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Why We Do A Pre-Anesthetic Exam

Let me count the ways... Among many other reasons, it is best for the patient, makes staff aware of any special attention the patient might need, and it is required by the state law. I'll give an example of the importance of the Pre-anesthetic exam. A red dog named Rose was brought in by her family for spay yesterday. Rose had wandered up to their house two years previously, had given birth to three litters of puppies since then, and had just weaned her last litter born 6 weeks ago. Her adoptive family was very interested in having her spayed. Rose was examined shortly after she arrived, and it was noted that she was very quiet, seemed tired, and was about 5% dehydrated. This prompted the veterinarian to perform optional bloodwork, which revealed that kidney values were mildly elevated. The vet called the owner and asked if they had noticed that Rose was ill. The owner replied she had not noted anything unusual. Rose also had hookworms and whipworms, and had a strong positive result on her heartworm test. Because of the abnormalities detected on pre-Anesthetic exam, surgery was canceled, as she was just too ill. Throughout the day, Rose became less responsive, and appeared incoordinated and possibly intoxicated, despite treatment with fluids, antibiotics and anti-inflammatories. It began to look as if she might have ingested anti-freeze. Rose was hospitalized overnight, and the next day it was clear she was in kidney failure, likely due to drinking anti-freeze.

While in a vast majority of cases nothing abnormal will be found on pre-anesthetic exams, and we might begin to wonder while we do them when other practices don't, Rose's case illustrates why the exam is so important for a few. You never know which will need it most until you examine them all. Performing anesthesia on a dog with compromised kidneys could have finished them off forever. It's possible she could have even died during surgery, as she happened to be very ill at the time of her scheduled surgery.

One more story... Goldie had been dropped off at the shelter and was so frightened that she spent most of her time huddling at the back of her run. The shelter director thought her chances of getting adopted were somewhere between slim and none, as she often snapped at people who approached her. Just as Goldie was headed for euthanasia, a young professional came by the shelter and for some reason took a liking to Goldie. The Shelter Director counseled this man that Goldie might not be able to live up to the expectations of a family pet, but he assured her that he thought Goldie would be just fine with him. So she took a chance on this guy, and Goldie was scheduled to be spayed prior to adoption. During the pre-anesthetic exam the day before surgery, shelter staff noted that Goldie's heart did not sound right and asked the veterinarian to take a closer listen. Indeed, she had an abnormal heartbeat. The shelter vet took Goldie to her clinic for a thorough cardiac work-up, including chest x-rays, ultrasound and EKG. It was determined that Goldie had an arrhythmia that could likely be controlled with medications and a special anesthetic protocol so that her spay could be done more safely. Orders were carried out, Goldie sailed through her spay without a hitch and went home to her forever home where she still lives happily today.

The remainder of the Pre-Anesthetic training will cover abnormalities that can be detected during the pre-anesthetic exam, and what can be done to minimize associated risks during anesthesia and surgery. Click Here to return to PreA Exam Training.

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