It’s well known that precautions can be taken to mitigate the potential havoc anesthesia can wreak on any given patient, human or animal. In human medicine, safety measures are governed by scrupulous standards, which are the result of meticulous research.
The veterinary profession has learned a great deal from its human counterpart, given that science in the realm of animal-specific anesthesia has never been as well-funded as on the human side. Yet anesthesia in some ways is little different in animal patients than it is in humans.
That’s why so it’s no shock to learn that much of what we know about veterinary anesthesia comes from human models (as is the case in so many other areas of vet medicine). It’s not a perfect route to a complete understanding of what animals need…but it helps.
In particular, the care human medical practitioners take to prevent “adverse anesthetic events” (discussed in yesterday’s post) is analogous to the approach we take to our veterinary patients. Here’s the run-down on how vets play “follow-the leader” when it comes to caring for animals under anesthesia:
1-Physical examination
We veterinarians screen our patients to ensure they’re healthy, taking into consideration that non-routine procedures on less robust patients must be moderated to their specific challenges. Physical examination is the most basic (and in many ways the most important) method of screening patients.
2-Basic labwork
CBCs, chemistry panels and urinalyses, in particular, provide the foundation for assessing our patients’ degree of risk. Here we’re trying to assess a pet’s hydration status, electrolyte balance, basic liver and kidney function, red and white blood cell counts, platelet levels, etc. so that these can be addressed before administering drugs that might challenge a pet suffering any deficiencies in this area.
3-Additional testing
Any significant findings in the above two screening approaches may find us refusing to anesthetize a pet. It’s up to additional testing to better determine the real risks involved. Anvanced labwork, X-rays, ultrasounds and EKGs or full cardiac workups are common follow-ups. CT scans, specialist consults and MRIs may also play a role for the luckier, well-heeled pets whose owners can afford to spring for investigation into specific problem areas pre-procedurally.
4-Intravenous catheterization
No, not every vet will require every patient to sport an IV catheter throughout a procedure. But you should now that it’s always safest. In fact, it’s one of the easiest ways to make your pet safer during any given procedure, no matter how routine. If you have the extra $15-$30 to spend, you’ll definitely want to request one.
5-Fluids
Fluids can make a huge difference to many pets—especially during longer procedures or when using drugs that may cause drops in blood pressure (a great many of the drugs we use for anesthesia). Again, always safest…with very few exceptions.
6-Warmth and temperature monitoring
Some of our anesthetic monitoring equipment comes supplied with a rectal probe to continuously monitor our patients’ temperature. I’m a big fan of this feature. It’s easy to ignore temperature changes. And drops in temperature during anesthesia can be precipitous. Hot air/hot water pads (or simple, low-tech hot water bottles) can be invaluable, especially for our smaller patients whose temp drops are most likely.
7-Pulse oximetry
This is a fundamental tool, one for which no procedure is too routine to forgo. It’s a blood oxygen monitor and it’s applied to an extremity or tongue to measure the percentage of blood, a value which appears on the monitor’s screen.
8-Heart rate monitoring
This bit of equipment is usually built into the same monitor that reads the oxygen concentration. It beeps reassuringly throughout the procedure while registering the number of beats per minute on a screen.
9-Continuous EKG monitoring
This is another basic tool which may or may not be part of the pulse oximeter and heart rate monitoring equipment. And it’s simple. Just clip the lines onto a pet and watch the screen. It, too, records the heart rate and any vet can see at a glance when scary electronic changes are happening to the heart. This makes it much easier to tailor our drug administration in the event of a cardiac arrest.
10-Blood pressure monitoring
Many hospitals also have this capacity built into the EKG and pulse oximetry system. It can be essential to know exactly where your BP is at during surgery, though it’s a shockingly underused tool in vet medicine relative to the human side of things.
11-Judicious, individualized drug usage
Though you can easily request all of the above from the average vet’s facility, the choice of anesthetic drugs is a far more personal one than most of us want to admit. Most vets stick to drugs they’re comfortable using. That’s because we get used to the kinds of reactions and complications we see with the cocktails we’re familiar with. Ask us to use a drug we’re not experienced or comfortable with and the risks can climb—not exactly the goal you had in mind.
Ideally, you’ll trust your vet on this. If you have profound reservations about certain drugs, however, you’ll want to find a vet who does not use them or can easily shift course to another protocol that he/she deems perfectly acceptable.
Sorry if this section is somewhat lacking, but I’ll plan on writing a longer post on all the anesthetic drugs we tend to use (just as I did for euthanasia a couple months back).
12-Experience
Again, here’s another area where you’ll just have to be comfortable with your vet’s level of experience. Presumably, you’re not even considering an anesthetic procedure at a practice whose vets seem to lack the kind of experience and/or training you require for your pets, right?
But don’t assume that more years in practice equals greater competence in a crisis. Sometimes it’s young vets with a healthier dose of fear at the ready who make for the best practitioners in the case of an adverse anesthetic event.
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Looks like you've laid it out pretty well. It's easy to look at a young animal just having something simple like a dental and decide to skip some of those steps, but your 100% correct, it can make all the difference.
having said that, I don't think I've ever run labs on any s/n I was having done on young ones....something to think about no doubt. But for any of my animals over 5 having anything done, it's a definate.
LorriM November 17th, 2008 10:41:28 AM
Hee hee...laughing at my "electronic" changes to the heart. Sorry...I meant "electrical," of course...I'll fix that when my editor is working properly...
Dr. Patty Khuly November 17th, 2008 11:05:40 AM
I agree, sometimes one becomes ingrained with familiarity in protocol, even though advanced options become available. Citing drug combinations and safer available gases are an example. Here again , this is where Joe Q. pet-owner wouldn't have a clue where to start or what questions to ask, and the possible resentment on the part of the clinic or professional, when these questions are posed.
Barbara "Pocket's Story from NH" November 17th, 2008 11:19:54 AM
Good information. Doggie dental cleaning day for my four dogs is the worst day of the year for me. I imagine the worst they whole time they are gone. This is quite reassuring.
Jan
http://thepoodleanddogblog.typepad.com/
jan November 17th, 2008 11:32:36 AM
There are breeds (and mixes thereof) which have different values in bloodwork and different reactions to some anesthesia agents, and if the vet isn't aware of these things (and there are many who aren't - or don't 'believe' them), problems can arise. Dr. K., I don't know if you saw my late comment on yesterday's post asking about body fat percentage and how it can impact anesthesia.....? I also wonder about the BP monitoring you mention. My vet, who was trying to get a BP during an exam with a slightly fractious dog and having trouble getting a reading, was asked about sedating the dog for this, and he said that sedated BP readings aren't 'true' in that the heart is slowed down. Can you explain the difference?
Kate November 17th, 2008 11:35:38 AM
If ONLY all vets declined to anesthetize based on abnormal blood panel findings.
I would add -- I have read in vet board docs that it is very important to closely monitor the pet until it is able to hold itself sternal. Not safe to just leave the room with a still konked out patient and not check back for ages.
I'm going to ask about bp monitoring.
Stefani November 17th, 2008 12:01:38 PM
Your number 11 can be a little tricky, especially with the trust your vet part. My dog is an MDR1 mutant who reacts badly to acepromazine, which most of the vets around here use as a pre-anesthetic. She had dental surgery around a year ago, and I said no to the first two anesthesia protocols suggested because they contained drugs known to be hard on MDR1 mutants. Fortunately my vet was willing to work with me to come up with an acceptable protocol. The dog came through anesthesia and surgery a few weeks before her 12th birthday better than she did for anesthesia and X-rays when she was 7. I was very pleased. So, in addition to trusting your vet, I think it's a good idea to know what you can about your dog's reactions to anesthesia and what breed predilections may exist. I don't expect my vet to know everything about my dog's breed. I do expect her to be willing to listen when I tell her about the breed, esp. when I back it up with literature, studies, etc.
kabbage November 17th, 2008 01:13:45 PM
Kate: Yes, I did see your question. In fact, I'd written a response, got called away and promptly forgot when I rebooted my computer. Sorry. So on the fat thing:
Pets with higher body mass indexes (which implies higher percentages of fat) are more likely to have longer recovery times and a harder time clearing many anesthetics. That's because many of these drugs are fat soluble. That is, they are trapped in the fat, meaning they require a larger dose to effect anesthesia. You can see why that could become problematic should a poor reaction to one or more anesthetics occurred. Conversely, pets with very little body fat are theoretically also prone to overdosing.
This is a tremendous oversimplification but it should give you a gist of why titrating drugs to effect is a more careful approach than calculating doses with a blanket approach based on weight. It also provides a partial explanation for why we try to use combinations of drugs that work synergistically with one another.
On the blood pressure: I find fractious pets to be difficult to get real readings on. After all, their bps are likely to be elevated the same way a nervous human's bp rises while at the doctor's. When they're sedated it's sooo much easier. The trouble is that we have to play around with the cuff sizes and it's a PIA when one cuff gives you one reading and the other another. And the cuffs are expensive and fragile, to boot. That's a partial explanation of why they're not as commonly used as they should be.
Dr. Patty Khuly November 17th, 2008 03:15:09 PM
As an experienced RN who volunteers with a shelter vet doing mostly "routine" (if there is such a thing)spays and neuters, my job is to prep them and do the post-op monitoring (our shelter can only afford one paid vet tech, who works only part-time). As in the human medicine that I'm accustomed to, I've learned that anything can happen. Unfortunately, shelter medicine and its prohibitively restrictive budget precludes a lot of the pre-surgical stuff such as bloodwork and IV catheters for all, but we do some basic labs on senior animals, as well as IV's for those at highest risk like large fat bitches whose spays can turn lengthy and complicated, or a Dobe with von Willebrand's. Luckily, I've been able to scrounge some discarded (human) hospital equipment like IV pumps and cardiac monitors as our hospital replaces equipment (and I'm still desperately trying to locate a used blanket warmer)... These things are still not used as often as I'm used to in the human arena, but their availability has made a huge difference. We sometimes get some interesting cases, usually trauma cases brought to us (fractures, facial trauma, etc.) and having even limited technology available to us has dramatically reduced mortality. But even lacking these, the single most critical element (at least in a shelter setting) is close observation during the peri- and post-operative period.We usually do between 6-10 spays/neuters per day if no emergencies get thrown into the mix. As an "old-school" nurse, I was taught to rely on my own senses more than some of the "younger" ones who are more dependent on electronics; I tend to use touch(do they feel warm/cool), hearing(is the breathing regular/labored/wheezing), sight(is there much bleeding or any other drainage), even smell(I can identify the presence of certain bacteria by the odors alone) as part of my assessments in addition to whatever monitors are used. In a regular vet practice, there would be (I would hope) techs doing all the monitoring (and I insist on it with my own vet's practice); but in a shelter, I'm all that's available. And with my current training and experience with humans, I would at least hope that's better than nothing.
Shellie November 17th, 2008 03:19:09 PM
Very nice - I am wondering your thoughts on breed specific anesthetic sensitivity. Recently I spoke with a Vet in California who no longer "will see" Neapolitan Mastiffs, when I asked why they replied that "they have had to many die on the table". I have heard what I think are very large numbers of anesthetic related deaths in my breed (neapolitan mastiffs), most of what I hear is anedoctal of course but I am interested in pursuing this further. I "think" (no research to back it up, yet...) that dosing by weight is not a good idea with our breed instead dosing to effect approach and avoiding Ace of course and post monitoring needs to be emphasized..
Lisa November 17th, 2008 04:48:01 PM
I can attest to #11. I used to work in a large mixed practice with 6 or 7 veterinarians. It seemed like every one of them had a different favorite protocol, right down to the specific instruments they liked to have in the surgical packs. It was a challenge learning what each doctor wanted - but they all had great results. However, on the few times that one of them would try a different protocol favored by one of the other doctors things just wouldn't turn out as well. I don't recall any animals dying in those situations or anything like that... but the surgery wouldn't run as smoothly or the animal would have a rougher recovery period. So I am a big believer in a vet sticking to what he/she is comfortable with! The advice on finding a vet who already uses an anesthetic protocol that the pet owner believes is best for the pet - rather than trying to get a vet to change what he/she is accustomed to - is right on the mark.
Barb November 17th, 2008 08:26:59 PM
Jan: My nightmare--the death of my toy poodle in the hands of a board-certified surgeon. To this date, I have NO IDEA what he did to him, anesthesia protocol and post-op observation and treatment. http://alabamavetboardwatch.11oMB.com
Fotini November 17th, 2008 08:37:27 PM
Jan: Oops! I meant http://alabamavetboardwatch.110MB.com
Fotini November 17th, 2008 08:39:15 PM
It sounds to me that most of the bloggers are vets comparing notes, observations and protocols. What about us, the pet guardians?? We haven't the foggiest of what questions to ask before the surgery, and when we realize that the right questions would have helped to save our pets from DEATH, IT IS TOO LATE! Death has occurred so swiftly. . .then we turn to the net to find out what the SURGEON'S OR THE INTERNIST'S diagnoses, procedures and protocols should have been instead of what they THOUGHT they were.
Fotini November 17th, 2008 09:11:47 PM
Fotini, I am a pet owner, no medical training beyond first aid. What I have done is look for breed-specific email lists that deal with my breed(s) of dog. I read several and find that anesthesia concerns come up fairly frequently. If I knew my dog was going to have surgery or be anesthetized for X-rays or such, I would ask on the list in advance if people had suggestions on anesthesia protocols worked well or poorly on dogs in my breed. I'd also ask what questions people thought I should be asking the vet about anesthesia. If my dog were a known mix, I'd ask on both/all those breeds' lists. If my dog were anybody's guess, I'd look for general lists dealing with dog health and ask there.
kabbage November 17th, 2008 09:57:52 PM
Actually, Fontini reminded me of just what exactly are considered "ok" parameters in blood or labwork prior to anesthesia?? Most elderly pets have results outside of normal in some or several areas, particularly liver values. And if it is normal to recommend a follow up screen, what tests are generally utilized to rule out/decrease anesthetic risk? Another question would be, what adjustments, if any, are made for elderly pets for pre-anesthetic drugs ---such as ace, ketamine, valium, etc.?? What is effective but less taxing on kidneys/liver/heart??
Barbara "Pocket's Story from NH" November 17th, 2008 10:01:48 PM
kabbage: Have you lost any pets? If so, how did you lose your very FIRST companion and under what circumstances? Did you trust a board certified internist and a board-certified surgeon? Did you or your husband serve in the Armed Forces, traveled alover the world and the only vets your pets and you dealt with were military vets with no profit oriented minds? The answer to all these questions for ME is YES! For 13 years, my companion was cared for by military vets. We came back to the States Sep 30, 07, and within 3 months, my pet was misdiagnosed, mistreated, and died an agonizing death. I didn't ask any questions because I TRUSTED these vets--I thought they had my companion's BEST interest in heart just like the military vets did--not PROFIT! My pet's loss has caused me a lot of pain, but it has also taught me a hard lesson--I know now what questions to ask, but most importantly I NOW RESEARCH for any health issues my remaining pets have! Over my dead body will any vet hurt my pets ever again! http://alabamavetboardwatch.110MB.com
Fotini November 18th, 2008 01:01:08 AM
It is very good to have this information as a resource.
Having said that, I don't think that anyone can fault pet owners for NOT asking questions about an anesthetic protocol until some bad experience, OR some kind of knowledge of the field or medical background, causes them to get the big clue.
We are encouraged to trust vets. Period. Most of us simply listen to whatever the vet tells us, assuming they are the experts. Many of us are actually AFRAID to question the vets, fearing that doing so will insult them. Sometimes only a bad experience will cause you to be able to take that risk.
One thing that really makes me angry is that when we assert that our pets have been harmed as a result of substandard practice or negligence of some kind (in an anesthetic protocol or otherwise) veterinary staff or others often say words to the effect: "Well, you didn't do your homework, you didn't question the vet, so you are partly responsible." (As if we already weren't losing our minds with guilt)
Those same people will often make snide remarks about clients who come in with information off the internet, get pissed when they are questioned, reflexively blame adverse outcomes on clients' lack of "compliance" or client communication failures, and admonish us saying: "If YOU think YOU'RE the expert, why do you need a vet?" Some vets, when questioned, actually threaten to dump clients.
It's obviously a double-standard designed to totally relieve the veterinarian from any accountability. If something goes wrong because the vets approach can be shown to be wrong -- well, it's our fault because we should have taken it upon ourselves to know the vet's business better than the vet. OTOH, we're assailed for questioning vets.
I'm trying to say that while it's good to have anesthetic protocol information to discuss with our vets, I'm leery of it developing into a cause where it's assumed that if WE don't know this things as clients, THEN when the vet applies a substandard protocol and something bad happens, its somehow OUR fault for not having researched anesthesia protocols.
All the same, I'd of course encourage people to use this information. Being able to avoid tragedy in the first place -- if you have the chance -- is way more important than being able to know whose at fault when it's too late and your pet is dead.
Stefani November 18th, 2008 08:35:47 AM
This is an excellent list, thank you. If I ever have to put my bird under I will definitely ask about these things.
zandperl November 18th, 2008 09:27:28 AM
"I'm trying to say that while it's good to have anesthetic protocol information to discuss with our vets, I'm leery of it developing into a cause where it's assumed that if WE don't know this things as clients, THEN when the vet applies a substandard protocol and something bad happens, its somehow OUR fault for not having researched anesthesia protocols."
I don't think that's the intent behind Dr. Kuhly's post- I think she's just trying to give owners an idea of what can be offered as an anesthetic protocol, and that the lack of certain things (i.e. an IV catheter, IV fluids, etc) should maybe raise some red flags. The clinic I work at has a standard protocol for anesthesia (minus the drugs used pre-op, for induction, and post-op, since those are individualized), and they wouldn't hesitate to provide that to any owners who ask. Vets don't expect owners to be as well-versed in anesthesia as they are- after all, you pay your vet to be the expert. BUT, that doesn't mean vets shouldn't be willing to talk about protocols with owners who ask.
Megan November 18th, 2008 10:04:03 AM
Oh, Megan, I didn't think that was Dr. Khuly's intent. I appreciate this list. I'm just going into some other issues around delving into anesthetic protocols with vets. I'm totally for it, hackles raising or not. Not all vets are equally receptive to this kind of thing, but you are right, you should definitely find one that is. Notwithstanding that, it is the vets responsibility to use an appropriate anesthetic protocol whether their clients ask or not.
Stefani November 18th, 2008 10:48:25 AM
"it is the vets responsibility to use an appropriate anesthetic protocol whether their clients ask or not."
Totally agree :)
Megan November 18th, 2008 12:07:07 PM
Megan & Stefani, I agree, this is informing the readership, but not the general public. And when in human care, do you have an "interview" to run down the list of drugs with the anesthesiologist? So, it really behooves the profession to keep up with the latest, observe and learn , if necessary, to prevent mishaps. Older drug & gas protocols were nasty on the organ systems and posed greater risks. Just because one became familiar, is really not an "excuse" to stick with it."Medicine" is an ever evolving "practice"...
Barbara "Pocket's Story from NH" November 18th, 2008 01:57:31 PM
I worry that the pre-anesthetic tests are being misused. I have heard of people that have been given a runaround or forced into further diagnostics because their young, asymtomatic pet had a BUN and creatinine suggestive of early chronic renal failure. Thankfully, when this happened to my pet, my vet continued with her dental as normal and we did further diagnostics on a later date.
eli November 19th, 2008 12:00:53 AM
Fotini, I'm not faulting you for trusting the vet or not knowing to ask questions. I am very sorry for your loss, and you have every right to be upset about it. You asked how one would get knowledge as a layperson, and I told you how I would do and have done it. I've been fortunate: the animals I have owned to date have died at over 14 years of age or are still living. No serious emergencies, knock on wood.
Do I think it's good that I feel I need to do my research before going to the vet to try to protect my pet? No. Do I think it's reasonable to expect my vet to have every common medical eccentricity of every purebred dog and cat breed committed to memory? No. Vets are human and have a huge number of species to commit to memory, even before considering breed subsets of those species. I am grateful that my vet was able to listen to me when I said SOP didn't work for my dog and that she needed to be treated as an MDR1 mutant based on her prior reactions to anesthesia. Otherwise, given that she took longer and longer to come out of anesthesia, despite years between those times, she too might be dead.
It is now MY choice when I find out new medical stuff about MY breeds to take copies of the stuff to my vet whether or not it's immediately pertinent to MY dog. By making the vet aware of it, I may help protect the life of another dog of my breed. And like you and Barbara and many others have, I post about things I've learned. I know I've helped people who were heading into anesthesia situations with possible MDR1-mutant dogs through my posts. That's all I can do. I got lucky with my dog and my vet. Not everyone is that lucky. I am very sorry for your loss and applaud your efforts to ensure your living animals receive appropriate care.
kabbage November 19th, 2008 01:34:12 AM
Any ethical Vet should have no problem explaining and justifying any protocol with a client who asks for the information in good faith. In a perfect world everyone would practice at the highest standards and such inquiries would not be necessary. Unfortunately many veterinarians stay frozen in the past, afraid to leave a comfort zone. Others assume that every client wants the cheapest care possible and base their protocols and fees on the lowest common denominator. Most of their patients do survive anesthesia and the clients never know "what went on in the back". They do know what the bottom line is out front when they pay and wonder why the rest of us are so "expensive".
Hobson November 19th, 2008 09:50:53 AM
Hobson, you raise some really important points. Esp. re: "Others assume that every client wants the cheapest care possible and base their protocols and fees on the lowest common denominator" Clients rarely know that these assumptions have been made. I almost wish that there was a client handout that broke out the elements of a dental protocol like a menu -- with explanations next to them about why they are important (to safety, etc.). The vets could "pre-select" the elements that they consider non-negotiable for practising at the level they find acceptable. If clients opt out of additional optional measures and there is increased risk associated with that, it should be discussed with them (by the vet or a licensed tech) and they should be made to undertand the added risk, and sign something. Of course, that does nothing for the poor animal that is getting "less" because their owner is focused on cost. The practice could have a strong statement at the bottom of the menu saying why they strongly recommend choosing all options in spite of increased cost. That would help clients make the connection between quality of care, safety, and cost. It would also mean the vet was explicitly revealing the elements of the protocol.
Stefani November 19th, 2008 04:24:44 PM
Stefani: As a younger, more idealistic vet I tackled this problem muhc in the way you described in you comment. Problem is, the hospital I work for did not support this bit of paperwork I devised when the clients almost uniformly expressed their distaste for it. "We trust you," they said. Why would you make us sign something so official? And that was the end of that experiment. These are also the clients who get very upset when the specialty hospital asks for detailed paperwork and payment up front. "How rude!" they cry. But the speciality hospital has it right. After all, how many of the same clients carry chronic balances and are the first to complain when something goes wrong and they "were not properly informed."
OK, can you tell I'm having a bad week? ;-)
Dr. Patty Khuly November 20th, 2008 09:38:38 AM
When I introduced the forms years ago, I got little resistance from clients, and have refined them many times. When clients do complain, I jokingly blame lawyers and insurance for this (whichy is partially true), after explaining the need. Staff resisted more than clients, as they usually do when you change protocols. As my practice and standards of care evolved over the years, there were fewer things we allowed clients to opt out of. I am all for a change of pet status from something other than mere property, it is hypocritcal for us to celebrate the human animal bond on one hand and then declare them the same as a toaster when things go wrong. But what has not been addressed in this debate is more responsibility from all pet owners to provide proper care. If you cannot afford or are not willing to provide basic care, then you should not own a pet. Too many people live beyond their means. For every pet that suffers from a veterinarian's mistake, there are thousands that suffer from preventable diseases and injuries due to the owner's negligence.
Hobson November 20th, 2008 12:53:31 PM
Don't forget the value of a trained certified technician monitoring the pet while under anesthesia.
You would be surprised the number of clinics that do not have anyone other than the doctor performing the surgery. You would be even more shocked to know that many of the them do not use monitoring equipment.
Owners need to ask these questions before their pet is put under anesthesia. Only by being held accountable will these practices changed.
Michelle November 21st, 2008 09:06:53 AM
Re: "These are also the clients who get very upset when the specialty hospital asks for detailed paperwork and payment up front. "
I actually really appreciate that paperwork, especially the opportunity to specify "code" instructions. Because I've been caring for older/sick pets for a long time now (right now is the first time in 4 1/2 years I've had a house of reasonably healthy non-elderly animals) I've been at speciality hospitals a lot. I know there are lots of people who want others to make all the decisions for them and don't want them explained. Have a hard time understanding that.
Stefani November 22nd, 2008 03:01:29 PM
Here goes yet another vote for a pre-op bloodwork even on young otherwise seemeanly healthy animals-
Goodman, my 2 year old otherwise healthy dog (I got him about a month ago from a pound) was schduled for a neuter today.
He seems perfectly healthy, but we did the pre-op bloodwork. Lo and behold, from the bloodwork it looks like he has Ehrlichiosis (in the sub-clinical stage). So no neuter and lots of DOXYCYCLINE for us.
Xslf November 24th, 2008 01:03:17 PM
It is probably way too late to comment on this, but I did want to thank you for this valuable information.
Unfortunately, I didn't have this when I took my litter of 8-week-old puppies in for early spay. My vet assured me that she was very competent in early spay and neutering and I trusted her.
Not long after I dropped my babies off, I got a call from the vet to say that one of my pups had a cardiac arrest during surgery but that she had revived her. Very long and involved story that I won't go into...the pup was taken to a specialist hospital where, after a week, we finally had to let her spirit go.
My vet had wanted me to get her out. She could do nothing more for her. I believe she did not want the pup to die in her office.
Well, later I discovered (from a former vet tech at that office) that this vet, although she took the CBC and charged me for all of the necessary preliminary testing...never had the results when the operation was scheduled! On top of that, she never monitored my baby. When I went to pick her up, I went inot the room, the pup was alone in a cage with no monitors and on one watching her.
My other pups seemed to be very groggy. I think that she over-sedated them.
The vet's comment to me, when I picked up my pup (after I was told to take her, there was nothing more she could do for her)? "Before you leave, you need to pay the bill."
I will NEVER forget this lesson. Your information is so valuable to me. Thank you, from the bottom of my heart.
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