Questions about anesthesia

Dr. Marie replied:

Hi Jazmin,

While I can't legally discuss drug dosages online, I'll let you know what kind of drugs I would use in a situation like this and then you can look up in your textbooks what the dosage is.

One thing to keep in mind here is that I practice in Canada, so if you are in the US it's possible that the type of drugs you have available are slightly different.

For my pre-op meds for this kitty I would likely be giving a combination of hydromorphone, acepromazine and glycopyrrolate. I would then place a catheter and induce with propofol IV. Next, I would intubate the cat and use isofluorane anesthetic.

Regarding maintenance and monitoring, this is a tough one to "predict. The oxygen level depends on the weight of the cat, but generally for a 10 lb cat I would use about 300ml/min and for iso I would start at about 2 and adjust as necessary.

I'd be monitoring the respiration, pusle, temperature, and blood pressure throughout surgery.

Depending on how long the surgery is I'd likely give hydromorphone after surgery. If I had one, I would have placed a fentanyl patch at least 12 hours before surgery. If I didn't have the luxury of 12 hours I would have put one on as soon as I knew I was doing surgery. This will provide some lasting pain relief in the days following surgery.

I would also continue to give hydro every 2-4 hours as necessary to control the cat's pain.

Hopefully that helps! I debated on whether to answer because I didn't want to do your homework for you, but it sounds like the idea was for you to seek out a vet and ask rather than look it up in your textbooks, right?

I may be online a little bit later this morning and then my internet access will be sporadic as I am doing a lot of traveling today.

Dr. Marie.


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Dr. Marie replied:

Sorry for the delay. I was traveling yesterday and had my flight delayed so it was a late night last night!

I would likely give lactated ringers to this kitty. I'd likely use a surgical drip rate (10 ml/kg/hr) during surgery and maintenance after that.

10 lbs sound like a normal sized cat to me.

If the cat's kidney function was ok I'd also give 0.1 mg/kg of Metacam by injection and possibly follow that up with 3 days of oral Metacam.

I can't really answer what drugs I'd give for the urinary problem because it depends on what is causing it. In some cases, Prazosin would be good to help with urethral spasm. But, if there is a neurological issue then I'd be not giving Metacam and instead giving high doses of steroids. I wouldn't think that you would be expected to know this in a veterinary technician project though.

As far as post op instructions go, that's a whole other discussion. It all depends on what the problems are, what type of surgery was done and a number of other factors. Rest would probably be advised for the fracture for several weeks.

Dr. Marie replied:

I would be thinking that the inability to urinate would be more likely to be neurological than obstruction, but it's hard to say. I really can't say for sure which medications because there are too many variables. The only conflicts I can think of are if I thought it was a neurological problem then I'd use high doses of steroids and this would mean that I wouldn't want to use an NSAID like Metacam. If I was using something like Prazosin to help with urethral spasm I'd have to look up in my texts to see if there would be any conflict with other drugs but none come to mind.

Dr. Marie replied:

Hi Jazmin. This would be a whole new question. If you'd like to ask another one, here is the question page.