Feline Anesthesia Flashcards
Compared to dogs cats are
-more difficult to intubate
-more sensitive to CV depression due to inhalant drugs
-more likely to become hypotensive
-slower to metabolize and eliminate drugs
-More sensitive to NSAIDS and lidocaine adverse effects
What is a common disease that cats can get that increase their risk of anesthetic death and how would you be able to test for it
Hypertrophic cardiomyopathy
Detecting a murmur in HCM predisposed cat (reach out to cardiologist before anesthesia) but some of them won’t have a murmur so a point-of-care NT-proBNO SNAP test to screen for heart disease
What is the concern of having cats with HCM receiving anesthesia
-Anesthetic related death due to fatal arrhythmias
-post anesthetic related CHF
What plays a major role in behavior of cats during the physical exam
Physical restraint technique and premeds
What are some at-home premedications for cats
-Gabapentin
-Trazodone
What are some pre-meds (in hospital) you can give cats
-Dexmedetomidine - need higher doses than dogs and vomiting is most likely to occur
-Ketamine - very common use
-Benzodiazepines - given in combo with ketamine (w/o combination will cause paradoxical excitement)
-Opioids
*Methadone causes less excitement than morphine
*Fentanyl CRI intro/post operative analgesia
*Buprenorphine for visceral analgesia
(Buprenex - ELDU low dose multiple times, Simbadol - SQ SID, Zorbium - Transdermal lasting 4 days)
What pre-med in dogs is not advised to use in cats
Acepromazine
Not as effective and can aggravate side effects
What are good chemical restraints in aggressive cats
-Oral transmucosal
*desmedetomidine and Ketamine
Good sedation
-IM
*Alflaxalone/Ketamine (+ alpha2 + opioid) = kitty magic
What are some induction agents you can use in cats
IV
-propofol (safe in cats just don’t use repeatedly as it can cause Heinz body anemia)
-Alflaxalone
-Etomidate
-ketamine +/- telazol (dissociative anesthetic)
What is the induction anesthetic of choice in a cat with cardiovascular disease
Etomidate
When is ketamine contraindicated in cats
Cats with renal disease/dysfunction as it prolongs the duration of action
When do you want to avoid Ketamine and telazole in cats
When they have cardiac disease diagnosis or suspect ion as it can precipitate CHF in cats
Why is mask induction not recommended in cats
-It can trigger a stress response -> release epi/norepi causing arrhythmias
-high doses can cause hypotension
What makes orotracheal intubation in cats difficult and what would would you do to prevent it
Cats are prone to laryngospasm
Give topical lidocaine to prevent the arytenoid cartilage spasm
What is the risk of advancing the ET tube too far
Risk of mainstem bronchus intubation and pneumothorax
Can cause treachery damage causing SQ emphysema and pmeumomediastinum
What is an alternative to ET intubation in cats
V-gel supraglottic airway device (laryngeal mask airway)
It’s a single use devise that is designed to fit over the larynx and is easier to use by inexperienced personnel
What is some maintenance anesthetic in cats
-Inhalant anesthetic- ISO (MAC is higher in cats than dogs)
-Adjunct drugs CRIs
*Opioids
*Ketamine
What CRI drug can you use in dogs for maintenance but not for cats
Lidocaine
-cats are more sensitive to CNS toxic effects
-can cause additional cardiovascular depression
-can use as a local block though just at a smaller dose than dogs
What are some common complications of anesthesia in cats
-pulmonary edema/ fluid overload
-Hypotension
-Blindness +/- neurological deficits
-neuro deficits secondary to open mouth as spring loaded mouth gags compromise maxillary artery blood flow
-cerebral hypoxia caused by poor perfusion and hypoxemia
-renal and GI effects from NSAIDs
-blood transfusion severe reaction
What is the total blood volume of cats
60 ml/kg
What should be the intro-op fluid rate in cats
3ml/kg/hr
What are some things you can give to cats to reduce/correct hypotension
-give MAC sparing inhalant anesthetic
-use vasopressors/ inotropes
*dopamine is a good first choice and effect drug
Why are cats more sensitive to the toxic effects of NSAIDs
-defective hepatic glucuronidation and have altered drug metabolites -> extends drug half life and accumulation-> toxic effect
What are the 2 approved NSAIDs in cats
-Robenacoxib (3x SID but has been shown to be safer for longer use due to its short half life in cats)
-Meloxicam (one SQ dose)
