Anesthesia for Cats, Diabetic Cat Care

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Diabetic Cat Care

ANESTHESIA 101

A Necessary Evil

To most cat owners - diabetic or not - it is very frightening being told your cat needs to be anesthetized for a procedure. Yet, the use of anesthetics is common in veterinary practices, and provides an essential tool for surgical or other painful procedures such as dental cleanings. Please do NOT choose the recently popular "anesthesia free" dentals procedures as they are terrifying for your cat.

Post Operative Anesthesia used for Sedation

Cats are generally given sedatives or tranquilizers, either singly or in combination, prior to or as a first step in the induction of anesthesia. These drugs sedate and calm the animal prior to introduction of a mask or tracheal tube required for an inhalant anesthesia. Sedatives allow for a smaller amount of general anesthetic needing to be used; help to minimize vomiting; and allow for a quicker recovery period. Sedating drugs are generally administered by injection, intravenously for the most part, although Ketamine can be given intramuscularly. Injectable anesthetics are also used for relatively quick procedures, such as C-sections or spay/neutering.

Injectable anesthetic agents fall into three main groups: Barbiturates, Dissociative Anesthetics (DAs), and Non-barbiturate Hypnotics. Acepromazine or acetylpromazine (more commonly known as ACP, Ace, or by the trade names Atravet or Acezine 2), the most commonly used sedative, is used in conjunction with an analgesic such as pethidine or buprenorphine to provide a reliable sedation.

Propofol (a non-barbiturate hypnotic), is the "injectable of choice" for certain veterinary procedures, as it is quick-acting, offers a rapid recovery period, and rarely induces drug after effects. Dosage for Propofol, as for all licensed drugs, is governed by the FDA. Propofol is primarily metabolized via the liver, at one time it was contraindicated for cats with hepatic liver (HL), however studies undertaken at Winn Feline Health concluded Propofol can be used for cats with HL.

Ketamine, (DA) a somewhat controversial drug, has been widely used as both a pre-anesthetic drug, and in combination with other drugs, such as Acepromazine, for full anesthesia for some procedures. It is generally considered safe, although some people believe that certain breeds of cats or dogs may be at risk with its use. Ketamine is non-narcotic and non-barbiturate, but interestingly, is a hallucinogenic and is used by some people as a recreational drug for that purpose. Ketamine shouldn't't be used in animals with hypertension, heart disease, liver disease, kidney disease, head trauma or known seizures. Ketamine may interact with other medications. Consult with your veterinarian to determine if other drugs your pet is receiving might interact with ketamine; for example, narcotics, and diazepam, halothane, chloramphenicol and thyroid medication.

Inhalant Anesthetics

Isofluorane revolutionized veterinary anesthesia because of its safety (particularly with older or compromised patients), rapid recovery of the patient after surgery, and the fact that it will not likely to induce nor exacerbate heart arrhythmias. Isofluorane recently lost its patent, so is becoming less expensive than newer inhalants, and is still considered the anesthetic of choice in veterinary medicine for pregnant animals (including for C-sections) and for animals with heart problems. Sevoflurane is relatively new, costing about four times more than Isofluorane. Halothane costs even less than Isofluorane, and is still in popular use. Both Isofluorane and halothane require the use of a precision vaporizer for measuring the appropriate deliverance of anesthetic. Your veterinarian can (and should) provide information to you as to which anesthetics they use and why.

It has been said that there is no such thing as the perfect anesthetic, and there is always potential for risk with any of them. As pet owners, we therefore need to do our homework prior to allowing any procedure requiring anesthesia, and to insist on a pre-anesthetic blood screening. This precaution is not a guarantee by any means (for instance, Cardiomyopathy will not show up on a blood panel), but it can help your veterinarian determine what is the best anesthetic or combination of anesthetics for your cat. Certain conditions may not obviate the need for anesthesia, but other precautions such as heart monitoring and/or oxygen assistance should be added for additional safety and it is highly recommended to confirm with your vet that they will be used during surgical procedures.

Anesthetics – Potential Side-effects, What You Should Know

Barbiturates (pentobarbital, thiopental, thiamylal, methohexital)

Potential for respiratory depression with excessive doses, contraindicated in pregnant cats. Prolonged anesthetic recovery can also be a problem when barbiturates are used in older animals, obese animals (which require higher dosage), or other animals with compromised hepatic and renal function which decreases metabolism of the drugs.

Ketamine
Potential for depressed cardiac function; compromise respiratory function, including apnea (failure to breathe and/or sudden pulmonary edema (fluid in the lungs) for cats with cardiac disease or severe debilitation. Contraindicated for cases of head trauma, or cats with kidney failure.

Propofol

(sold as PropoFlo, Rapinovet, and Dipravan) Can cause apnea when inducted quickly, and over-dosage can cause cardiac arrest, however ordinarily there are minimal effects on the cardiovascular system.

Acepromazine
Because it is not an analgesic, Acepromazine is usually used in conjunction with another sedative. It is contraindicated in animals with CNS (central nervous system) lesions, and can sometimes cause hypothermia.

Halothane (inhalant)
Cardiopulmonary depression, and a risk of malignant hyperthermia in some breeds/strains.

Isoflurane (inhalant)
Respiratory depression and cardiovascular depression.

Telazol (tiletamine HCl and zolazepam HCl- injectable)

A non-narcotic, non-barbiturate, injectable anesthetic agent for dogs and cats. The use of Telazol is contraindicated in dogs and cats with pancreatic disease. Telazol is also not recommended for use in cats suffering from renal insufficiency.

For more information on anesthesia used during surgery and post operative considerations, please read about the various types of anesthesia for small animals .