Sunday, July 24, 2011

515. Anaesthesia & Surgery In Old Dogs - 13 years old

HIGH-RISK ANAESTHETIC CASES
AN EXAMPLE FOR VETS AT TOA PAYOH VETS

CASE STUDY FOR VERY OLD DOGS

HISTORY
On Oct 28, 2010. Not eating. Tense abdomen. Uterus thickened. High WBC count (44 compared to normal 6-17). Suspected closed pyometra. Operated by Dr Vanessa Lin. Recovered fully. Now, the owner requested dental work. Review medical history and make judgment as to the risks of another anaesthesia.


October July 25, 2011
Jack Russell, Female, Spayed, 5.6kg, 38.6 deg C. Excellent bodily condition
Today, 10 am, phoned gentleman owner to confirm request for dental checkup and extract loose teeth. 10.30 am Dental scaling & extraction of M1 (left upper, roots exposed), PM2 (left upper, roots exposed) & PM2 (right upper, roots exposed). Overall, teeth in good condition.

Last dinner at 7 pm yesterday
Sedation: Domitor 0.1 ml + Ketamine 0.2 ml IV. Shivering.
Others: Atropine 0.5ml IM. No shivering.
10 minutes: Isoflurane 0.2 - 1%

Dental scaling. 3 loose teeth with exposed roots extracted. Sleeps
Antidote: Antisedan 0.25 ml IM. Wakes up in 5 miniutes.
Antibiotic & pain-killer: Tolfedine 0.7 ml & Baytril 0.7 ml SC

Duration of anaesthesia: 15 minutes. No IV drip.
IV drip not given as the dog was eating and drinking with normal stools and urine for the past 3 days.
Dog OK. Goes home.

CONCLUSION
1. In weak and sick old dogs, IV drip should be given. Baytril via IV. Lasix IV if indicated in heart diseased dogs.
2. Blood test strongly advised. Record in case file if the owner objected to blood test.
3. Informed consent form must be filled up properly be the vet and signed by the owner. Case record should note risks and complications being explained.
4. Anti-sedan to be given to wake up the dog.
5. In dogs with heart disease, IV drip post-op.
6. Post-op pain-killer tolfedine + antibiotics SC as soon as possible after surgery

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