General anesthesia for pets used to be a lot simpler when I was a kid working for a vet in the 1970s. He gave the dog or cat a couple of shots and it fell asleep. If the pet started to wake up during the procedure, he gave it some more drugs with the syringe of barbiturates he had taped to its arm.
The drugs took a long time to wear off and complications, including death, were not rare occurrences in the office. Needless to say, he didn't anesthetize many animals for teeth cleaning. It just wasn't worth the risk.
Now that I'm the vet, I often tell my clients to choose anesthesia for teeth cleaning. What's so different about anesthesia today? The differences in how we anesthetize pets today vs. 25 years ago are numerous. Better drugs, patient selection, monitoring equipment and technical staff all make safe anesthesia routine in modern veterinary practices.
About 20 years ago, gas anesthesia changed everything in veterinary anesthesia. Before gas, anesthesia drugs were given by injection and were removed slowly from the bloodstream by the liver and kidneys. Gas anesthetics enter and leave the body mainly through the lungs. Adjustments in anesthesia depth can be made more rapidly and safely. Animals also wake up faster once the procedure is over.
Injectable anesthetics have also improved. Most vets no longer use barbiturates as their main anesthetic. Newer drugs that are much shorter acting can often be used with a reversing agent for short procedures. We also use combinations of injectable drugs and gas anesthesia. This allows us to make full use of several different drugs' advantages while using lower doses of each drug to reduce side effects. The options open to veterinarians in choosing anesthetic drugs for your pet have improved dramatically in the past couple decades.
Patient selection is critical for safe anesthesia. Today, we are able to safely anesthetize patients that years ago we would have considered too sick for safe anesthesia. All patients are now given a thorough exam prior to anesthesia. Problems are identified and treated before anesthesia whenever possible.
Pre-anesthetic lab work is routinely done even on apparently healthy pets. Pre-anesthetic drugs and intravenous fluids are used to stabilize patients prior to and during anesthesia. Pain medications are given before they are needed so anesthetic levels can be kept as low as possible.
Perhaps the most difficult part of anesthesia is patient monitoring. Good monitoring allows vets to tailor the anesthesia to the patient while the procedure is in progress. This used to mean the vet, often working alone, would glance at the patient's gums every few minutes during a procedure to make sure they were still pink (good) instead of blue (bad). Now we have college-trained technicians and many types of automated equipment to assist them.
We have an excellent technician school at Foothill College in Los Altos Hills. Trained veterinary technicians make it possible to monitor anesthesia and alert the veterinarian of changes in anesthetic depth and patient well-being.
Every now and then I picture myself practicing 30 years ago, spaying a dog with a syringe of pentobarbital taped to its arm, wondering why its gums are turning from pink to blue, and what I was going to do about it. My how things have changed!
Dr. Glynn Echerd is the veterinarian and owner of Kindness Pet Hospital at 440 First St., Los Altos. He can be reached at 948-8287.