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Anesthesiology 398 and 466 > Lecture 9 Anesthesia in Dogs and Cats Part 2 > Flashcards

Lecture 9 Anesthesia in Dogs and Cats Part 2 Flashcards

1
Q

Why is intubation more difficult in cats?

A
  1. Small oropharyx
  2. Prone to laryngospasm
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2
Q

What do you need to intubate in cats?

A
  1. Induction agent
  2. Laryngoscope
  3. Endotracheal tube & tie
    • Size 3, 4 or 5 mm
  4. Topical anesthetic
  5. +/- stylet
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3
Q

What Positioning do you intubate cats in?

A
  1. Sternal recumbency, extend head/neck toward ceiling
  2. Thumb & forefinger behind canine teeth
    • no fingers in mouths!
  3. Tongue out of mouth between lower canines
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4
Q

How do you position tounges in cats?

A
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5
Q

How do you apply Local Anesthetic on Aryteniods in cats (2 ways)

A
  1. Swab with Q-tip soaked in Lidocaine x 2
    • This way is better
  2. Lidocaine 1-.2 mls 2% in syringe
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6
Q

What are the Local Anesthetic on Arytenoids that you don’t want to use

A
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7
Q

Describe the technique how intubation is done in cats

A
  1. Blade of laryngoscope on tongue, press down
    • Epiglottis flattens out
  2. DO NOT touch epiglottis
  3. Direct tube to ventral aspect of glottis
  4. Rotate bevel of tube if arytenoids are closed
  5. Stylet
    • 5 or 8F polypropylene urinary catheter
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8
Q

What are causes of Tracheal Rupture regarding anesthesia

A
  1. Likely causes:
    • Over-inflation of ET tube ***
    • Use of stylet
    • Change of positioning without D/C from Y piece
  2. Anesthetic machine ‘pop-off’ accidents
    • Pressure alarms
    • ‘pop-off’ buttons
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9
Q

When you have an aggressive dog, what are 3 causes?

A
  1. Pain
  2. Fear
  3. Anxiety
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10
Q
  1. What are some drug combination used for aggressive dogs when you dont have an IV catheter in
  2. Mode of administration?
A
  1. Drugs
    • Dexmedetomidine - 5.0 – 10 mcg/kg
    • Ketamine - 1.0 – 2.0 mg/kg
    • Opioid
      • Butorphanol 0.3 – 0.4 mg/kg or
      • Hydromorphone 0.1 - 0.2mg/kg
  2. give IM
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11
Q

After you have given the sedation for aggressive dogs, where do you put the dogs?

A

Observe but leave undisturbed for 10 minutes

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12
Q

If you want to sedate aggressive dogs with IV catheters what do you do?

A
  • Slow Propofol induction thru IV extension
  • Opioid analgesics
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13
Q

You have an aggressive cat, what are your sedation options

A
  1. Kitty magic:
    • Dexmedetomidine
    • Ketamine
      • Not with cardiac disease, hypertrophic cardiomyopathy (HCM)
    • +/- Opioid
      • Butorphanol
  2. Inhalant Chamber induction last resort
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14
Q

What are the downfalls of Inhalant Chamber induction last resort (Boxing) for aggressive cats

A
  1. High doses needed
  2. Unable to monitor
  3. Waste gas pollution
  4. VERY stressful, increase SNS stimulation
  5. Thorough PE not possible
    • Increased risk?
    • 25% non-symptomatic cats have hypertrophic cardiomyopathy

Use as last resort

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15
Q
  1. What are your induction agent options for dogs?
  2. cats?
A
  1. Dogs
    • Propofol
    • ketamine/benzodiazepine
    • alfaxalone
  2. Cats
    • above or total injectable anesthesia
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16
Q
  1. Does •Propofol cause respiratory and cardiovascular depression directly related to dose and rate or is always the same?
  2. How do you administer it for intubation
A
  1. Respiratory/CV depression directly related to dose & rate of administration
  2. Give 1.0mg/kg slowly over 15 seconds,
    • then to effect for intubation
17
Q
  1. What is the DOA for propofol
  2. analgesic properties?
  3. How is it metoblized?
A
  1. Short DOA,
  2. no analgesic properties,
  3. extra-hepatic metabolism,
18
Q

Propofol has neurotoxic or neuroprotective effects?

A

neuroprotective

19
Q

If you want to use propofol as a CRI, what drugs must you give first?

A

–Lidocaine/Ketamine loading doses needed for CRI

20
Q
  1. How is the recovery for Propofol
  2. Can you use it for sedation?
  3. Is it controlled?
  4. Is it expensive?
A
  1. Smooth recoveries, no ‘hang over’,
  2. good for short procedures
  3. Not controlled
  4. Cheap
    • ~ $20/20mL bottle (~$1/mL)
    • Propofol 28 slightly more expensive
21
Q
  1. Ketamine/Midazolam as induction causes analgesia?
  2. What are the cardiovascular effects?
  3. How do you administer it?
A
  1. Analgesia,
  2. hemodynamic stability (↑heart rate, BP)
  3. Give 1/3 to ½ as bolus, then to effect
22
Q
  1. When you use Ketamine/Midazolam as an induction what drug must you give first?
  2. Are they controlled?
  3. Do the effects last into recovery?
A
  1. Use with Lidocaine loading dose
  2. Both controlled
  3. Effects may last into recovery
23
Q
  1. Alfaxalone is what kind of drug
  2. Does it cause –Dose & rate dependent respiratory depression
  3. Analgesia?
A
  1. neurosteriod anesthetic
  2. Dose & rate dependent respiratory depression
  3. No analgesia
24
Q
  1. Alfaxalone causes good or bad recovery?
  2. Is it controlled?
  3. Cheap or expensive
A
  1. ↓ recovery quality with high doses and minimal premedication
  2. Controlled, schedule IV
  3. Expensive!
    • ~$54/10mL (client cost at ISU) = $5.40/mL
25
Q
  1. What type of patients do you use Opioid + Benzodiazepine for induction?
  2. What is a good option for these patients?
A
  1. Induction protocol for critically ill patients
    • GDV, septic/hemo abdomen, severe heart disease
  2. Fentanyl and Midazolam => intubate
26
Q
  1. Isoflurane mac in dogs
  2. cats
A
  1. MAC in dogs 1.3%,
  2. 1.6% cats
27
Q
  1. Sevoflurane mac in dogs
  2. What are its disadvantages
A
  1. 2.3
  2. Disadvantage:
    • expense ~$150/250mL bottle,
    • toxic metabolites => no low O2 flow
28
Q
  1. Nitrous oxide mac in dogs
  2. Benefit to using it
  3. provides analgesia?
  4. What do you do with waste gas?
A
  1. MAC in dogs ~200%
  2. Benefits
    • ↓ MAC Sevoflurane by 25% with 50% NO, 50% O2
    • inexpensive
  3. provides adjunct analgesia
  4. **must scavenge waste gas
29
Q

What are the Intra-op & Post-op Constant Rate Infusions options

A
  1. •MLK - Morphine, Lidocaine, Ketamine
  2. •HLK- Hydromorphone, Lidocaine, Ketamine
  3. •FLK – Fentanyl, Lidocaine, Ketamine
  4. •Fentanyl
  5. •Fentanyl + Ketamine
  6. •Dexmedetomidine*
  7. •Dexmedetomidine + MLK*

Anesthesiology 398 and 466 (22 decks)

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