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Anesthesia complications

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  • Original Poster

    #21
    Originally posted by BuddyRoo View Post
    If you always do what you think is right at the time with the information you have, no one can ever fault you.
    I think this is an important thing for us to all remember when losing a pet. I have thought over and over how I could have done something differently, yet I know that I did everything for her.

    Comment


    • #22
      I am so very sorry for the loss of your beautiful girl!!
      Whatever you can do, or dream you can, begin it. Boldness has genius, power, and magic in it. Goethe

      Comment


      • #23
        Im so so sorry. I can tell you the most common reason for anesthesia related deaths are human error. Im not saying this is what happened in your cats case.

        The sad thing is, its often the routine surgeries (dentals, spays, neuters) which run into complications, not the aged, heart murmur, septic dog. People really need to take the utmost of care while monitoring anesthetic.

        Man, Im so sorry. Hugs.

        One of the most common reasons for arrest under anesthetic is due to the pop-off valve being left off. Human error, but with proper monitoring this should be detected BEFORE it leads to arrest. This would certainly cause lung dammage.

        I would also wonder that if that "mass" under her chin may have been a mast cell tumor. Sometimes these when irritated release a large amount of histamine, which can stop the heart.

        Comment

        • Original Poster

          #24
          What is a pop-up valve?

          I have also found out that she had fluid in her lungs, which they were trying to get out with a syringe during the procedure. Not sure how that fits in, but it's more info.

          This really stinks. I miss her.

          Comment


          • #25
            A pop-off valve, not pop-up. When the pop-off valve is not opened, it causes the patient to not be able to ventilate (exhale). You get major barotrauma and the lungs can rupture/collapse.

            Proper monitoring should prevent this from ever happening. A CO2 monitor will tell you in real time when you are approaching abnormal values. I never ever do an anesthetic without it. Every anesthetic machine should also have a monometer which reads pressure. Anything over 20cm/H20 is considered too much. With a pop-off closed, pressures are well over 20.

            Again, not saying this is what happened to your kitty, as often respiratory arrest happens before cardiac (but cardiac is easier to detect), but its a very common human error which causes major barotrauma and death in patients.

            Something like resecting a mast cell tumor, or having a patient go under anesthetic with lung pathology can also result in this horrible situation.

            Im so sorry for your loss, sometimes seemingly healthy animals can have hidden illnesses that are undetectable with routine bloodwork. Hugs for you, and although her life wasnt long enough, at least she didnt endure any suffering or pain.

            Comment

            • Original Poster

              #26
              Thank you for the info. I appreciate it.

              Yes, I do take comfort in knowing she wasn't in pain, nor did she suffer.

              Early August something wasn't quite right with her. Blood work and examination showed severe muscle trauma and infection. The only thing we can come up with is she fell off the stair railing. She is a spoiled show cat who never goes outside! She was hospitalized for 2 full days. I wouldn't be surprised if this left her body weak and vulnerable in some way. Dang kitties, it can be so hard to know something isn't quite right!

              Comment


              • #27
                there's ALWAYS a risk of death or serious complication when you put an animal (or a human) under general anesthesia. ALWAYS. Consider what you are doing: you are giving the animal a hefty dose of drugs intended to shut down most of the brain for a considerable period of time. It's not a benign thing; the drugs affect the heart, lungs, kidneys, liver, and the brain.

                That's why you should think long and hard before doing it, about whether the benefits of the procedure outweigh the possible complications.

                I personally would never do a "routine" dental cleaning on any animal under general anesthesia for this reason- you hear about people taking in their perfectly healthy animal every single year to be anesthesized for this. Ridiculous. Not worth the risk. Find some other, safer way to clean the teeth. Some people will even put pets under general anesthesia for even more trivial reasons, like grooming.

                Comment


                • #28
                  I am very sorry for your loss. She was a beautiful kitty. I love both calicos and British shorthairs. A calico British shorthair like yours is my dream cat.
                  I'm a second hand Vegan. Cows eat grass. I eat cows.

                  Comment


                  • #29
                    So sorry for your loss -- especially under such circumstances.

                    It may not relate at all, but I knew a couple once who raised Arabians, had a beautiful Arab stallion at stud. When the first batch of foals started to undergo gelding, they realized that all of them had bad reactions to anesthesia. Every one. They immediately stopped breeding the stud and had him gelded -- and nearly lost him under anesthesia, too. There was something, somewhere, that he was passing on. Perhaps something similar could be the case here, or perhaps it was human error.

                    Comment


                    • #30
                      Originally posted by wendy View Post
                      That's why you should think long and hard before doing it, about whether the benefits of the procedure outweigh the possible complications.

                      I personally would never do a "routine" dental cleaning on any animal under general anesthesia for this reason- you hear about people taking in their perfectly healthy animal every single year to be anesthesized for this. Ridiculous. Not worth the risk. Find some other, safer way to clean the teeth. Some people will even put pets under general anesthesia for even more trivial reasons, like grooming.
                      Wendy, it is just for folks like you that I asked the questions about preanesthetic blood work, monitoring, iv fluids and type of anesthesia. People tend to lump everything together, but not every anesthetic "event" if you will is the same.

                      For most pets who get all of the above done and are having a safer anesthesia used, it is actually less risky to anesthetize a healthy pet than it is to have bacteria trapped near the gum line due to poor dentition or lack of dental care.

                      What you call a "healthy" pet may not really BE a healthy pet once you look at the blood work pre anesthesia. And without proper monitoring, things can go wrong for awhile before noticed and cause irreversible complications.

                      As you and others (and I) mentioned, there is ALWAYS risk associated with any procedure. But there are things that we can do before, during and after to lower the risks.

                      I'm not directing this at the OP...I just hate to have people be fearful of doing routine and medically necessary procedures for fear of anesthesia because in most cases, when precautions are taken, the risk of death is very low. It CAN happen, but not very often.

                      In all the (10) years I worked in veterinary medicine, we had zero, count them ZERO, deaths on the table for routine procedures in healthy animals.

                      We did have 2 deaths in older cats and 1 in an older dog during a dental, but in all three cases, their teeth had been grossly neglected and they had abscesses and were not well. The infection from teeth was already affecting other organs. It was a crap shoot. And the owners were made well aware.

                      All other deaths under anesthesia during my time at the clinic were in trauma cases where there were lots of other issues.

                      I chalk this success rate up to the fact that we required pre anesthetic blood work, iv fluids, and monitoring. If there was a problem on the blood work, we could deal with it prior to doing a procedure. If there was a problem during the procedure, we knew because of monitoring.

                      Again...not really talking about the OP at this point. Just about the fact that generally speaking, anesthesia is safer than a walk to the dog park crossing a busy street. Safer than the drive to the vet clinic. But people hear about one death where maybe things weren't ideal and then say they'll NEVER DO IT. It's just not logical to me.
                      A good horseman doesn't have to tell anyone...the horse already knows.

                      Might be a reason, never an excuse...

                      Comment

                      • Original Poster

                        #31
                        BuddyRoo, I appreciate your posts. I feel like a more educated owner.

                        Even though I lost her, would I make the appointment for her procedures again? Yes. The lump had grown, and her teeth were really nasty. Both things could have had major repercussions down the road if left unchecked.

                        I know now to be more diligent with blood work.

                        What do you feel are the key questions to ask a vet before a pet goes under?

                        Comment


                        • #32
                          Puglet, I promise I am not directing all that at you--again, you did what you thought was right with the info you had at the time. You didn't do a darned thing wrong and i'm not saying that your clinic did either. I just hate to see "fear" of anesthesia be a reason for a pet not getting necessary care.

                          I recently changed veterinarians after getting married and moving to another town. I wanted my dog to have a dental and have teeth checked out because he really wasn't eating well. (turned into a major surgery at the university, but nonetheless...) Here are the questions I asked:

                          1) Do you do pre anesthetic blood work? In house? How long before the procedure do we have to do it? (many now do basic CBC/chem panels in house)
                          2) Do you offer IV fluids during the procedure?
                          3) What kind of monitoring is in place during and after the procedure? Who is doing it?
                          4) What kind of pre med do you use?
                          5) What anesthetic do you use? (I was hoping for either isoflurane or propofol)

                          If a pet already had major inflammation around the gumline or an infection prior to the dental, I would hope for a pre dental round of abx. Much like what we do for humans with abscesses and such.

                          But I'm not a vet. So keep that in mind. I trust my veterinarians to advise me as needed.
                          A good horseman doesn't have to tell anyone...the horse already knows.

                          Might be a reason, never an excuse...

                          Comment

                          • Original Poster

                            #33
                            Cool, I didn't feel anything directed at me. Just trying to learn and be a better pet owner

                            Comment


                            • #34
                              Originally posted by BuddyRoo View Post
                              Puglet, I promise I am not directing all that at you--again, you did what you thought was right with the info you had at the time. You didn't do a darned thing wrong and i'm not saying that your clinic did either. I just hate to see "fear" of anesthesia be a reason for a pet not getting necessary care.

                              I recently changed veterinarians after getting married and moving to another town. I wanted my dog to have a dental and have teeth checked out because he really wasn't eating well. (turned into a major surgery at the university, but nonetheless...) Here are the questions I asked:

                              1) Do you do pre anesthetic blood work? In house? How long before the procedure do we have to do it? (many now do basic CBC/chem panels in house)
                              2) Do you offer IV fluids during the procedure?
                              3) What kind of monitoring is in place during and after the procedure? Who is doing it?
                              4) What kind of pre med do you use?
                              5) What anesthetic do you use? (I was hoping for either isoflurane or propofol)

                              If a pet already had major inflammation around the gumline or an infection prior to the dental, I would hope for a pre dental round of abx. Much like what we do for humans with abscesses and such.

                              But I'm not a vet. So keep that in mind. I trust my veterinarians to advise me as needed.
                              A few more questions to add....

                              What type of monitoring equipment do you have?
                              (ie. gold standard is ECG, PulseOximetry, C02, Blood Pressure (ideally doppler) and temperature).

                              Next biggest question - WHO is doing the monitoring. For my pet, a high school co-op student is NOT acceptable. A technician who has not been registered is also not acceptable. I want a fully licenced registered technician to be monitoring my patient during the procedure. Sadly, often times the technician is the one doing the dental cleaning and monitoring - this is where subtle changes are missed.

                              As far as anesthetic goes, isofluorane or sevofluorane are the gas anesthetics used to keep animals asleep. 95% of procedures over 10 minutes will be on a gas anesthetic. Propofol and Ketamine/Valium are induction agents, which can also be CRIs to keep patients under anesthetic who are iso/sevo sensitive.

                              Bloodwork is important, especially for kidney and liver diseases. It can also check for infection, anemia etc. Thesee results not just assess if the patient is ok for anesthetic, but allow us to pick the proper drugs and anesthetic protocol best suited to the patient. Heart/lung diseases are picked up through a thorough auscultation.


                              My current hospital has anesethized over 3000 patients in one year. There have been ZERO anesthetic related deaths. We do not anesethize ANY patient without bloodwork (day of) and a physical exam (day of). That is the policy, if you dont like it you go somewhere else. We also have our registered technicians working with board certified anesethists to expand their knowledge and troubleshooting. Not to say that an anesthetic related death wont ever happen, but all these precautions and staff training will prevent unnecessary deaths.

                              Comment


                              • #35
                                Originally posted by wendy View Post
                                there's ALWAYS a risk of death or serious complication when you put an animal (or a human) under general anesthesia. ALWAYS. Consider what you are doing: you are giving the animal a hefty dose of drugs intended to shut down most of the brain for a considerable period of time. It's not a benign thing; the drugs affect the heart, lungs, kidneys, liver, and the brain.

                                That's why you should think long and hard before doing it, about whether the benefits of the procedure outweigh the possible complications.

                                I personally would never do a "routine" dental cleaning on any animal under general anesthesia for this reason- you hear about people taking in their perfectly healthy animal every single year to be anesthesized for this. Ridiculous. Not worth the risk. Find some other, safer way to clean the teeth. Some people will even put pets under general anesthesia for even more trivial reasons, like grooming.
                                It's been many years since I worked in veterinary medicine, but I just wanted to say, I have never worked for a vet that willy-nilly put pets under anesthesia, they know the risks. For some animals yearly dental cleanings are necessary because they build up more tartar than others. I have yet to meet a cat that would willingly put up with a full cleaning without being completely out. It's a time consuming procedure that cannot be safely done with an animal moving around. I also wanted to say that a yucky mouth is a dangerous mouth as bacteria build up can affect the organs.

                                As to the grooming, I don't know what your experiences have been but the only animals I have ever "groomed" under anesthesia were so horribly matted that the body shaving I had to do would have been too painful for them to endure awake. Any other grooming would be done at a groomer who may be able to give a light sedative to prevent being bitten but not be able to fully put an animal under.

                                Again, OP, I am really sorry for your loss and I hope this thread isn't getting to off the mark.
                                My blog: Crackerdog Farm

                                Comment


                                • #36
                                  I am so sorry for your loss Puglet. She was beautiful. There's a lot of interesting information on this thread. I hope it will be helpful for all of us.
                                  Hugs to you...

                                  Comment


                                  • #37
                                    I am so sorry for your loss. What a beautiful cat. RIP.
                                    ~Veronica
                                    "The Son Dee Times" "Sustained" "Somerset" "Franklin Square"
                                    http://photobucket.com/albums/y192/vxf111/

                                    Comment


                                    • #38
                                      I am so sorry you lost her - what a beautiful girl!!
                                      ((hugs))

                                      Originally posted by Puglet View Post
                                      Thank you, everyone, for your kind words. It is much appreciated.

                                      Here she is.... https://www.facebook.com/photo.php?f...7&l=bc09247201

                                      She had been under once before. Same vet. It was just over a year ago when she was spayed. They did do an autopsy and found a healthy heart. She had some lung damage and fluid in her chest. Her only living offspring unexpectedly passed away Saturday. Ironic that they went within days of each other. This makes me rethink dentals for cats in the future.

                                      You just never know when you will lose them.
                                      The problem with political jokes is that they get elected.
                                      H. Cate

                                      Comment


                                      • #39
                                        Squish, thank you for elaborating on the monitoring. See, that's part of the problem--I just ASSUME that "proper monitoring" includes all that stuff. On the other hand, rather than asking if they do x, y and zed specific monitoring, I try to ask more open ended questions and let them tell me what they do. Else, you can end up with a lot of smiling and nodding. "Oh yeah, we do all that." Meanwhile, they have no clue what you're even talking about.

                                        Anyway...lots of good info. And again Puglet, I am so sorry for your loss. I would be a freaking wreck to be honest. You're handling it much better than I. ((hugs))
                                        A good horseman doesn't have to tell anyone...the horse already knows.

                                        Might be a reason, never an excuse...

                                        Comment


                                        • #40
                                          This is all very interesting. There is so much to learn for a "casual" pet owner. I am very much less well read on cat issues than horse.

                                          I feel very fortunate in my choice of vet. As I've mentioned in my other thread, my sister works at the hospital where we take our cats. When I said how much I appreciate that particular vet sis sighed and said "She's always there. She is so hard to work for. She is critical, demanding, and she will try everything. She hasn't been out of vet school long enough to relax." Yup, I replied... that's EXACTLY why I like her.

                                          Three cheers for over achieving vets!

                                          This thread has been very educational.
                                          Life is what happens while you are busy making other plans

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