but NOT ignore it.
I lost my best friend, my light of my life, my “reason” on Monday 01/25/2021 and to say that I was handling it poorly was an understatement. I was on “autopilot”, masking my utter sadness and heartbreak behind a false smile and felt so incomplete that I felt would be permanent and just simply “who I was” from now on.
Until Monday 03/08/2021.
I heard commotion in my veterinary clinic I work for with my name coming up several times (which peaked my interest) as I saw a small crowd circling something … something tiny. I as made my way into the small group of women I saw him… meet Maxwell Walker (Maxwell after The Beatle’s song “Maxwell Silver Hammer”) an eight week old pug puppy (though the doctors suspect he may be younger) who is a “swimmer puppy”.
Swimmer Puppy Syndrome is a developmental deformity that results in a puppy having a flattened thorax/chest. They may have mobility issues that with physical therapy can be (for the most part) corrected it just takes a lot of patience and humility.
Max will never replace Maggie ever and in fact he may be nothing like Maggie which I accept and understand also (I used to often joke that I wasn’t a “pug person” but I was an avid “Maggie person”) but I can only hope that somewhere tucked deep inside that tiny little pug puppy is a quality or two that Maggie had for so long – that patience, that calmness and most of all affection.
I know it will take time for Max to grow on me (frankly he’s creeping into my ❤️) and it will take even more time to work on getting him to use his back legs and be more mobile (without my assistance).
If you’ve been wondering why the site and our social media platforms went on a short, short sabbatical it’s because of this little dude. We’re working with him constantly as far as physical therapy, hydrotherapy, puzzles and exercise regularly (in addition to trying to potty train) as well as care for the other part of the crew has managed to occupy the rest of my day (happily of course!).
Please be patient with us as we work to find a happy medium between Maxwell and the rest of the day’s agendas — I promise we will return with gusto! Stay tuned folks!
A very special THANK YOU to our friends over at Meow as Fluff for showing off another beloved favorite in our adorable house of misfits — Bart! You can check our pal Caitlin and the rest of the Meow as Fluff family by going here.
When Suzi Langer’s friend, who was working at a veterinary hospital near her home in Youngstown, Ohio, told her about Taloola and Bart, a pair of sick kittens who had recently arrived at the clinic, she and her husband Michael volunteered to foster them. “A good Samaritan found these two kittens alone with severe upper respiratory infections — a female calico and a domestic short-haired black male, about 12 weeks old,” remembers Suzi. Sadly, Bart’s upper respiratory infection was so severe and had gone untreated for so long, his left eye had ruptured and his right eye had suffered severe corneal scarring, leaving him only able to see light and shapes.
The black kitten also had a broken back leg, most likely due to being attacked by another animal before he was rescued, and he had a hernia that required treatment. While a lot of people might have been reluctant to foster a cat with so many different medical issues, Suzi and Michael had three special needs pets at the time — including a Rat Terrier with epilepsy, a deaf Pug with bladder cancer, and a cat with cerebellar hypoplasia — so they welcomed Bart and his sister Taloola into their home in July 2017. “Bart was — at best — leery of people,” says Suzi, so after he was neutered and had his hernia repaired and his ruptured eye removed, she and her husband gave the skittish black cat plenty of time and space to adjust to his new environment. “For the first few months Bart was a ghost in our home — his presence lingered but you never saw him.”
Over time, Bart eventually started to trust his foster parents, but in November 2017, Suzi learned the veterinary clinic would no longer be providing him with free medical care, claiming he was a financial risk. “I knew what that meant,” says Suzi. “He was a not nice, not really cute, extremely shy black cat with vision issues. In their eyes he was the least desirable cat to anyone and thus not worthy of proper medical attention.”
Suzi knew Bart needed an advocate who would make sure he received the care and treatment he deserved, so she and her husband adopted him! Shortly after adopting Bart, Suzi, who works at a vet’s office, had her employer remove a piece of gauze that had been accidentally left behind by the previous vet when he had his left eye removed. “They reopened his eye to remove the offending material and flush it out,” explains Suzi, “and ever since then Bart has not had any issues with sneezing or constant discharge.”
Nearly four years later, Bart is in good health, and while he’s unable to see very well, he’s an extremely active cat! In fact, this handsome one-eyed cat loves racing around his home, but because of his vision issues, Suzi and Michael try not to change the layout of their house. “Every so often when Bart is rushing about he will run into things,” says Suzi, “and we make it a courteous point to not rearrange the furniture.”
While Bart is much healthier today than he was when he first arrived at Suzi and Michael’s home, the biggest change has been in his personality. Initially, Bart, who had a difficult life on the streets before he was rescued, was easily frightened and incredibly shy, but over the past few years, he has blossomed in his forever home. “We gave Bart his space and slowly but surely he began to trust us,” says Suzi, “and now he is the most cuddly, sweet, affectionate and ornery little boy — and we wouldn’t have it any other way!”
By sharing Bart’s story, Suzi hopes other people will consider fostering and adopting cats who are often overlooked for a variety of factors, including age, appearance, temperament, and health issues. Even though they might take a little more time and energy, Suzi believes special cats like Bart are definitely worth the extra effort! “If we would have given up on Bart early on we would have never been introduced to his bubbly amazing personality that came later on with his confidence after finally feeling better,” explains Suzi.
When Suzi and her husband offered to foster Bart more than four years ago, they only planned to care for him until he was healthy enough to find a forever home. However, after just a matter of months, they knew Bart was meant to spend his life with them, and now Suzi and Michael can’t imagine their family without this special boy. “Bart has evened our home out in such a beautiful and poetic way,” says Suzi. “He is affectionate, adventurous, clown-like and never passes up the opportunity to ‘give up the belly,’ which is his way of showing his love and affection to us!”
Living with a Maxwell here at the adorable house of misfits has been a whirlwind of emotions and overall trial and error on things to best help Maxwell thrive. After hearing from various veterinary professionals and pet parents alike on what Maxwell’s official diagnosis was I finally decided to end the debate and scheduled Maxwell to see the neurology department at Akron (Ohio) MedVet.
Being someone in the veterinary field who handles curbside appointments daily I can tell you that it was a very humbling experience and reminded me to be patient and compassionate and reminded myself that despite not being allowed to go inside with Maxwell the staff, technicians and doctor’s treated him with kindness, compassion and respect (and they absolutely did! I cannot thank Akron MedVet enough!).
The neurologist stated that (among other things) Maxwell has multiple limb deformities along with kyphosis of the thoracic limb region with potential hemivertebra but she reminded me that with the “right family ANY pet can thrive!” and she is absolutely right.
I am unsure why I so badly wanted an official title for what was up with Maxwell, maybe it was because I felt if “it” had a name then I would know better what to expect maybe — but much with life there is no true preparation and we just all have to “roll with the tide” whatever or where ever that may take us!
Kyphosis is a type of spinal deformity similar to scoliosis the difference is that scoliosis is a lateral (side to side) curvature of the spine whereas kyphosis is a posterior (up and down) curvature of the spine, specifically in the upper, or cervical, portion of the spine.
This curvature can cause nerve damage, which is the reason behind many, if not all, of the symptoms presented.
In older dogs, the condition can be caused by trauma (like a spinal fracture) or wear-and-tear on the spine (which could lead to arthritis or osteoporosis).
In younger dogs (less than 1 year old), the condition is most likely congenital, meaning it was inherited by the individual at birth, as was the case for Olivia, so this is the type of kyphosis of focus throughout this website.
If you suspect your dog’s kyphosis was inherited, it is important to get in contact with his/her breeder (if possible) to let them know. They will want to make sure to not keep breeding your dog’s biological mother/father so as to stop these defective genes from passing on to any more offspring
Some of the signs/symptoms MAY include:
Atrophy (loss of muscle tone in affected areas)
Loss of sensation
Incontinence (loss of control over bladder/bowel )
weakness in the back legs
signs of muscle wastage in the back legs
an abnormally shaped back
Is the future scary? Absolutely it is! But I would feel the future as scary regardless if Maxwell was in our life or not! I am unsure what the future holds for Maxwell but I know one thing for sure: He is going to live a safe, happy & loving life with myself and the rest of the adorable house of misfits!
When it comes to caring for your cat, I have a few simple recommendations:
Maintain a safe environment (keep him indoors)
Feed a high quality food (e.g., a meat-based protein)
Think about preventive care (e.g., an annual physical examination, laboratory tests, and the appropriate vaccines)
Provide lots of affection and exercise
By following these basic tips, you can help keep your four-legged, feline friends healthy–potentially for decades! But as cat guardians, you should also be aware of five “silent” killers in cats. By knowing what the most common silent killers are, you can know what clinical signs to look for. With most of these diseases, the sooner the clinical signs are recognized, the sooner we veterinarians can treat.
1. Chronic kidney disease One of the top silent killers of cats is chronic kidney disease (CKD) (This is sometimes called chronic renal failure or chronic kidney injury). These terms are all semantically the same, and basically mean that 75% of both the kidneys are ineffective and not working. Clinical signs of CRD include:
Larger clumps in the litter box
Bad breath (due to toxins building up in the blood and causing ulcers in the mouth, esophagus, and stomach)
Thankfully, with appropriate management, cats can live with CKD for years (unlike dogs where CKD usually progresses more rapidly). Chronic management may include a low-protein diet, frequent blood work, increasing water intake (e.g., with a water fountain or by feeding a grueled canned food), medications and even fluids under the skin (which many pet guardians do at home, once properly trained).
2. Hyperthyroidism Hyperthyroidism is an endocrine disease where the thyroid gland produces too much thyroid hormone. This is seen in middle-aged to geriatric cats, and can result in very similar clinical signs to chronic kidney disease including:
Increased water consumption/urination
However, as hyperthyroidism increases the metabolism of cats, it causes one defining sign: a ravenous appetite despite weight loss. It can also result in:
A racing heart rate
Severe hypertension (resulting in acute blood loss, neurologic signs, or even a clot or stroke)
Secondary organ injury (e.g., a heart murmur or changes to the kidney)
Thankfully, treatment for hyperthyroidism is very effective and includes either a medication (called methimazole, surgical removal of the thyroid glands (less commonly done), a special prescription diet called y/d® Feline Thyroid Health), or I131 radioiodine therapy. With hyperthyroidism, the sooner you treat it, the less potential side effects or organ damage will occur in your cat.
3. Diabetes mellitus Another costly, silent killer that affects cats is diabetes mellitus (DM). As many of our cats are often overweight to obese, they are at a greater risk for DM. With diabetes, the pancreas fails to secrete adequate amounts of insulin (Type I DM) or there is resistance to insulin (Type II DM). Insulin is a natural hormone that drives sugar (i.e., blood glucose) into the cells. As a result of the cells starving for glucose, the body makes more and more glucose, causing hyperglycemia (i.e., a high blood sugar) and many of the clinical signs seen with DM. Common clinical signs for DM are similar to those of Chronic kidney disease and hyperthyroidism and include:
Excessive urination and thirst
Larger clumps in the litter box
An overweight or obese body condition with muscle wasting (especially over the spine or back) or weight loss
A decreased or ravenous appetite
Lethargy or weakness
Abnormal breath (e.g., acetone breath)
Walking abnormally (e.g., lower to the ground)
Treatment for DM can be costly, as it requires twice-a-day insulin injections that you have to give under the skin. It also requires changes in diet (to a high protein, low carbohydrate diet), frequent blood glucose monitoring, and frequent veterinary visits. With supportive care and chronic management, cats can do reasonably well; however, once diabetic complications develop (e.g., diabetic ketoacidosis, hyperosmolar, hyperglycemic syndrome), DM can be life threatening.
4. Cardiac disease Heart disease is very frustrating for both cat owners and veterinarians. That’s because, while dogs almost always have a loud heart murmur (i.e., one we can hear with our stethoscope) indicative of heart disease, cats often don’t have a heart murmur present. In fact, it’s estimated that 50% of cats with heart disease have no auscultable heart murmur. Clinical signs of heart disease include:
A heart murmur
An abnormal heart rhythm (e.g., an abnormal beat and rhythm)
A racing heart rate
Passing out (e.g., syncope)
Increased respiratory rate
Open mouth breathing
Acute, sudden paralysis (e.g., typically of the hind limbs)
Cold, painful hind limbs
Once cardiac disease is diagnosed (typically based on physical exam, chest radiographs, Cardiopet® proBNP Test, and an ultrasound of the heart called an “echocardiogram”), treatment may include emergency care for oxygen therapy, diuretics, blood pressure support, and heart medications. Long-term prognosis is poor, as the heart medication does not cure the heart disease; it prevents cardiac disease from getting worse. The exception is when cardiac disease is caused by hyperthyroidism, which often gets better once the hyperthyroidism is treated!
5. Cancer As dogs and cats live longer, we as veterinarians are seeing more cases of cancer. The most common type of cancer in cats is gastrointestinal cancer, often due to lymphosarcoma. Clinical signs of cancer include:
Abdominal distension or bloating
Once diagnosed, the prognosis for cancer is poor. For this reason, the sooner you notice clinical signs, the sooner diagnosis and treatment may be initiated. Note that there are other common emergencies that can cause death in cats, including trauma, urinary obstructions, poisonings, and more. When in doubt, to keep your cat safe, follow these 5 simple tips:
Keep your cat indoors to prevent any trauma (e.g., being hit by a car, attacked by a dog, accidentally poisoned, etc.)
Make sure to keep your cat’s weight down – this can help prevent costly problems due to obesity such as diabetes down the line.
Make sure to schedule your annual visit with your veterinarian. This is especially important as we can pick up on physical abnormalities sooner. Note that even if your cat is indoors, she still needs an annual exam; you may be able to skip some of the vaccines (and schedule them to every third year instead) but don’t skip on the exam!
Keep the litter box clean. While this sounds simple, frequent and daily cleaning of the box is a must. Not only will this alert you to life-threatening emergencies like feline urethral obstructions, but it’ll make you aware if your cat is urinating more or less than usual — and help you pick up medical problems sooner!
Seek veterinary attention as soon as you notice any clinical signs – not months after your cat has been urinating and drinking excessively!
When it comes to your cat’s health, make sure you’re aware of these common silent killers. The sooner you notice the signs, the sooner we can run blood work and diagnose the medical problem. The sooner we diagnose the problem, the sooner we can treat it!
If you have any questions or concerns, you should always visit or call your veterinarian — they are your best resource to ensure the health and well-being of your pets.
DISCLAIMER:Veterinary cannabis is still a very fresh and constantly changing/developing aspect of veterinary medicine. If you ever have questions/concerns, or want to discuss the potential of adding CBD/cannabis to your pet’s medicine protocol and/or treatment plan we always stress to have an open and honest dialog with your veterinarian/specialist! We do not support nor condone veterinary cannabis but simply answering a question that a “President” Bifford supporter e-mailed us earlier in the week. We remove all responsibility for any effects (both positive & negative) that your pet may endure by trying veterinary cannabis!
Cannabis has important interactions with pharmaceutical drugs! If not managed carefully and properly, those interactions have the potential to be dangerous! Working together YOU and YOUR veterinarian can ensure that all medications & supplements work synergistically to reduce side effects and improve overall outcome while meeting your goals for your pet.
Your veterinarian should recommend periodic examination and laboratory evaluation (of both blood & urine) of your pet to ensure that all aspects of the treatment plan are supporting the positive goals that you and your veterinarian have established. We STRESS to have diagnostics accomplished PRIOR to starting veterinary cannabis as CBD has been noted to increase some liver enzymes, and at this time we do not know the significance of these changes. Regular monitoring and diagnostics are also an important part of caring for your pet!
Be aware that the “trial & error” period can take time and may need periodic changes and re-evaluation.
As veterinarians, they are NOT authorized to prescribe any Schedule 1 drugs — including marijuana (products that contain more than 0.3% THC) or other types of cannabis. Since the DEA authorized cannabis as a scheduled 1 drug NO veterinarian can prescribe these products. Pet parents nee to choose a quality product and MUST have accurate information about the amount of THC and other cannabinoids it contains.
With the passage of the 2018 Farm Bill, there is a clear distinction between marijuana (containing >0.3% THC) and hemp (containing <0.3% THC) types of cannabis & veterinarians may have more flexibility when working with hemp-based products. However, there still remain state-specific and even clinic-specific restrictions that the veterinary health care team and you as the pet parent must navigate together.
Cannabis products derived from either hemp or marijuana (in certain states) may be legally obtained by a pet parent in accordance with their state and local laws.
Once purchased, a cannabis product may be administered to an animal by a pet parent — that is YOUR right to decide as your pet’s guardian.
Once you, as the pet parent, have decided to investigate the use of cannabis in your pet, you can then start the conversation with your veterinary health care team to seek guidance and education on product safety as well as administration and monitoring plans.
Starting The Conversation
Make sure to mention the use of cannabis products when asked about your pet’s medical history and/or supplements. This may be something that you mention to the receptionist when first making the appointment or to the staff when checking in. Knowing if cannabis is being used at home helps the veterinarian make important decisions about other medications, supplements & treatment plans.
Ask to work with a veterinarian/veterinary health care team that is “cannabis-knowledgeable”. Not every veterinarian is trained in cannabis topics or is comfortable providing guidance about the use of cannabis in your pet. To make sure that you’re working with the right veterinarian — just ask!
If you already started your pet on a cannabis product prior to your clinic appointment, keep a journal that tracks trends such as appetite, sleep habits & energy levels. This journal can be extremely useful in identifying subtle trends, both positive & negative, associated with the use of cannabis in your pet.
What To Bring To The Appointment
The cannabis product with as much original packaging as possible! The package label can provide essential information about product source and manufacturing, active & inactive ingredients and concentration or strength of the product. Since cannabis laws vary from state to state, make sure to ask your veterinary clinic if you should bring pictures of the packaging instead of the ACTUAL packaging material!
A list of ALL medications & supplements currently being administered to your pet. The list should include all herbal supplements, over-the-counter medications and any special diets. DON’T FORGET about flea/tick & heartworm prevention!
A list of goals for cannabis use. Take some time prior to the appointment to think about why you want to utilize cannabis in your pet- what are your short and long term goals for your pet that you hope to accomplish using cannabis?
Journal — consider bringing pictures and/or videos in addition to your written journal to help explain symptoms observed at home that may not be evident during the appointment.
Want more information on this subject? Visit www.cannabismd.com
DISCLAIMER: Veterinary cannabis is still a very fresh and constantly changing/developing aspect of veterinary medicine. If you ever have questions/concerns, or want to discuss the potential of adding CBD/cannabis to your pet’s medicine protocol and/or treatment plan we always stress to have an open and honest dialog with your veterinarian/specialist! We do not support nor condone veterinary cannabis but simply answering a question that a “President” Bifford supporter e-mailed us earlier in the week. We remove all responsibility for any effects (both positive & negative) that your pet may endure by trying veterinary cannabis!
Accessibility:Hemp and CBD-only products can be found in pet stores and online. Products with higher THC content can be found in a dispensary only. Make sure that you are familiar with and abide by ALL cannabis laws applicable in your area.
Manufacturer Reputation: Look for a company with high ethical standards that are open and honest about their manufacturing techniques, ingredients and resources.
The “entourage effect”: Products that utilize the 600+ compounds of the whole cannabis plan are safer and more therapeutic than those that utilize a single or few compounds.
Contaminant-Free: Look for products that are tested and confirmed to be free of contaminants such as pesticides and heavy metals as well as mold and bacteria.
Safe Extraction Technique: C02 and alcohol are the safest extraction techniques for the products used in animals. Other extraction methods may leave behind toxic residual chemicals in the product.
Tinctures (cannabis in liquid form): Tinctures are one of the safest & most accurate form of cannabis use in animals. The veterinary cannabis society recommends AGAINST the use of edibles (cookies, gummies, etc.,) made specifically for humans for use in animals.
Quality Ingredients: Animal tinctures should be formulated in a high-quality oil base and NOT alcohol. NOTE: alcohol is fine as an extraction method but NOT as a tincture base!
No Additives: Avoid products that have additives such as coloring, preservatives, or other herbs. Be especially careful to AVOID any product that contains xylitol which is extremely toxic to animals.
Ratio of CBD/THC: A combination of both CBD & THC has a greater therapeutic effect for most conditions than either one used alone. Work with your veterinarian to determine the right ratio for your pet & their condition(s).
Concentration: How many milligrams (mg) are in each drop or milliliter (ml)? Higher concentrations allow easier administration in bigger animals. Lower concentrations are safer for smaller animals because of their lower body weight.
Measured Dose: A marked dropper, syringe or easily calculated number of drops is required to provide accurate dosing.
Cautions: Although cannabis is remarkably safe, if your animal is taking other medications, please make sure to discuss your animal’s [potential] cannabis plan with your veterinarian. Do not use cannabis in immature or pregnant animals.
Go Slow: Always start with a low dose and slowly work up to your target dose. Gradually introduce any change in brand, CBD/THC ratio, or concentration. Re-evaluate your dosing if your animal’s health status changes.
Set Up For Success: Arrange the home environment so your animal feels safe & comfortable at ALL times. If an animal receives an inappropriate dose of cannabis, they may be overly sensitive to bright lights and loud sounds. ALWAYS contact your veterinarian if you feel your pet received an inappropriate dose!
Keep A Journal: Consider keeping a log of your animal’s cannabis dose and their reactions.
How CBD is thought to help dogs
Researchers are still learning CBD’s specific effects on dogs, but here’s how the compound is THOUGHT to work:
Dogs have an endocannabinoid system (ECS) just like humans.
The ECS is a network of cellular activators and receptors in the body that regulate physiological processes, including pain, mood, inflammation, stress & more.
CBD binds to and activates the vanilloid, adenosine & serotonin receptors in a dog’s ECS and helps to regulate pain perception, inflammation, temperature & more. It also boosts dopamine levels, helping to reduce anxiety & improve mood.
CBD also blocks GPR55 signaling, which decreases cancer cell reproduction.
CBD can help improve:
Anxiety & Fear
Appetite Loss & Digestive Problems
Arthritis, Joint & Mobility Issues
Cancer & Tumors
Seizures & Epilepsy
Want more information on this subject? Visit www.cannabismd.com
Especially with COVID-19 and these uncertain times it can happen to anyone! If you are having financial restraints and need help covering veterinary care/costs (or caring for your pet in general) there are programs out there to help you out! Check them out to see if you qualify!
Disclaimer: Bifford for President has NO connection to these organizations/programs and have no weight in each programs approval/denial process. If you have questions pertaining to a specific program please contact them DIRECTLY.
I also listed organizations in Ohio & PA since we are located in Northeast Ohio but also listed nationwide organizations that can also help!
The Big Hearts Fund(Financial assistance for the diagnosis & treatment of canine/feline heart disease) bigheartsfund.org
The Binky Foundation binkyfoundation.org
Brown Dog Foundation(prescription medications) browndogfoundation.org
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.
Healthy Pet, No Disease
Mild systemic disease or localized disease
Healthy geriatric pet, mild anemia or obesity
Moderate systemic disease limiting activity but NOT life-threatening
Cary Craig Health Science Associate Clinical Professor Surgical & Radiological Sciences UC Davis Veterinary School
There are no medical contraindications to any anesthetic technique in CH. However, I think there are considerations, particularly with respect to recovery from general anesthesia. My preference would be to use short acting or reversible techniques. Inhalant anesthetics such as isoflurane have the advantage of being very short acting and recovery is rapid once the inhalant is discontinued. My own CH kitties I have induced anesthesia either with propofol (a short acting injectable anesthetic) or isoflurane or sevoflurane by mask. For anesthetic maintenance gas anesthesia is best, maintaining anesthesia with injectable anesthetics for a spay would require doses that would prolong the recovery period. The gas should be delivered by an endotracheal tube rather than a facemask. Anesthetized animals, with or without CH, cannot protect their airways and are at risk for aspiration and/or airway obstruction. I would also recommend the use of an analgesic (pain control medication) and it is best used as a premedication, i.e., given prior to the surgical procedure. Usually this is a narcotic. The doses used for pain control are safe. Occasionally, some cats have some behavioral changes when they are given narcotics which can be sedation, euphoria or dysphoria. These are temporary; they go away as the drug wears off. If the drug effects are unacceptable the narcotic can be reversed.
To dispel any myths- gas anesthesia is not safer than injectable anesthesia but it does offer a number of advantages in many circumstances. In CH kitties the rapid recovery is the primary advantage. It is not dangerous to use ketamine in CH kitties but I expect recovery from ketamine to be a very unpleasant experience for a kitty that has difficulty with balance and coordinated movement. Ketamine has a fairly long duration which gets very long if it is used intramuscularly as an anesthetic.
Acceptable medications for CH cats are; Dormitor/Antisedan, Dormitor(medetomidine), is a sedative/analgesic that can provide profound sedation and short term analgesia. It is reversible with Antisedan(atipamizole) which makes it very useful for short procedures. It is not really an anesthetic so I would not recommend it for a spay which is an abdominal surgery. I think it is suitable for castrations in young, healthy animals.
Neurologic injury from anesthesia is caused by a period of inadequate oxygen delivery to the brain. The severity of the neurologic damage is proportional to the length of time the brain is oxygen deprived. The part of the brain involved in vision is particularly sensitive to lack of oxygen so blindness is the most common symptom, more severe deficits are certainly possible.
There are basically two reasons why the brain would not get enough oxygen during anesthesia in all patients (normal or otherwise) and with all anesthetics (there are no safe anesthetics, only safe anesthetists):
Not enough oxygen gets into the blood – this would occur if there is a problem at the breathing level. Almost all anesthetics depress breathing in a dose dependent manner, the deeper the level of anesthesia the more depressed breathing is. A kitty breathing room air (21% oxygen) probably will not get enough oxygen into his/her lungs if breathing is depressed. This is why anesthetized patients should always be provided supplemental oxygen. Another thing that can prevent enough oxygen from reaching the lungs is an obstruction of the airway. Anesthetized kitties cannot protect their own airways reliably and are at an increased risk for airway obstruction. This why a fully anesthetized (as opposed to sedated) kitty should have an endotracheal tube placed. It keeps the airway open and helps prevent any fluid (saliva, blood, mucous, vomit, etc.) from being aspirated into the lungs. One caveat, in the hands of someone not experienced intubating cats, intubation itself can be associated with complications (tube accidentally placed in the esophagus, traumatic intubation, spasm of the larynx)
Not enough blood gets to the brain. Even if there is plenty of oxygen in the blood if blood flow to the brain is inadequate the brain will become hypoxic (oxygen deprived). This can happen if blood pressure gets very low. Most anesthetics decrease blood pressure in a dose dependent manner. It is impossible to predict how much blood pressure will decrease in any given patient by any given dose of any anesthetic. Cats are particularly sensitive to the blood pressure lowering effects of commonly used anesthetics so blood pressure should be routinely measured in cats that are under general anesthesia. That way, a drop in blood pressure will be detected and appropriate action can be taken to restore it to normal.
I think one of the most common causes for a cat to wake up with neurologic problems is a prolonged period of very low blood pressure. If not enough oxygen gets to the lungs so that there is not enough in the blood the gums and pink skin will turn bluish purple (cyanotic) and if anyone is looking at the cat they should see this. If there is enough oxygen in the blood but not enough is getting to the brain you have no way of knowing this unless you are measuring blood pressure. It can even happen sometimes when blood pressure seems ok – blood flow is extremely important and we infer blood flow from blood pressure. So it is important that the person monitoring the anesthesia can interpret the blood pressure numbers in the context of the cat’s clinical signs of adequate blood flow.
There are still too many practices that do not routinely measure blood pressure in their anesthetized patients with the assumption that standard drug protocols and dosages won’t cause a problem. But normal doses in normal patients can, and often do, cause problems. If the problems are detected and addressed they are not serious. If not detected there may have serious consequences.
This is scary stuff but it should not stop client’s from having their cat’s anesthetized for necessary procedures (e.g. spay, neuter). The incidence of cats that aren’t ill dying while anesthetized has been found to be about 0.3% (or 175 out 80,000). That figure goes up substantially if the cat is sick when it is anesthetized. This is much better than 10 or 15 years ago (but still ten times the mortality rate seen in people) and we are working very hard at finding ways to make it even better.
I think the most important factors in improving the safety of anesthesia are experience with the drugs being used and in anesthetizing the species they are being used in, experience and skill with endotracheal intubation and vigilant monitoring.