Patient evaluation during the anaesthesia in animal

Health, temperament and BCS should be evaluated.

Physical examination includes cardiovascular and respiratory evaluation.
Among the blood work PCV and TP should be evaluated.

What happens during anaesthesia?

Decrease of blood pressure and organ perfusion and incomplete tissue perfusion can cause irreversible
tissue damage. .
It shouldnot be given during pre-existing renal disease.
NSAIDs can even worsen the condition.

Advantage of precondition knowledge

It will help plan for the proper ananesthetic protocol or plan.

Questions to be asked?
- Is pet anaestehsized before.
- How was recovery
- What was the drug used, was there any complication
- Relatives of pet experienced complications
- Pet allergic to any medication
- Recent changes in drinking or urination habits.
- Exercise and etc.
When and when not to use pre-anaesthetic sedative?
For the aggressive, restless animal sedative should be used.

Obese animal?
- Obese animal willnot breathe well under anaesthetic bec of the abd and thoracic fat increases the
work of breathing and dose calculation.
- All anaesthetic drugs circulate 1st to organs that receive high % of cardiac output. And then slowly
to the organ of low perfusion. So, the turn of adipose tissue always comes at last.

Thin animal?
- Thin animal will get colder sooner during anaeshesia due to lack of insulating fat.

Young or geriatric patient?

- < 5 months has immature liver function i.e. slower to metabolism and are not useful at
gluconeogenesis ; so glucose should be checked during anesthesia.
- Normal glucose level should be maintained.

Geriatric?
- Screened for cardiac, renal, hepatic, CNS and neoplastic disease.
- The anaesthetic monitoring is as quickly addressed and it may compromise the organ function i.e
hypoxemia, hypotension, hypothermia.

Key organ to focus during physical exam to anaesthetic plan:

- CVS and respiratory because drugs have side effect of cardiac and respiratory system.
- Check list:
a. Blood:
  MM- pink, wet and CRT less than 2 secs.
 Well hydrated.
b. Heart
 HR- normal, no murmur, no arrhythmia, strong peripheral pulse
c. Lungs
 RR – normal, good airflow, no labour
- Other organs:
a. Abdominal palpation
b. Evalution of CNS function
c. Normal visual reflex
Blood work:
- PCV: it tells us about dehydration (increases) and anaemia (decreases). This compromises the O2
carrying capacity O2 delivery capacity to tissues. If PCV is less than 25% blood transfusion is done.
- TP: it tells us about the dehydration ( if high ), chronic infectious disease (if high, due to increase
of gamma globulin) OR poor liver function ( if low ) , makes the animal risk for hypotension
because of low plasma oncotic pressure. Liver function if poor coagulation factors will be low
and high surgical blood loss. Low TP also indicate the protein loss.
- In case of young animal glucose and given through the fluid and glucose therapy.
- Kidney function – when more about blood profile of animal is needed, kidney function is
performed.

Patient preparation:
a. Fasting:
- To reduce the risk of peri-operative regurgitation and reduce gastric contents. Adequate glycogen
level will maintain blood glucose during the fasting period.
- Diabetic patient foe only 4-6 hours.
- Young patient-(<12 weeks, 3 months) – only for 2-4 hours. (<4 weeks, nurse from mother until
the time of anesthesia).
Anaesthetic equipments:
- Oxymeter
- Anaesthetic machine
- Breathing system
- Airway device

USE OF SEDATIVE
Sedative:
- It reduces patient stress and anxiety
- It avoids injury to animal and the staff.
- Lt lessens the CV and respiratory depression
Drugs Used:
Alpha 2 agonist- medetomidine, Xylazine
Benzodiazepines – midazolam and diazepam
Dissociative – Ketamine and telazol
Phenothiazine- ACP
NSAIDS and Opioids

ACP:
 - Long acting sedative metabolized by liver
- Aggressive animal can override its effect, if used alone
- Not to use in liver disease patient
- It decreases BP. Secondary to vascular smooth muscle relaxation and vasodilation.
- Best in young, healthy non-fractious dogs as sedation is reliable and BP decreases are modest not
use in gegriatic, dehydrated, blood loss, systemic disease and coagulapathies.
Benzidiazepines:
- It should be used in combination with opioids because if used alone, will make animal excitable
and more difficult to restrain.
Ketamine:
- Not a sedative rather it acts on CNS and are excitatory. It causes the dilation of pupil, salivation,
animal becomes rigid if used alone.
- HR, Contractibility increases and respiratory pattern becomes apneustic.
- Is not metabolized in liver but excreted by kidney has side-effect in the renal disease patient.