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Posted on 04-10-2017

The Only Thing to Fear is the Fear of Anesthesia

I didn’t realize I had a fear of anesthesia until my veterinarian explained that my dog had stage 3 dental disease and needed a dental cleaning under anesthesia. As I learned, pets, unlike humans, won’t consciously tolerate a thorough examination of the full mouth; the only way a veterinarian can do the examination, cleaning, and any necessary extractions is to put the pet under anesthesia. The anesthesia, together with post-procedure pain medications, also minimizes the pain involved with cleaning and extractions. Thinking about how scared my dog would be as strangers poked around in her mouth, and also knowing much pain toothaches can cause, I quickly understood the need for the examination and cleaning under anesthesia.

But as we discussed the procedure, I felt nervous. I didn’t like the idea of my pet being anesthetized. What if she never woke up? When I started researching it, I discovered that many people are afraid of going under anesthesia themselves. According to “Psychiatric Issues in Surgical Patients” in Primary Psychiatry, about one-third of patients have a fear of anesthesia distinct from their fear of the surgery itself. I decided to look into how safe anesthesia really is for pets.

According to Richard M. Bednarski, DVM, MSc, DACVAA, a board-certified veterinary anesthesiologist, “The most recent statistics indicate that the death rate related to anesthesia [in pets] is approximately one anesthetic-related death for every 1,000 anesthetized.” But, he says, “The dog or cat with a significant pre-existing disease, such as chronic heart or lung disease, is at an increased but acceptable risk, while the death rate for relatively healthy dogs and cats is less than this average.”

It turns out there are things pet owners can do to not only relieve their fears of anesthesia but also help ensure the safety of their beloved animals. Says Dr. Bednarski, “Every pet owner should feel free to discuss their pets’ anesthetic risk with their veterinarian at the time oral care requiring general anesthesia is required.” There are several questions veterinary clients can ask of their veterinarian.

Dr. Bednarski elaborates, “I would want to know that my pet’s anesthetic plan begins with a physical and laboratory examination appropriate for my individual pet. I would be certain that during the procedure my pet is intubated (breathing tube inserted through the mouth into the wind pipe) to protect his lungs from blood and fluids present in the mouth and also for delivery of supplemental oxygen. I would like to know that heart and lung function are monitored frequently and regularly by a trained and experienced person familiar with the effects and side effects of the anesthetic drugs used. I would also like to know that emergency drugs in doses appropriate for my pet are readily available. Finally, I would like to know how any post-procedure pain will be treated.”

He also says, “The older or sicker my pet, the more laboratory tests will be needed to ensure safer handling. I would expect my veterinarian to suggest addressing and possibly treating any significant health concerns prior to anesthetizing.”

Laurie Miller, RVT, CVT, CVPM, a practice consultant with the American Animal Hospital Association (AAHA), concurs, recommending the following questions:

  • Does the practice require blood work prior to the anesthetic event, and if so how far in advance?
  • Will my pet have an IV catheter and fluids during the procedure?
  • Is there someone dedicated to monitoring my pet while he is under anesthesia? Who is that person, and are they credentialed, or what training do they have with anesthesia?
  • What type of monitoring devices are used during my pet’s anesthetic event?
  • While my pet recovers, what is the process for observing and monitoring her?

AAHA also has standards for AAHA accreditation, some of which are mandatory, regarding anesthesia. As Laurie Miller says, “AAHA does take anesthesia very seriously, and as such, the points [systems in place] to achieve AAHA accreditation… requires a practice to have a good anesthetic plan and processes in place.”

Both Dr. Bednarski and Laurie Miller state that anesthesia will never be completely free of risks. But Dr. Bednarski says, “Modern anesthesia, which I define as an anesthetic plan customized for each individual that takes into account each animal’s… health risks, is very safe.”

Knowing that, along with the questions I can ask my veterinarian about anesthesia, helps to relieve my concerns. I would rather accept the minor risks of anesthesia than leave my dog to suffer silently from tooth decay or other oral diseases or problems.

Bess Vanrenen

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