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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
What premeds can you use in aggressive dogs?
IM ketamine, tolazol, or alfaxalone combo with A2-agonist
26
What type of premedication should be used for patients with pre-existing high vagal tone?
Anticholinergic (antimuscarinic) | Eg Brachycephalic or Ophthalmic Disease
27
The following prodecures cause vagal stimuation - ophthalamic - laryngeal, GI, or urogenital - upper GI endoscopy What would be a useful premedication in these procedures?
Anticholinergic (antimuscarinic)
28
What are the most important side effects of a2 agonists?
Hypertension —> reflex bradycardia
29
How should propofol, alfaxalone, and etomidate be administered for induction ?
Titration to effect Give slowly- may give 1/2 of calculated induction dose over 10-15seconds and evaluate, then small boluses until intubatable
30
T/F: Ketamine has a fast onset of action and can be used for rapid sequence induction
False Long onset of action
31
Why should we used the largest ETT tube that will pass?
Lower resistance to gas flow Less likely to obstruct Cuff requires lower inflation pressure—> lower chance of tracheal trauma
32
What are the CRI injectable anestherics
Propofol and alfaxalone
33
T/F: etomidate can be used CRI
False | Causes adrenal suppression
34
What adjunct drugs can be administered as CRIs?
Opioids Lidocaine Ketamine Benzodiazepines
35
What is the average blood volume?
90mL/kg
36
What is the most common IV fluids used for cardiovascular support and what rate is commonly used?
Isotonic crystalloids -LRS, Plasmalyte-A, Norm-R 10mL/Kg/hr
37
What is most commonly used to treat hypotension in healthy dogs?
Dopamine Dobutamine Ephedrine
38
What is the most common way to treat hypotension in sick dogs?
Norepinephrine and vasopressin
39
T/F: regurgitation is common in dogs and cats
False Common in dogs, not cats
40
What are clinical signs of esophagitis?
Dysphagia Gagging Pain Weight loss
41
What should you do after regurgitation?
Flush esophagus with water—> increase pH and reduce esophageal damage ** make sure ETT is inflated**
42
What are the consequences of aspiration?
Chemical irritation and pulmonary edema “Aspiration pneumonitis” Extend hospital stay, increased morbidity and mortality
43
How can you prevent aspiration?
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
What drugs can be used if your patient is high risk for regurgitation?
Proton pump inhibitors - omeprazole or esomeprazole (Increase GI pH -> reduce injury secondary to regurg) Prokinetic drugs- metoclopramide or cisapride
45
T/F: Cats are generally more difficult to anesthetize than dogs
True - smaller body size- difficult to intubate - higher mortality - more likely to be hypotensive - differences in drug metabolism
46
T/F: in dogs and cats, you can use a cough to identify heart disease
False Dogs- yes Cats- no —> cats only generally cough due to asthma
47
What breed of cat is at risk for hypertrophic cardiomyopathy ?
Maine coon —> anesthetic-associated death d/t fatal arrhythmia —> post-anesthetic congestive heart fialure (d/t dugs like ketamine or telazol, or stress)
48
What should you do if you detect a murmur in a Maine Coon before you do any anesthesia?
Get a cardiologist consult | —> identify level of risk and formulate appropriate anesthetic plan
49
Why might oxymorphone and methadone be preferred over morphine or hydromorphone in cats?
Possibly cause less excitement
50
What opioid is used often as a CRI intra- and post- operatively for analgesia ?
Fentanyl
51
All opioids can cause post-op __________ in cats
Hyperthermia
52
What sedatives used in dogs, also can be used in cats, but require a higher dose in cats
Acepromazine and dexmedetomidine
53
T/F: benzodiazepines can cause excitement in cats
True Better used IV at time of induction rather than IM pre-med
54
What combination of IM anesthesia will provide immobilization for fractious cats?
Alfaxalone or ketamine
55
What is the combination for “kitty magic”?
Ketamine + a2 agonist + opioid Dexmedetomidine (a2) Buprenorphine (opioid)
56
Is chamber induction recommended for cats?
No —> stress response (release of epi and norepi—> arrhythmias)
57
Why do we use caution with repeated propofol use in cats?
Heinz body anemia
58
T/F: propofol 28 can be used in cats
False NOT FDA approved -benzyl alcohol (preservative) is not metabolized will in cat
59
Laryngospams are common in cats during intubation. How can you reduce this?
Lidocaine on arytenoids Ensure appropriate depth
60
Cats are suseptible to tracheal damage, therefore you must carefully inflate the ETT cuff. What conditions can result from tracheal tears?
SQ emphysema | Pneumomediastium
61
Is MAC higher in cats or dogs?
Cats have higher MAC ISO 1.4. 1.6
62
What adjunct drugs can be administered as CRIs in cats?
Opioid (fentanyl most common) Ketamine Benzodiazepines NOT lidocaine —> causes severe CV depression in cats when given IV
63
How can you treat hypotension in cats under anesthesia ?
Bolus -> be careful, blood vol is only 60mL/kg —> intolerant to fluid overload Decrease anesthetic rate Dopamine if first choice drug
64
Why can cats develop post-anesthetic cortical blindness
Secondary to decreased O2 deliver to the brain (hypoxemia or poor perfusion)
65
What type of blood transfusion can be fatal in cats?
Type B cats receiving Type A blood
66
What is the most common blood type in cats
Type A
67
A cat that is type AB can receive what types of blood
Type A and B
68
NSAIDS often cause what undesirable effect in cats?
Renal damage Meloxicam has been show to have some long term safety

RUSVM Anesthesiology (32 decks)

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