1398. Domitor +
Ketamine Anaesthesia
for spay duration +
KPI
Feb 27, 2013 I
spayed a 7-month-old
Maltese X., 4.3 kg.
The happy couple
took leave and made
an appointment with
me. Usually spays
are done by Dr
Daniel as they are
routine surgeries.
This dog had been
vigorously licking
her vulval lips such
that the area above
the vulva became
black. "Much less
licking after
antibiotics last
month," the lady in
her late 20s said to
me. I had advised
spaying as there
could be pyometra
which leaked out
vaginal discharge
causing the need to
lick. It could be a
urinary tract
infection too. The
dog was on heat with
uterine horns and
ovaries very red and
congested when I
spayed her.
ANAESTHESIA
Based on formula of
10 kg, young healthy
dog Dom=0.4 and Ket=0.5,
I gave this 4.3 kg
dog IV Dom=0.2 + Ket
= 0.17 totalling
0.37 ml IV one
syringe with 0.13 ml
Hartmann.
A: Injection of D+K
IV 10.22 am
B: Isoflurane first
given 10.43 am
C: Isoflurane
stopped 10.53 am
D: First skin
incision: 10.34 am
E: Completion of
skin stitching:
11.01 am.
E-A = 39
minutes.
This
is because
the dog started
moving at 10.43 am (21
minutes
after injecton)
and the surgery was
paused to give gas
by mask to stabilise.
This shows that
duration of D + K is
21 minutes for this
dog. Spay should be
completed in 21
minutes but there
was some delay as
there was training
of the new
veterinary staff on
gas anaesthesia.
Without traiining,
spay should be
completed in 30
minutes for this
small breed.
E-D= 27
minutes. Dog
was on heat. More
time was spent
ensuring no bleeding
and on speed on
hooking out the
ovaries.
Hooking left ovary
took 3 trials and it
was hooked out at
10.38 am. 4 minutes
after
incision. Right
ovary was hooked out
at 10.42 am, 8
minutes after skin
incision.
Conclusion: Usually
the above formula
gives at least 20
minutes of
surgical
anaesthesia. If spay
takes longer,
isoflurane top up is
needed. Efficiency
and timing are
important in
productivity of a
vet surgeon. Taking
too long to spay a
dog is not good.
Conclusion:
Much time was wasted
between first skin
incision and
injection (D-A=12
minutes) as I
was teaching a new
assistant since Mr
Min was poached. He
had worked 2 years
for me and I wished
him well as he ought
to move on for a
better future and
more income. Surgery
should commence
around 7 minutes
around injection as
IV effects would
occur in 5 minutes
usually. Check
reflexes for
surgical anaesthesia
like eyelid
blinking. 5 minutes
extra off the E-D
process would mean
that I would take
22 minutes and
would not need
isoflurane top up.
The planning and
proper prompt
process is essential
in veterinary
surgery procedures
and process and in
less wastage of
resources.
TOA
PAYOH VETS
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