Anesthesia, Fatigue Questions- More Questions Post 8

[macoduck]

A friend's boxer did not do well under anesthesia in that for several days afterward he acted "drunk". My friend does not know exactly what drugs were used but he does know they didn't use Propofol.

This dog is 10 years old. He's in fairly good health although he had a large lump removed that had some spindle cells. He's had a few other smaller lumps come up and only one aspiration came back with a few spindle cells.

What is an anesthesia protocol that might work best? I told him to ask about Propofol. Oddly enough, there appears to be a shortage of Propofol for humans.

 

The hospital's therapy dog is a 7 year old golden retriever. She had a lump removed that came back as benign. She stayed out of service for over a week until she was healed. A few weeks passed and her hospital handler called the owner to report that the dog was acting very tired. She has had bloodwork and urine check for UTI (had UTI a couple of months ago). Both tests came back negative. What could cause her fatigue? She spends the whole day at the hospital with that day's handler. She has plenty of time to take naps. She is normally a happy, happy dog.

Edited November 2, 2012 by macoduck

[4My2Greys]

I'll have to find out from my vet what he used when I had Chase's teeth cleaned. When I picked him up that afternoon he showing no residual signs whatsoever of having been under. He did so good with Chase I'm planning to have Nadir's and Beanie's teeth done too. I do remember him saying a lot had to do with controlling the amount that was used.

[macoduck]

Bumping. Still interested in any tips.

[Batmom]

Really hard to say anything useful without knowing the full protocol used. Some things that can contribute -- type of anaesthesia used (including which induction agent), how much used, whether fluids were given during the procedure, the dog's general condition (including cardiac -- common problems in boxers) ..... Dogs can also get viruses that may lay them low for a bit, and a vet's office is a "good" place to pick up stuff like that.

 

Hope both dogs are 100% back to themselves soonest.

[tbhounds]

I would question of course the protocol (pre-op, induction and gas agent) and if they used IV fluids or not. I found just running fluids during and post procedure really helps them bounce back quicker.

[macoduck]

Hmm, I'm thinking they did not use IV fluids on that boxer. I do not use this vet office. I'll have to owner review his receipt to see what was used.

[JJNg]

I agree that we really can't comment on the boxer's prolonged anesthetic recovery without more info about the specific protocol and drug doses used. There are also a lot of other factors that can affect anesthetic recovery. Was pre-op bloodwork done?

 

Regarding the golden retriever, fatigue or lethargy is a very non-specific sign that can be caused by just about anything. Did the bloodwork include a thyroid check?

[macoduck]

I checked with the boxer's owner again. He had not saved the paperwork to see what protocol was used with the previous anesthesia. He said is vet is very dog-skilled but low on bedside manners with the humans. He trusts this vet but would like to have a discussion about sedation.

Owner asks if those in the vet medicine field could provide a description here of what standard anesthesia protocol you would utilize for his dog. Actually, this dog was taken in by my friend after the original owner (also our coworker and friend) was brutally murdered by her boyfriend.

 

10.5 year old male boxer

in general good health

recent skin tumor removal was large but benign

soon after a few more smaller tumors appeared

- biopsy via aspiration showed some spindle cells in one of those tumors

- owner thinks removal of these will only result in a stitch or two each

owner is about to schedule the next tumor removal and asks for info on sedation agents that should or should not be used

I have told the owner to ask about getting chest and abdomen xrays while the dog is sedated. He wants the xrays to be done.

He is going to ask if a pre-op bloodwork panel was done, and if not or too long ago, will get another

--------------------------

Regarding the golden retriever, the boxer's owner is also her handler while at our hospital. He will relay to that owner the question about the thyroid test. I can pretty much guarantee you that only a T4 was done. Since this golden is our in-house therapy dog, I'm wondering if she could have picked up a nosocomial infection. She did not test positive for another UTI but was put on antibiotics again. My firned will also ask the owner if a culture was done.

[tbhounds]

It's bit worry some that more tumors are being seen on this boxer-as most folks know boxers are cancer prone-especially with Mast Cell Tumors. I would definitely run prep bloodwork (we have bloods done with a 5 week window) including a T4-if the T4 comes back low then they could run an add test including a FT4/TSH. It might benefit the pet by re-aspirating the tumor(s)---knowing what the mass is may be helpful to determine how wide the surgical incision should be. Have the slide send out to the lab (obviously this needs to be done prior to the surgery date).

As far as the anesthesia protocol-it's really what the vet is comfortable using. I can tell you what we use at our clinic-of course it will vary on a pet by pet bias though. A commonly used protocol would be to pre-med with morphine (or Buprenex) and atropine. The induction used is usually ketamine/Valium or propofol. Our guys are maintained on O2/Iso (some clinics use sevoflurane). All pets receive an IV cath and are given IV LRS fluids intra/post op.

As far as the rads-if the client really wants them performed-might be beneficial to have them done prior to the surgery date as a pre operative precaution. Along with being predisposed to cancers you would want to rule out heart disease (Dilated Cardiomyopathy) and potential mets.

[macoduck]

Tracy, what is the relationship between the tumors and running the FT4/TSH?

Can dilated cardiomyopathy be revealed in other ways, as in listening with a stethoscope?

[tbhounds]

Tracy, what is the relationship between the tumors and running the FT4/TSH?

Can dilated cardiomyopathy be revealed in other ways, as in listening with a stethoscope?

No relationship -just should rule out that this boxer may have mct(s)-perhaps have a few of these new masses aspirated. I would run a pre-op chemistry including a T4--if the T4 returns low then you should follow up with a FT4/TSH. Sorry I wasn't clear. Hypothyroidism would make for a very low recovery.

DCM can't always be picked up by asculting the chest however, many times there will be a murmur. I'm not implying this dog has dcm but, I am racial profiling and if the owner wants rads performed its best to do them prior to surgery-before the dog is sedated. It's just one more step to ensuring a safe procedure.

Complete exam, bloodwork and radiographs :-)

[JJNg]

There are lots of different sedative and anesthetic drugs and the specific anesthetic protocol can vary widely. With a dog who has had an abnormally prolonged recovery period, the protocol that was used may need to be adjusted to account for this the next time he is put under. Some drugs may need to be used at lower doses, or different drugs with a shorter duration or milder effect might be considered. Again, it's hard to give specifics without knowing what the dog actually received, or what drugs his vet is familiar with and has in stock.