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How to get better, safer pain relief for your pets’ anesthetic procedures

Posted Jan 22 2009 4:32pm

Your dog is all set to undergo a simple spay or—God forbid!—your kitty is scheduled for a major mass removal. You want the best kind of anesthetics and pain relievers. You may even be leery (if not downright afraid) of the anesthesia she’ll require for the procedure. But are you aware of the many choices for pain relief that can make anesthesia safer and dramatically reduce your pets’ discomfort at the same time?

Though it’s true that many savvy consumers of veterinary services (you, presumably) can be picky about the kinds of pain relief your pets get, none of you is likely to decline pain medication on principle, right? You all understand that pain relief is as indispensable to your pet’s welfare as the anesthesia itself.

On Dolitter, we’ve discussed the many ways in which anesthesia can be scary, dangerous and its risks reduced, but in the past I may have neglected to focus on how addressing anxiety and pain before, during and after the procedure can drastically improve our pets' comfort level.

Yesterday’s post on the so called, “pet centered” practice may have touched on this issue obliquely. Today we’ll examine it in more detail so that you can make better decisions about how your pet can be treated more safely and humanely than you may have thought possible…with simple techniques every vet understands and can accomplish—but which relatively few employ routinely.

Eye removal, dental extractions, onychectomy (claw removal), amputations, joint surgery, abdominal surgeries, emergency procedures. Indeed, there is NO surgical approach that cannot be enhanced with safe and powerful pain relief protocols you may not know are available.

Sure, we all know that any drug strong enough to help your pet can also hurt her. But when we tailor an anesthetic experience to your pet’s individual needs, veterinarians have found that the use of multiple drugs can reduce the overall, potentially life-threatening impact of any one of them.

In fact, this concept, referred to as “multi-modal” pain relief, typically reduces the total drug requirements for pets undergoing anesthesia and/or any potentially painful procedure.

Here’s a sampling of what this concept offers—with examples, of course:

That tail’s gotta go

A backyard stray turns up with a dangling, “dead” tail. Your vet finds a piece of fishing line wrapped midway down the appendage. He offers amputation as the only alternative to a tail that will forever be a liability.

Before anesthesia, he injects kitty with a titch of an opiate pain reliever for overall comfort and mild sedation. He uses less of the injectable anesthesia-induction drug, as a result. The gas flow he can now set at a lower level.

He then injects the tail at its base with a ring of deep injections of nerve-blocking drugs that will pre-empt the pain of removal. When the tail is sliced and diced, kitty’s heart rate does not even flicker on the monitor. He feels nothing. The nerve block’s action will linger for an hour or more. A half-dose of a kitty-approved NSAID (to last a day or two) seals the deal.

The tooth fracture

A rough game of tug-o-war with the Wuba yields one fractured canine tooth. Whether you elected the gold standard root canal approach at the veterinary dentist’s or your own vet’s careful extraction with gingival flap surgery, it’s gonna hurt some.

What better, then, than to perform a simple nerve block with an extra long-acting effect. The simple addition of ubiquitous epinephrine to the commomplace bupivicaine (local anesthetic) means this area will experience the first critical hours post-op with absolute freedom from pain. Any dental extraction can be thus treated.

Fear is NOT our friend

Is your rescue dog the most sensitive sentient on the planet? Sedatives and tranquilizers are great if they need to be at the vet’s for any length of time before the procedure. (Getting them there just before showtime may be even better.) Consider that tranquilizers reduce the amount of drugs required to induce anesthesia.

The simple spay

Ask about a "linea block" at the incision site. I use this local anesthetic approach for all my C-sections to decrease her anesthetic requirements and respiratory depression in the pups. Large dog spays and long incisions are similarly treated. (In smaller pets, the slightly higher risk of infection may not make it worthwhile.) How much better to wake up with a painless belly and later require lower doses of opiates and non-steroidals?

Visible nerves

Removing anything with a visible nerve attached (eye, limb, toe)?  Inject the nerve itself before cutting it cleanly. Human docs suggest the possibility of phantom pain is reduced as well as the post-operative pain.

***

Aside from their pain-relieving effects and the increased safety they provide, the best part of these multi-modal techniques? They can be had at any practice, not just at the specialists’ where they’re more routinely employed. Just ask…and you shall receive.

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