If anyone “gets” anesthephobia, I do. I don’t like my dog to enter into a controlled form of unconsciousness any more than you do. It’s somehow very stressful at a very raw, animal level: it’s unnatural and bizarre, if you think about it for too long.
But faced with two alternatives: my dog will suffer forty minutes of avoidable pain or my dog will receive fifteen minutes of anesthesia, I’d vote for the latter. Yet Saturday’s client did not agree with my personal and professional recommendations. He flat-out refused to have his dog undergo an anesthetic procedure. Here’s the story:
The patient: A seven-year-old, medium sized female dog of indeterminate, long-haired breed provenance.
The emergency: Attack by stray dog resulting in multiple puncture wounds, generalized bruising and one large but shallow laceration on her back.
The negotiation: “She’s sore all over and the areas I’ll have to clean most thoroughly are especially painful. The laceration will require sutures for most effective closure and, in my opinion, local anesthesia will be more painful over that wide area than simply suturing with a small gauge needle. We’ll have to anesthetize her.”
The client’s answer: No dice. “She doesn’t need it. Remember—this was the dog that let you scale her teeth without anesthesia!” (He’s referring to a small amount of tartar I scaled off her canines once—not even at the gumline.)
The conclusion: There’s no arguing with certain people. I knew the battle was lost unless I absolutely demanded. Instead, I chose to warn him of the risks of inadequate wound cleansing and less-than-secure laceration repair. Some battles are not worth fighting. I decided to save up my energy for a disaster case.
Probable worst case scenario?: Monday I’d be anesthetizing her to clean and culture her wounds.
The procedure: A good all-over bath (she was most dirty) with special attention to the puncture wounds (mostly on her limbs and underside). A rough clipping over these areas of interest (multiple close shaves are out of the question without anesthesia), and the same over the laceration, leaving more length of hair for use in the repair. Copious flushing of the laceration site (“dilution is the solution to pollution”) and a gentle blow dry completed the ablutions.
The closure: Finally, repair of the site using two tiny, strategically placed sutures (for a four-inch length wound) and braiding of the hair over the wound to achieve closure. Next, a line of surgical glue to keep the braid in place and voilá—a tenuously repaired laceration. We’ll see if it holds.
The medication: Pain relievers (Rimadyl) and antibiotics (Penicillin) were administered at the outset, of course. More Rimadyl and some Clavamox were prescribed to go home with her. But none of those pesky medications with the word “anesthetic” in them were employed.
The price: Because it took more than twice as long to accomplish the task, the client was charged more than double what I might otherwise have charged with anesthesia (for what would have been a more effective procedure). At least this client had the good sense not to complain.
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I've only questioned my vet once about whether to use anesthesia or not.
It was when my senior cat needed a tooth pulled. I didn't want him awake, but I didn't want him completely under either has he has heart problems. We peacefully agreed to giving him just enough sedation where he would be comfortable and relax enough to have a dental done, but would wake up shortly afterwards.
Our plan worked well as he was awake within 5 minutes after the procedure was done. They monitored him all day before releasing him to make sure there wasn't going to be any bad after effects of the kitty cocktail they used. I'm happy to say that there wasn't any side effects and he was fine the next day.
Overall, it was more aggravating giving him Amoxi a week before the dental and the week that followed. I had dried, pink splatter marks all over my kitchen for the longest time. Just when I thought I got them all, I'd find more in the oddest places.
As for your client on Saturday, if there a medical concern with his dog ( like mine with Oreo) I could understand his point, somewhat, but if he's just one of these owners that feel as though animals should just tough everything out for one reason or another, that's just mean.
Stacy February 12th, 2007 05:30:00 PM
I trust you gave him a handout on Rimadyl and warned him that if he saw any of the side effects mentioned to stop the drug immediately and get him to the vet as fast as his little legs could carry him.
Gil. February 13th, 2007 12:01:00 PM
Years back, a family friend took their cat to the vet for teeth cleaning. They gave the cat general anesthesia b/c a tooth had to be pulled. The cat woke up blind, did not walk properly, and within a couple weeks had to be put to sleep. I don't know any more detail of what went wrong than that - feel free to shed some light if you think you have any.
This event has prejudiced me against general anesthesia for pets, and similar anecdotes about birds and anesthesia has made me decide that I will NOT let any bird of mine undergo anesthesia unless it is required for a procedure that might save his/her life.
zandperl February 13th, 2007 11:51:00 PM
Gil: When it comes to NSAIDs, everyone goes home with a pamphlet or package insert in addition to the stiff warning--just in case.
Zandperl: Your friend's cat had an adverse anesthetic event. 1 per thousand or so (same stats in humans, btw). Most recover fully. Some die. Some are euthanized for blindness and other neuro issues. It's truly sad but it does happen even in the best places.
Dr. Patty Khuly February 14th, 2007 07:37:00 AM
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