CH & Anesthesia

DISCLAIMER
Bifford for President is simply a group
ran by “special needs pet parents” and simply
an informal educational site. If you have any
concerns regarding your pet’s health, condition,
anesthesia concerns please consult your
veterinarian/veterinary facility!
Bifford for President simply provides
various information, educational resources or
materials but the best avenue to always take is
speaking directly with your
veterinarian/veterinary facility.
We DO NOT dispense medical advice,
treatment/care options or advice just simply
provide a collection of data/research to help pet
parents make an educated decision for their pets.
We take absolutely NO responsibility for
any outcome of your pet’s health, diagnostics,
procedures or overall care.

  • The American Animal Hospital Association (AAHA) estimated the risks of anesthetic- related deaths were roughly about 0.05% (1 in 1,849) in healthy dogs and 0.11% (1 in 895) in healthy cats with death most frequently occurring in the first 3 hour postoperative.
  • Tailoring each pet’s anesthetic plan to their specific needs allows the veterinary team to provide optimum care, including patient-specific anesthetic monitoring as well as clear and open lines of communication between you as the owner and the veterinary staff caring for your pet.
  • By choosing an accredited hospital (which only about 15% of veterinary facilities are AAHA accredited hospitals!) you are ensuring your pet is getting the gold standard of care and medicine. AAHA ensures that these facilities practice the highest quality of medicine and safety as well as record keeping/maintaining and other rigorous protocols that must be followed to stay AAHA accredited.

Dr. Cary Craig from UC Davis Veterinary was the
only doctor that debunked the common
misconceptions surrounding anesthesia & CH:


✓ There are NO medical contraindications
to any anesthetic techniques in CH,
however there are considerations
(particularly with respect to recovery
from general anesthesia).


✓ Strongly recommended to use short acting
or reversible techniques.


✓ Inhalant (like isoflurane) has the
advantage of being short acting &
recovery is rapid once the inhalant is
discontinued.


✓ Propofol (a short acting injectable
anesthetic)
or isoflurane/sevoflurane are
recommended.


✓ Gas should be delivered by endotracheal
tube rather than face mask (this is to help
protect their airways and help avoid
airway obstructions/aspiration).


✓ Strongly recommend use of analgesic
(pain control medication) and it is also
best used as pre-medication (given prior
to surgery).


✓ Gas anesthesia is not safer than
injectable, but it does offer several
advantages in many situations.


✓ In CH cat’s rapid recovery is the primary
advantage!


✓ It is NOT dangerous to use Ketamine in
CH pets but recovery from Ketamine can
be unpleasant for ANY animal.


✓ Ketamine has a long duration which gets
longer if used IM as an anesthetic.

Questions To Ask Before Anesthesia

  1. What are the risks of anesthesia for my pet?
    Some pets – like humans – are more ideal candidates for
    anesthesia (such as a healthy 6-month-old kitten who needs
    neutered) whereas others can present risks because of a variety
    of health conditions such as heart murmur, liver disease,
    infection etc. Therefore, special precautions should be taken at
    every step – which you should discuss with your veterinarian.
  2. Will my pet have IV catheter & IV fluids?
    The duration & invasiveness of your pet’s procedure will
    usually determine if your veterinarian will place an IV catheter
    & give IV fluids. For minor procedures (radiographs, bandage
    placement, nail trim etc.) it may not be necessary. For others
    (most surgeries, dental procedures etc.), it is very beneficial to
    place an IV catheter. The catheter helps administering
    anesthesia drugs & pain medications.

3. What happens during anesthesia?
Typically, a tranquilizer is given first which will make your pet
drowsy. Following this an IV catheter is placed and roughly about
20-30 minutes later anesthesia drugs are administered via IV. A
plastic tube is then placed in the windpipe or trachea (intubate)
which allows 98% pure oxygen and 2% anesthesia gas on average.
Anesthesia is then maintained with gas then at the end of anesthesia,
the gas is turned off and your pet is kept on 100% oxygen. When
your pet starts to wake up, the tube is pulled out of the trachea
(extubate) and normal breathing starts again.

  1. What is the difference between sedation & general anesthesia?
    In order for a procedure to be carried out safely and to minimize
    stress to your pet, they may need to be given sedation or general anesthesia. All sedations & general anesthesia is tailored specifically to your pet and their needs, overseen by a veterinarian and team of veterinary technicians. If your
    pet needs a sedation, they will be given a combination of drugs by injection to make them more relaxed or sleepy. Sedated animals are often still aware of their surroundings and may even be able to walk to and from the procedure room/clinic. Sedation is used for simple, short diagnostic procedures which
    are not painful such as radiographs, ultrasound scans or simply needed in a special position. If your pet needs surgery this would be performed under general anesthesia, not sedation. When pets (or humans!) are given a general anesthetic, your pet will become unconscious while the drugs are being administered. This is often described as “sleeping” and your pet will not be aware of anything that is happening during this anesthetic plane. They will also not remember what has happened once they have woken up from the anesthesia. Veterinarians use a combination of drugs during the general
    anesthesia which may work in slightly different ways, providing an individual approach specific to your pet. Some drugs may be administered by injection while others are a gas that your pet breathes into their lungs.

Ask the Veterinarian

Questions to ask your veterinarian/veterinary staff that will be performing your pet’s procedure:

  1. Are pre-anesthetic physical examinations & pre-surgical bloodwork completed?
  2. Premedication(s) (what type(s) are utilized?)
  3. Are IV catheters utilized to facilitate administration of medication(s)?
  4. Do they monitor body functions under anesthesia (HR, RR, BP, ETCO2, SPO2, Temperature etc.)?
  5. Documentation of patient parameters during anesthesia & recovery (anesthesia record)?
  6. Continued patient support & monitoring in recovery (post-anesthesia)?

Pre-Anesthetic Bloodwork  Important or Not?

To ensure your pet can appropriately process and eliminate an anesthetic, diagnostic testing is STRONGLY recommended (or at some veterinary hospitals, a requirement prior to any surgery/procedure) to confirm that your pet’s organs are functioning correctly and to find any hidden health conditions that
may put your pet at risk.
The top reasons to test your pet BEFORE anesthesia:
1) Enjoy Peace of Mind & Detect Hidden Illnesses  Healthy looking pets may be hiding symptoms of a disease or ailment. Testing helps detect this kind of
illness/disease so problems/complications can be avoided during anesthesia/surgery.
2) Reduce Risks & Consequences  If preanesthetic testing results are normal, your veterinarian can proceed with confidence with using anesthesia and the
procedure itself. If not, they can alter the anesthetic procedure or take other precautions to safeguard your pet’s health & wellbeing.
3) Protect Your Pet’s Future Health

These tests become part of your pet’s medical record/history, providing a baseline for future reference.

Hematology Complete Blood Count (CBC) – CBC provides detailed information about red blood cells, white blood cells &
platelets. The total white blood cell count, along with individual leukocyte counts, can help identify underlying stress,
inflammation, an inability to fight infection and potentially, leukemia. Low Platelets – This can indicate a potential
bleeding problem. Low platelet counts could cause serious surgical complications.

Blood Chemistry Aklaline Phosphatase (ALKP) – An enzyme present in multiple tissues, including liver and bone. Elevated levels can indicate liver disease, Cushing’s Disease or steroid therapy. Total Protein (TP) – Can indicate a variety of
conditions, including dehydration, inflammation & diseases of the liver, kidney or intestines. Blood Urea Nitrogen (BUN) – BUN is produced by the liver and excreted by the kidneys. Abnormally high levels can indicate kidney disease or dehydration and low levels can be associated with liver disease. Alanine Aminotransferase (ALT) – An enzyme that becomes elevated with liver cell injury. Creatinine (CREA) – Creatinine is a by-product of muscle metabolism and is excreted by the kidneys. Elevated levels can indicate kidney disease, urinary tract obstruction or
dehydration. Blood Glucose (BG) – High levels can indicate diabetes. In cats, high levels can also indicate stress,
which can be a result of the trip to the veterinary hospital. Low levels can indicate liver disease, infection or certain
tumors.

ElectrolytesSodium, Potassium Chloride (Na+, K+, Clˉ) – The balance of these electrolytes is vital to your pet’s health.
Abnormal levels can be life-threatening. Electrolyte tests are important when evaluating vomiting, diarrhea,
dehydration and cardiac (heart) symptoms.

Urinalysis – The urine contains byproducts from many organs such as the kidneys, liver & pancreas. Abnormal levels of
these byproducts can indicate diabetes, liver or urinary tract disease.

Electrocardiogram – Detects heart rate & electrical rhythm. Certain abnormal rhythms & heart rates can be harmful to animals
undergoing anesthesia.

EndocrinologyThyroxine (T4) – Is a measurement of the level of thyroid hormone circulating in the blood and is helpful in
identifying thyroid disease. Thyroid disease occurs in both dogs & cats and can have a serious impact on health if left untreated. Testing is especially important in cats older than seven years old.

Veterinarian Questions/Check-List

  1. Are you familiar with cerebellar hypoplasia?
  2. Are you comfortable administering anesthesia to my CH cat?
  3. Will you complete blood work on my cat before administering
    anesthesia?
  4. Will you pre-medicate my cat? If not, why?
  5. Will my cat have an IV catheter placed? If not, why?
  6. Will my cat be intubated? If not, why?
  7. What underlying diseases have you tried to rule out prior to
    anesthetizing my cat? Would you recommend any additional tests
    before my cat’s procedure?
  8. Who will be monitoring my cat and how often?
  9. How long before the procedure should I withhold my cat’s
    food/water?
    10.What should I expect from my cat when she comes home? Will she be
    drowsy or extra wobbly? If so, how long should I expect her to be this
    way?
    11.When and what should I feed my cat after anesthesia?

In search of a cerebellar hypoplasia friendly veterinarian? Check our map: https://presidentbifford.com/ch-friendly-veterinary/