Evaluation of a case study 1

Evaluation of a case study

Surgical and Anesthesia nursing

Tarleton University

Auna Fleischhacker, CVT

Evaluation of a case study 2

First thing that concerns me for an anesthetic case is the high liver values of the

ALK and GTP- 300 over the high end of normal. Although this could be from the

constant use of prednisone, it should still be taken into consideration when selecting

anesthetic drugs and patient monitoring. This case study doesn’t explain why the dog is

on this constant use of prednisone. Why is Bally on the steroid? Is it allergies? Skin

issues? Why the low platelets? I feel like that should be in something that should be

included in this case study.

The effect of surgical drugs can have a more prolonged effect because the liver

may have a harder time metabolizing those drugs. Valium should have been used in

caution in patients with liver disease; same with ketamine because it prolongs the effects

(Plumb, 2011). Those two drugs plus the inhalant anesthesia might have caused the initial

deep plane of anesthesia. Propofol would have been a better induction agent. “Its rapid

redistribution after injection is helpful in terminating its anesthetic effects. Propofol is

also eliminated from the body by extrahepatic mechanisms, as clearance of the drug from

the body is faster than hepatic blood flow” (Well, 2011).

The technician should have taken all of that into account when administering and

monitoring the effects of the induction agents prior to starting inhalant anesthetics. The

clinic I work at, we slowly give the induction agents and given to affect- and its

sometimes not the whole dose. If we notice that their pre-medication and induction agents

have hit them hard, we will start at a 1% gas anesthesia level.

Evaluation of a case study 3

References

DACVAA, A. W. (2011, October 01). General anesthesia for patients with renal or

hepatic disease (Proceedings). Retrieved February 25, 2018, from

http://veterinarycalendar.dvm360.com/general-anesthesia-patients-with-renal-or-

hepatic-disease-proceedings

Ivancic DVM Todd Deppe DVM DACVIM (internal medicine), M., & Deppe, T., DVM,

DAVICM,. (2005, November 1). Practical Matters: Several liver enzyme

activities may increase in dogs receiving corticosteroids. Retrieved February 25,

2018, from http://veterinarymedicine.dvm360.com/practical-matters-several-liver-

enzyme-activities-may-increase-dogs-receiving-corticosteroids

Plumb, D. C. (2011). Ketamine. In Plumb's Veterinary Handbook (7th ed., pp. 568-572).

Stockhold, WI: PharmVet Inc.

Plumb, D. C. (2011). Diazepam. In Plumb's Veterinary Drug Handbook (7th ed., pp. 304-

307). Stockholm, WI: PharmVet Inc.

Rezende, M., DVM, PhD, DACVAA, & Mama, K., DVM, DACVAA. (2015, January).

Anesthesia in Hepatic Disease. Retrieved February 24, 2018, from

http://www.cliniciansbrief.com/sites/default/files/attachments/ASK_Anesthesia%

20in%20Hepatic%20Disease.pdf