Special Considerations for Small Animal Anesthesia Flashcards
what can considerations affect?
drugs
necessary equipment
monitoring
supportive care
minimum database
which species are important in considerations?
cats
rabbits
what are the unique risk factors for cats?
extremes of weight
intubation
fluid therapy
unique metabolism
why are cats technically more difficult to intubate than dogs?
smaller larynx
prone to laryngospasm
cannot open mouth as wide/less space in mouth to visualize
what are some tips to successfully intubate a cat?
make sure sufficiently deep
spray vocal cords with lidocaine
spend time watching rhythm of vocal cords with breathing pattern
intubate with inspiration
consider using flexible stylet
what does the doppler reading for blood pressure in a cat correlate with?
between systolic blood pressure and mean arterial pressure
what can anesthetic agents cause in cats?
hyperthermia
what are the risk factors for rabbits?
difficult intubation
difficult catheterization
high surface area to weight ratio
high resting heart rate
prey animals
respiratory infections common
what should you treat bradycardia in rabbits with?
glycopyrrolate
what is special about brachycephalics that impacts anesthesia?
airway
cardiovascular
gastrointestinal
musculoskeletal
what are the components of brachycephalic obstructive airways syndrome?
elongated soft palate
stenotic nares
hypoplastic trachea
everted laryngeal saccules
aberrant nasopharyngeal turbinates
what is special about brachycephalics’ cardiovascular systems?
high vagal tone
what are the anesthetic goals for brachycephalics?
avoid airway obstruction
avoid aspiration
what dog breeds have considerations to take into account?
herding breeds
doberman pinschers
sighthounds
giant breeds
what should be considered with aging?
perceived sensitivity and increased vulnerability to side effects
alterations in many physiologic parameters affect care
consider from body systems perspective
what is geriatric?
animal has lived 75% of expected lifespan
what is cardiac output dependent upon in pediatrics?
heart rate
what are pediatrics at increased risk for due to their respiratory system?
hypoxemia
why are pediatrics prone to hypoglycemia?
limited glycogen stores
what are dosage requirements like in pediatrics?
decreased from adults
what are geriatric patients at greater risk for due to their respiratory systems?
hypoventilation
hypoxemia
what changes in the renal system of geriatric patients?
decreased cortical mass and functional nephrons
decreased GFR and renal blood flow
decreased response to anti-diuretic hormone
what is the hepatic system like in geriatric patients?
decreased liver mass and hepatic blood flow
enzyme function well maintained
decreased metabolism of lipid soluble drugs
which procedures have special considerations?
urgent or emergency
trauma
ocular procedures
dental
endoscopy
should you give NSAIDs to trauma patients?
no
what should you consider giving in the pre-med for ocular procedures?
anticholinergic
which endoscopy procedures can be very stimulating?
rhinoscopy
upper GI
which medications should be stopped prior to anesthesia?
ACE inhibitors
anticoagulants
what is the mortality rate for cats under anesthesia?
0.11%
what is the mortality rate for rabbits under anesthesia?
0.73%
what drugs do cats sometimes require higher doses of than dogs?
sedatives
anesthetics
not opioids- lower
should you preoxygenate a rabbit?
yes
why is an elongated soft palate a problem?
epiglottic entrapment
thickened soft palate
macroglossia
what percentage of brachycephalics have GERD/regurgitation when they are awake?
84%
why would you use an anticholinergic in a brachycephalic during premed?
high vagal tone due to chronic upper airway disease
what is the most significant risk with pediatrics due to?
maybe their size more than their age
what is the pediatric cardiovascular system like?
limited ability to increase heart rate or inotropy
cardiac output is heart rate dependent
low pressure system
what can you use in pediatrics to avoid decreases in heart rate?
anticholinergics
what are pediatric respiratory systems like?
high minute volume
more compliant chest
increased oxygen consumption
when does hematopoiesis begin?
4 weeks of age
how much of pediatric blood is fetal hemoglobin?
60-70%
why is thermoregulation important in pediatrics?
large surface area to volume ratio
poikilothermic
lack adequate fat stores
warmth is analgesic to newborns
anesthesia and hypothermia
why do pediatrics have decreased dosage requirements?
increased volume of distribution
decreased plasma albumin
decreased hepatic function
decreased renal function
immature blood brain barrier
when should alpha2 agonists be avoided in pediatrics?
before 8-16 weeks
which drugs should you avoid before 8 weeks in pediatrics?
alpha2 agonists
many injectables
NSAIDs
what are geriatric cardiovascular systems like?
increased incidence of disease
decreased compliance
decreased maximal heart rate
decreased maximal cardiac output
why are geriatric patients at greater risk for hypothermia?
decreased skeletal muscle mass
decreased basal metabolism
what is the blood of geriatrics like?
decreased plasma proteins
decreased total body water
decreased muscle mass +/- increased lipid fraction
decreased volume of distribution for most drugs
how should you avoid an increase in intraocular pressure?
smooth induction and recovery
avoid emesis
avoid neck restraint
avoid drugs that cause
which medications should be stopped?
ACE inhibitors
anticoagulants
what should you do for presumptive MMVD?
maintain high normal heart rate and inotropy and low normal afterload
what should you consider in hepatic disease?
delayed drug metabolism?
hypoalbuminemia
hepatic blood flow
coagulopathy
what drugs should you not use in diabetic patients?
ketamine
alpha2 agonists with caution
which drugs should you avoid in pregnancy?
ketamine
benzodiazepines
opioids prior to delivery
NSAIDs prior to delivery
