Dog owners should set aside the idea that age alone dictates whether or not an anesthetic-required procedure should be considered. An excellent example is a recent patient of mine named Digger, a 16-year-old West Highland White Terrier. He was suffering from long-standing oral infections, advanced gingivitis, loose teeth, foul mouth odor and he had difficulty eating due to the pain in his mouth. Too much emphasis on chronological age interfered with judgments made years prior regarding the health benefits of a thorough dental procedure under anesthesia. Now the owner was desperate to help little Digger.
The clinic staff assured the owner that Digger’s chronological age was of secondary relevance; of primary importance were Digger’s total health status (irrespective of age) and the objective measurement of his health parameters. Usual hospital protocols were followed and his blood and urine test results were quite good. Appropriate pre-anesthetic medications were given, monitoring devices provided us with real time patient data, an intravenous catheter delivered fluids and IV induction anesthesia, and modern gas anesthesia was administered through an endotracheal breathing tube during the dental procedure.
Within five minutes after the final polishing of Digger’s remaining teeth and a thorough rinsing of his oral cavity he was awake and wondering how he got in the recovery cage! The prospects for a newly energized, comfortable, healthier, and huggable Digger were excellent.
Many other successful cases underscore that fact that chronological age does not, by itself, disqualify the use of general anesthesia.
Advancements in Anesthetics
What improvements might we see in the future regarding anesthesia in animals? Novak predicts, "In the near term most of the anesthesia improvements will be in gas anesthetics. These are great products because they are so easy to control in the patient. We currently use one called sevoflurane, which is the same one often used in human pediatric cases. We are continually looking for safer and better ways to provide pain free procedures. Most of the safety in the future of both human and pet anesthesia is based on improvement in the protocols and patient monitoring."
Note that Novak emphasizes patient monitoring. New patient monitoring instruments and techniques are available to veterinarians today that are vastly improved over what was considered practical just a few years ago.
The American College of Veterinary Anesthesiologists recommends specific patient monitoring guidelines that many animal hospitals follow. These include close observation and recording of circulatory status (heart rate and blood pressure), ventilation assessment (depth and frequency of respirations and blood gas concentrations), and fine tuning the concentration of anesthetic delivered to the patient. Placement of an intravenous catheter allows for quick administration of supportive medications if they are needed. In addition, there should be a trained staff member who is responsible for direct observation of the patient throughout the anesthetic period.
Be aware that problems arising in a patient under anesthesia may not be related to the anesthetic at all! Surgically induced blood loss, hypothermia, low blood pressure, vomiting with subsequent inhalation of gastric contents, and undiagnosed pathology such as an infection that triggers septic shock and circulatory collapse all could contribute to an adverse outcome for the patient. Treating every patient as a unique entity is precisely why close patient monitoring is the norm during anesthetic events.
The next time your veterinarian brings up the topic of anesthesia be encouraged that modern veterinary medical protocols and anesthetic agents, both injectable and gas, are widely available to all practitioners. Ask questions, do the pre-operative tests, obtain input on what procedures the veterinarian considers appropriate for your dog.
If the "pros" for doing the procedure far outweigh the "cons," your dog’s health status and quality of life stand to improve thanks to modern anesthetic administration and standardized protocols that greatly improve the prospects for a successful outcome for every patient.
Image: Honou / via Flickr