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that can be exacerbated by anesthesia. Keep cats away from dogs and dogs away from cats. That alone can help to reduce the stress of those animals significantly. Consider this: Outsmart your patient but do not out power them. You must stay calm, use your brain and be sneaky. Do not use brute force to restrain the animal. That will only cause frustrations for you and your team and stress for your patients. Remember: With cats, the less restraint the better. Also, do not use a catch poll for cats. That causes too much stress for them. Search for a “Freeman cat net” this is a great device to help you to reduce the animal stress. Squeeze cages can also help you get your injections with a minimum stress for both ends: you and your patient.
3-It is acceptable to anesthetize pregnant or lactating patients, animals in estrus, animals that have pyometra, mild infectious or noninfectious diseases (i.e.: upper respiratory tract disease, parasite infestation, or subclinical heartworm infection) however, additional monitoring should be available for those patients. For these cases you should consider running blood work and obtaining a complete physical exam before the beginning of anesthesia, when possible.
4-Fasting helps to reduce the chances of regurgitation and aspiration pneumonia. It is recommended 2-4 hours of fasting for pediatric animals and 6-8 hours for adult animals. Exceptions may be made for feral cats in traps when it is not safe to remove food from traps due to human safety. Removing water is neither necessary nor recommended.
5-Many cats have hyperthermia during anesthesia recovery. The mechanism triggering the post op hyperthermia is not well understood. Stress, opioids and ketamine could be trigger factors. Also, there is a believe that under anesthesia, the more hypothermic the patients are, the more hyperthermic they will be during recovery. Therefore, consider checking the body temperature as soon as possible and throughout the recovery phase
as well. Provide heat when necessary. To treat the hyperthermia: non-steroidal anti-inflammatory drugs work well; consider reversing any opioid medication. If you do reverse the opioids with naloxone then the patient may suffer from pain. Butorphanol is a partial antagonist of the mu opioid receptors and can be used for the reversal
of the hydromorphone and morphine as well. When butorphanol is used as a reversal agent, the patient will have some analgesia; Use water instead of alcohol since alcohol only causes peripheral vasoconstriction that prevents heat loss. Also a simple fan helps to get the temperature down.
6-When you are planning your anesthetic protocol for your shelter program consider safe and efficient protocols. Balanced anesthesia should always be the goal with analgesia as the first priority. Choose safe drugs with wide therapeutic indexes. Ketamine and
tiletamine are great examples of safe anesthetic drugs that provide potent analgesia. When ketamine or tiletamine is used in combination with a benzodiazepines (diazepam, midazolam or zolazepam) and an opioid (butorphanol, morphine, hydromorphone, buprenorphine) or an alpha2-agonist the animal gets good muscle relaxation, immobilization, effective analgesia and
loss of consciousness without patient compromise. Another advantage of ketamine over other induction agents like propofol and alfaxalone is in regard to the necessity of endotracheal intubation. Ketamine leads to a maintenance of the laryngeal reflexes which help the prevention of aspiration pneumonia.
7-After sedation make sure someone trained is observing the animals to have fast treatment when necessary. Oxygen supplementation could significantly reduce shelter mortality
8-Finances are important. When designing anesthetic protocols check local prices and pick the least expensive drugs however, do not forget that anesthesia is not analgesia and to be fair, the shelter animals need both. Think about cheap opioids and non-steroidal anti- inflammatories. Also to reduce cost, check with your local pharmaceutical representative if they have programs to help shelters and other organizations to either provide the drugs for free or at least with a subsidized cost.
9-Eye lube is very important. Animals cannot generate tear while under general anesthesia and corneal ulcers may form if eyes are not well lubricated after anesthesia induction.
10-Besides the surgical procedure, consider the use
of flea medicine when necessary. We recommend the identification of the surgical site with a tattoo to prevent possible future surgeries in the same animal. Some areas allow ear notches to identify the castrated animals however that technique tends to reduce the likelihood of adoptions afterwards.
11-Communication between staff is essential. You need a well-trained team where every one involved knows exactly what to do. Someone should be responsible for double-checking drug labels, concentrations and volumes. Usually the total drug volume is based on estimated body weight and to speed up the process there are ways to pre-calculate drug volumes per kilogram.
12-Use local anesthesia. An intra-testicular block with lidocaine is safe, cheap, fast and efficient analgesic protocol. There is no described local analgesia technique for OHE. Incisional local anesthesia have been described but it usually causes a prolongation of surgical site healing and is contraindicated, specially for cats
and dogs that will be release after the surgery and no veterinary care will be available.
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