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RUSVM Anesthesiology > Canine And Feline Anesthesia > Flashcards

Canine And Feline Anesthesia Flashcards

1
Q

What medications are the most common concerns for dog and cat anesthesia ?

A

Heartworm prevention ( more or less risk depending on location)

Diuretics (hypovolemia concern and electrolyte imbalances)

ACE inhibitors , Ca channel blocks, B blockers (concerned about unresponsive hypotension)

Anti-epileptic (additive sedation)

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2
Q

What are signs of systemic disease that you should look for prior to anesthesia ?

A

Coughing and exercise intolerance

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3
Q

What information should you gather in a history prior to any anesthetic procedure?

A 
Duration of complaint 
Current meds 
Signs of systemic disease 
Previous blood transfusions 
Previous anesthesia (any complications??)

Age-young and old have special considerations
Gender- preg?
Breed ?

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4
Q

Special anesthesia considerations with Sighthounds?

A

Significantly prolonged recovery with thiobarbiturates

Longer recovery with propofol and alfaxalone

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5
Q

Special anesthesia considerations with boxers?

A

Possibly sensitive to acepromazine

Concern for collapse (vagal mediated)

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6
Q

Special anesthesia considerations with bulldogs, pugs, and boston terriers

A

Brachycephalic airway syndrome

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7
Q

How can you decrease the risk of brachycephalic airway syndrome??

A

Careful with sedatives and MONITOR after premeds

Will need smaller tube than expected

Preoxygenate

Rapid IV induction and return to consciousness

Keep on O2 until extubation, and extubate late

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8
Q

Special anesthesia considerations with small breeds?

A

Tracheal collapse

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9
Q

How can you reduce tracheal collapse in small breeds?

A

Avoid excitement - panting/coughing

Use sedatives as needed

Longer ETT to reach carina

Supplemental O2

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10
Q

Cardiomyopathy is associated with what breeds?

A

Dobermans and boxers

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11
Q

Sick sinus syndrome is associated with what breed?

A

Schnauzers

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12
Q

Mitral valve disease is associated with what breeds?

A

Small breeds

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13
Q

Increased vagal tone is associated with ??

A

Brachycephalic

Dachshunds

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14
Q

Von willebrand disease is associated with what breeds?

A

Doberman

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15
Q

Hemophilia is associated with what breed?

A

German shepherd

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16
Q

Usually ________+ __________ is given IM before catheter placement for premedication

A

Opioid; sedative

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17
Q

What mu agonists are LEAST likely to cause vomiting?

A

Fentanyl

Methadone

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18
Q

In what cases would you want to reduce likelyhood of vomiting?

A

Increased ICP or IOP

Patient unable to protect airway (laryngeal paralysis, decreased mentation)

Megaesophagus

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19
Q

What is the MOA of diphenhydramine and when would you use it a a pre-med?

A

H1 antihistamine

When removing a mast cell tumor

Histamine release would cause vasodilation and leaky vessels

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20
Q

What is the MOA of maropitant and when would you give it as a pre-med?

A

NK1 receptor antagonist

Decrease the risk of vomiting

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21
Q

What is the main side effect of acepromazine ?

A

Hypotension

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22
Q

T/F: acepromazine causes a mild-moderate sedation and analgesic effect for premedication

A

False

Is a mild-moderate sedative

NO analgesic effect

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23
Q

Dexdomitor causes marked sedation in dogs, what are the main side effects?

A

Hypertension, reflex bradycardia, decreased CO

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24
Q

T/F: Benzodiazepines are very sedating in healthy dogs

A

False

Not very sedating in healthy, occasionally causes excitement

Sedation in young, old, or sick (minimal effects of CV or resp systems)

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25
Q

What premeds can you use in aggressive dogs?

A

IM ketamine, tolazol, or alfaxalone combo with A2-agonist

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26
Q

What type of premedication should be used for patients with pre-existing high vagal tone?

A

Anticholinergic (antimuscarinic)

Eg Brachycephalic or Ophthalmic Disease

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27
Q

The following prodecures cause vagal stimuation

  • ophthalamic
  • laryngeal, GI, or urogenital
  • upper GI endoscopy

What would be a useful premedication in these procedures?

A

Anticholinergic (antimuscarinic)

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28
Q

What are the most important side effects of a2 agonists?

A

Hypertension —> reflex bradycardia

29
Q

How should propofol, alfaxalone, and etomidate be administered for induction ?

A

Titration to effect

Give slowly- may give 1/2 of calculated induction dose over 10-15seconds and evaluate, then small boluses until intubatable

30
Q

T/F: Ketamine has a fast onset of action and can be used for rapid sequence induction

A

False

Long onset of action

31
Q

Why should we used the largest ETT tube that will pass?

A

Lower resistance to gas flow
Less likely to obstruct
Cuff requires lower inflation pressure—> lower chance of tracheal trauma

32
Q

What are the CRI injectable anestherics

A

Propofol and alfaxalone

33
Q

T/F: etomidate can be used CRI

A

False

Causes adrenal suppression

34
Q

What adjunct drugs can be administered as CRIs?

A

Opioids
Lidocaine
Ketamine
Benzodiazepines

35
Q

What is the average blood volume?

A

90mL/kg

36
Q

What is the most common IV fluids used for cardiovascular support and what rate is commonly used?

A

Isotonic crystalloids
-LRS, Plasmalyte-A, Norm-R

10mL/Kg/hr

37
Q

What is most commonly used to treat hypotension in healthy dogs?

A

Dopamine
Dobutamine
Ephedrine

38
Q

What is the most common way to treat hypotension in sick dogs?

A

Norepinephrine and vasopressin

39
Q

T/F: regurgitation is common in dogs and cats

A

False

Common in dogs, not cats

40
Q

What are clinical signs of esophagitis?

A

Dysphagia
Gagging
Pain
Weight loss

41
Q

What should you do after regurgitation?

A

Flush esophagus with water—> increase pH and reduce esophageal damage

** make sure ETT is inflated**

42
Q

What are the consequences of aspiration?

A

Chemical irritation and pulmonary edema
“Aspiration pneumonitis”

Extend hospital stay, increased morbidity and mortality

43
Q

How can you prevent aspiration?

A

Proper ETT cuff lube and inflation

If regurgitation occurs:

  • postural drainage while still anesthetized- nose down
  • swab or suction caudal oropharynx before extubation
  • keep cuff inflated or partially inflated for extubation
  • place in sternal recumbency
44
Q

What drugs can be used if your patient is high risk for regurgitation?

A

Proton pump inhibitors - omeprazole or esomeprazole
(Increase GI pH -> reduce injury secondary to regurg)

Prokinetic drugs- metoclopramide or cisapride

45
Q

T/F: Cats are generally more difficult to anesthetize than dogs

A

True

  • smaller body size- difficult to intubate
  • higher mortality
  • more likely to be hypotensive
  • differences in drug metabolism
46
Q

T/F: in dogs and cats, you can use a cough to identify heart disease

A

False

Dogs- yes
Cats- no —> cats only generally cough due to asthma

47
Q

What breed of cat is at risk for hypertrophic cardiomyopathy ?

A

Maine coon

—> anesthetic-associated death d/t fatal arrhythmia
—> post-anesthetic congestive heart fialure (d/t dugs like ketamine or telazol, or stress)

48
Q

What should you do if you detect a murmur in a Maine Coon before you do any anesthesia?

A

Get a cardiologist consult

—> identify level of risk and formulate appropriate anesthetic plan

49
Q

Why might oxymorphone and methadone be preferred over morphine or hydromorphone in cats?

A

Possibly cause less excitement

50
Q

What opioid is used often as a CRI intra- and post- operatively for analgesia ?

A

Fentanyl

51
Q

All opioids can cause post-op __________ in cats

A

Hyperthermia

52
Q

What sedatives used in dogs, also can be used in cats, but require a higher dose in cats

A

Acepromazine and dexmedetomidine

53
Q

T/F: benzodiazepines can cause excitement in cats

A

True

Better used IV at time of induction rather than IM pre-med

54
Q

What combination of IM anesthesia will provide immobilization for fractious cats?

A

Alfaxalone or ketamine

55
Q

What is the combination for “kitty magic”?

A

Ketamine + a2 agonist + opioid

Dexmedetomidine (a2)
Buprenorphine (opioid)

56
Q

Is chamber induction recommended for cats?

A

No

—> stress response (release of epi and norepi—> arrhythmias)

57
Q

Why do we use caution with repeated propofol use in cats?

A

Heinz body anemia

58
Q

T/F: propofol 28 can be used in cats

A

False

NOT FDA approved
-benzyl alcohol (preservative) is not metabolized will in cat

59
Q

Laryngospams are common in cats during intubation. How can you reduce this?

A

Lidocaine on arytenoids

Ensure appropriate depth

60
Q

Cats are suseptible to tracheal damage, therefore you must carefully inflate the ETT cuff. What conditions can result from tracheal tears?

A

SQ emphysema

Pneumomediastium

61
Q

Is MAC higher in cats or dogs?

A

Cats have higher MAC

ISO 1.4. 1.6

62
Q

What adjunct drugs can be administered as CRIs in cats?

A

Opioid (fentanyl most common)
Ketamine
Benzodiazepines

NOT lidocaine —> causes severe CV depression in cats when given IV

63
Q

How can you treat hypotension in cats under anesthesia ?

A

Bolus -> be careful, blood vol is only 60mL/kg —> intolerant to fluid overload

Decrease anesthetic rate

Dopamine if first choice drug

64
Q

Why can cats develop post-anesthetic cortical blindness

A

Secondary to decreased O2 deliver to the brain (hypoxemia or poor perfusion)

65
Q

What type of blood transfusion can be fatal in cats?

A

Type B cats receiving Type A blood

66
Q

What is the most common blood type in cats

A

Type A

67
Q

A cat that is type AB can receive what types of blood

A

Type A and B

68
Q

NSAIDS often cause what undesirable effect in cats?

A

Renal damage

Meloxicam has been show to have some long term safety

RUSVM Anesthesiology (32 decks)

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