Modern anesthesia is very safe. The risk of a pet dying under anesthesia is less than 1%
based on surveys taken from veterinary practices nationwide. The rare patients that are
lost under anesthesia are generally emergency surgeries, when the patient’s condition is
extremely critical. The risk of a pet dying under anesthesia while undergoing an
uncomplicated spay, neuter, dental or mass removal is extremely low, but this risk can be
affected by the anesthetic drugs used and the monitoring of the patient as well as any
underlying health condition that is not detectable on an exam.

Can you imagine an anesthesiologist in a human hospital using ether or chloroform in the
21st century? Of course not! But, unfortunately (and surprisingly), there are no standards
of care for veterinary anesthesia, and some clinics are still using out-of-date techniques.
Here is a list of questions to ask your veterinarian the next time your pet is scheduled for
an anesthetic event:

1. Is pre-anesthetic blood work performed? All patients, not just the old or sick,
   should have basic pre-anesthetic blood tests performed checking the blood sugar,
   kidney values, and red blood cell count. Many animals will require more
   extensive pre-anesthetic blood work. Even in animals under one year of age,
   blood work will occasionally detect abnormalities that could affect anesthesia.
   Here at New Berlin Animal Hospital, we run blood work on every patient before
   performing an anesthetic procedure.
2. Are intravenous fluids administered during anesthesia? Many drugs used for
   general anesthesia tend to cause blood pressure to decrease. Intravenous fluids
   will combat this decrease. In addition, if there are any adverse reactions under
   anesthesia, an intravenous catheter allows immediate administration of emergency
   drugs. All of our patients have an IV catheter placed and are on IV fluids during
   the anesthetic procedure.
3. Is the pet’s body temperature maintained during and after anesthesia? All
   pets, especially cats and small dogs, lose a lot of body heat under anesthesia. The
   resulting hypothermia can slow the anesthetic recovery. Anesthetized pets should
   be placed on a recirculating warm water pad and/or under a warm air blanket. 
   Conventional heating pads are risky because they can cause burns. Our surgical
   and dental tables have warm water recirculating pads to keep the patient warm
   during surgery as well as warm body heat reflecting pads and warm air blankets
   available after surgery.
4. Is the patient intubated, and what anesthetic gas is used? Intubation means
   that the patient has an endotracheal tube placed through the mouth and into the
   trachea, through which gas anesthetic is administered. The endotracheal tube
   allows controlled respirations if the patient is not breathing well on his or her
   own, and prevents accidental inhalation of stomach contents if the pet vomits
   under anesthesia. Virtually every surgical procedure done in dogs and cats
   requires intubation and gas anesthesia. The modern gas anesthetics are isoflurane
   and sevoflurane. Halothane and methoxyflurane are out-of-date. We use
   isoflurane gas inhalant on all of our patients that require intubation for surgery.
5. What pain control is used? Surgery hurts! It doesn’t matter if the patient is a
   human, a dog, or a guinea pig. Analgesia is the relief of pain, and in modern
   anesthetic protocols, we strive for pre-emptive analgesia (blocking the pain
   pathways before the painful procedure starts), and balanced anesthesia (trying to
   block the pain pathways from as many directions as possible). At our hospital, we
   are very aggressive about pain management. Our patients are given pain
   medication before, during and after a surgical procedure. Research has shown
   that if pain medication is given before surgery that the patient will have less
   discomfort after.
6. What monitoring techniques are used? It is critical to monitor the patient’s
   vitals while under anesthesia to ensure that the respiratory and cardiovascular
   systems are functioning well, and to ensure that the patient is not under too lightly
   or too deeply. Most important is that someone besides the surgeon (who is
   occupied) is monitoring the heart rate, respiratory rate, and anesthetic depth. At
   New Berlin Animal Hospital, we exceed most clinics by providing:

• An electrocardiogram (EKG or ECG) to monitor the heart rate and
  rhythm looking for arrhythmias.
• A pulse oximeter/SPO2 to monitor the percentage of oxygenation of the
  blood, which should be close to 100%
• Blood pressure monitor because many patient’s blood pressure drops
  during surgery. If the pressure drops too low, organ systems such as the
  kidneys can suffer.
• End tidal CO2 or capnograph to monitor the respiratory rate and carbon
  dioxide level. This provides information on how well the patient is being
  ventilated.
• Body temperature monitor so that the patient stays warm and comfortable
  during the surgical procedure.
• Certified Veterinary Technician (CVT) that is dedicated to monitor and
  stay with your pet throughout the anesthetic procedure and after surgery.
  CVT’s are college trained and board certified. Many veterinary clinics do
  not have CVTs.

As you can see, modern anesthesia involves a lot of equipment and expertise, and this
unfortunately costs money. Cutting corners by not intubating patients, not keeping
patients warm, or skimping on pain medications and monitoring can save money, but the
price is decreased comfort and safety for your pet.

Although anesthesia is very safe, because of the unpredictability of the patient, we take
anesthesia very seriously here at New Berlin Animal Hospital. We feel that performing
pre-surgical blood work, using state-of-the-art anesthesia and anesthetic monitoring
equipment along with Certified Veterinary Technicians is not a compromise that we
would make with our own pets and you shouldn’t either.

If you have any questions about an anesthetic procedure for your pet, please speak with
one of our doctors. We want you to feel as confident as we are when your pet has his or
her next surgical or dental procedure.

Reference:  The doctors at New Berlin Animal Hospital