December 15, 2010

A Vet's Guide To Life: Evolving Anesthesia

This is an extract from an article by Chris Bern, an American vet...

Currently my practice is getting ready to change our anesthesia protocols.  We've spent time reviewing the literature, consulting with specialists, and deciding what is both safe and cost-effective to use.  I'm pretty excited about the changes, and really believe that it will allow us to have better and safer anesthesia, as well as better and safer pain control.

Most clients probably don't realize that the anesthesia can be extremely different from one veterinary practice to another.  There simply is no one, single consensus among veterinarians regarding which protocol should be used.  Some vets elect to do anesthesia as cheaply as possible to make it available to more people, recognizing that the cheapest drugs usually come with greater risks than others.  Some vets use the most modern equipment and drugs, realizing that their anesthesia will be more expensive than their colleagues, but willing to do so for the increased safety.  There are numerous variables to how anesthesia is performed, including drugs used (inhaled versus strictly injectable, and then several choices in each category), supportive care given (warming aids to reduce hypothermia, fluid support), monitoring (ranges from none at all to ECGs, blood pressure, and oxygen monitors), and analgesia (ranging from none at all to both pre- and post-operative pain medications).

I have seen many changes in my 13+ years of practice and 26 years in the field.  Many of those changes have been in the last 5 years as research expands and companies develop better drugs.  The way we as a profession look at anesthesia and pain control in 2010 is a far cry from how we looked at it in 1990.  And depending on how they have kept up with their continuing education, a veterinarian who has been practicing for 30 years is likely going to see the subject differently than someone who just graduated. 

What does this mean for a client?  Ask LOTS of questions about how your pet is being treated and monitored.  When you ask about surgery costs and ask "what does that include?", don't settle for an answer of "Oh, it covers everything."  Yes, I've heard veterinary practices state it that way.  Ask details of precisely what is included, which drugs are used, and how monitoring and supportive care is done.  If you're comparing veterinary clinics, please don't go simply on price, as there are inevitably shortcuts made or corners cut in the cheaper of two quotes. 

What does this mean for a veterinarian?  We all need to keep up with current research and options, striving to do the highest quality and safest care possible.  I can guarantee that how you were/are trained in school is not going to be the standard in a decade or two.  Change in medicine is continual, usually for the better, and it's our responsibility to keep up with the new knowledge.

In essence, anesthesia is willfully bringing a pet closer to the conditions of death than we do in any other circumstance.  It's important to make it safe and reversible with no long-term consequences.  There is no way to make this perfect in 100% of the cases, but we can continue to improve.  Embracing the change is a good way to do so.

Please read this if you own a pet. Chris has made some comments I totally agree with. You really do need to ask these questions of your clinic. I find it sad that so many of our vet nursing students, despite all our "best practice" teaching, find them selves working in clinics that work only to price. Sadder still that many of them come to think it must be acceptable because the vet says it is.
Owners are the best people to demand change and vote with their business, or not.

Posted via email from Four Paws and Whiskers


  1. What a pleasure to meet you! Any person who loves animals can only be a good person, that's what my father always said. I want to thank you for visiting my blog and tell you that I will be comming to visit with you often. And learn with you.

    Oh, I almost forgot. Hubby and I met on September 98. He went to my country on February 99. We got married on April 99. That was fast too, don't you think? ;)

  2. Loads of useful stuff on this blog! We have no choice of vet, but it's stil going to help being able to ask informed questions!

  3. Hey there...
    Thank you for this post - it is both interesting and thought provoking.
    I have deleted my comment a few times because it has prompted so much thought and I am NOT a Vet myself. I am commenting from a layperson's point of view. So please bear with me...
    What I wanted to perhaps point out was that the article (and the post) focusses primarily on Vets who have a 'domestic' practice and it excludes some other very important disciplines of Veterinary practice here in South Africa. For example: Here in South Africa we have Wild-life Vets, Production Vets and State Vets - besides the 'small animal' Vets. I would imagine that the methodology for anaesthesia would be different for each of these....Elephants for example have very specific requirements (cooling, revival etc) and most Veterinary procedures for many of our animals are conducted outdoors or the the options would be limited. I would imagine that this is the same in rural farming communities here.
    Nevertheless, thank you for provoking thought. I think we have a long way to go (here) before the generalised domestic Veterinary culture allows us (clients) to ask many questions. If we do, we may find ourselves without a Vet. Vets here are almost regarded as demi-Gods by us 'Joe public'
    Kind regards


Comments welcome....always love to hear what you think!


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