Introduction

• Neuroleptanalgesia, eg for radiography.
• Neuroleptanalgesia with local anesthesia, eg for minor/superficial surgical procedures.
  
  Often much safer to give a carefully planned and monitored general anesthetic than a heavy sedation for radiography and minor procedures

• History, eg exercise intolerance.
• General clinical examination.
• Auscultation.
• Radiography Radiography: thorax.
• Electrocardiography ECG: overview.
• Ultrasonography.
• Hematology Hematology: complete blood count (CBC).
• Biochemistry.
• Electrolyte assay.
• Urinalysis.
• Categories of cardiovascular insufficiency Heart: congestive heart failure , according to severity and to presence of secondary or concurrent disease:
  • Class III: moderate risk.
  • Class IV: high risk.
  • Class V: grave risk.

Standard preoperative preparation

• Stabilise any conditionaffecting animal's fitness for anesthesia (and surgery), eg pulmonary edema via diuresis Furosemide , pericardial effusion via pericardiocentesis Thoracocentesis , under local anesthesia Local anesthesia: overview , possibly guided by ultrasonography.
• Pre-oxygenatefor 5 mins, using mask, naso-pharyngeal tube Nasal oxygen administration , or chamber (for small breeds).
  
  
  Value decreased if animal struggles
  If animal too large for chamber and struggling with mask, try Elizabethan collar enclosed in clingfilm or polythene with oxygen supplied from caudal aspect, tube fed in between collar and neck. Seal at neck improved by applying collar onto a folded towel placed round patient's neck
  Oxygen is a fire hazard
• Place intravenous catheter Cephalic catheterization (largest bore convenient), to ensure reliable venous access. In critical cases, place a central venous catheter to also monitor central venous blood pressure and infuse large volumes of fluid rapidly if required.
• Prepare surgical site, without stressing the patient, before anesthetic induction.

Requirements

Procedure - premedication

Procedure - induction

Procedure - maintenance and monitoring

Procedure - recovery

Further Reading

Publications

Refereed papers

• Recent references from PubMed and VetMedResource.
• Garrod L A, Wetmore L (1999) Anesthetic agents in trauma patients. Comp Cont Educ 21 (9), 800-11 VetMedResource.

Other sources of information

• Day T K (1999) Intravenous anesthetic techniques for emergency and critical care patients. In: Current Veterinary Therapy XIII pp 122.
• Bedford P G C (1991) Small Animal Anesthesia. The Increased Risk Patient. London: Bailliere Tindall. pp 72. (Thorough consideration of anesthesia for small animals with cardiac disease.)
• Hellebrekers L J & Sap R (1991) Sufentanil-Midazolam Anesthesia in the Dog. Proceedings of the 4th International Congress of Veterinary Anaesthesia. (Brief paper on this technique, listing further references for narcotic infusion techniques.)
• Stoelting R K & Miller R D (1984) In: Basics of Anesthesia. New York: Churchill Livingstone. pp 257. (Selecting anesthetic techniques suited to the severity of the cardiac condition.)
• Edwards N J & Tilley L P (1981) In:Pathophysiology in Small Animal Surgery. Philadelphia: Lea and Febiger. pp 155. (Detailed discussion of medical and surgical considerations for common cardiac disorders.)