Anesthesiology & Pain Management

Most recent estimates suggest there are over 80 million cats in the United States. Many of these cats will undergo a procedure expected to result in pain, underscoring the need for sound pain assessment tools.

What is a geriatric patient? Geriatric patients are pets that have attained 75% of that species or breeds expected life span. Therefore, a 6 year old Yorkshire terrier would not be considered geriatric, but a 6 year old Irish wolfhound would fall under this definition.

The framework of effective pain management systems rests solidly on the foundation of recognition/assessment, pre-emption, and using multiple modalities. Multiple modalities allow for intervention at several different places of the nociceptive pathway, increasing effectiveness and minimizing the need for high or protracted doses of any one particular drug.

There are many physiologic variables that can be monitored in anesthetized small animal patients. The major goal of monitoring an anesthetized patient is to ensure adequate oxygen delivery to the tissue. Appropriate oxygen delivery to the tissue needs the proper functioning of the cardiovascular and respiratory systems.

Probably the most common condition associated with osteoarthritis, post-surgery and musculoskeletal abnormalities. Yet, it is rarely taught in veterinary university settings, few practitioners even know of its existence, all despite the fact that muscles compromise half of an animal's body weight.

The practice of veterinary anesthesia has been impacted by the short supply of propofol and discontinued production of thiopental. Thiopental is officially in the "Discontinued Drug" list of the FDA. The company that used to make thiopental decided to stop production because of its stand against the use of this drug for lethal injections.

To safely anesthetize small animal patients with preexisting cardiac condition, it is important that specific hemodynamic goals are set for the particular heart condition. It is easy to state that for patients with cardiac problem, "heart-friendly" drugs need to be used.

You can never become good at pain management without understanding basic pain pathways. You will have trouble understanding pain pathways without understanding the terminology used to describe them.

Our selection of analgesic options for the feline is influenced by the species' characteristic physiology and individual variation. The increasing popularity of the cat fuels exploration of this complex animal's unique attributes.

The risk of anesthesia is higher in emergency cases compared with elective cases. Most of these patients are compromised and this increases the danger of anesthesia, especially in cases when there is no time to optimize the condition of the patient before anesthesia.

Exotic small mammals (formally known as pocket pets) are challenging creatures to work with. When working with dogs and cats, it is usually easy to place an intravenous catheter, intubate, provide fluid therapy, hook up an ECG, place a blood pressure cuff, and keep track of the core body temperature.

Medical Acupuncture and Chinese Acupuncture

Local anesthetics were once a mainstay of pain management in veterinary medicine, and may now be one of the most under-utilized modalities. Administered locally or regionally, they are the only modality that renders complete anesthesia to a site, i.e. no transmission of nociceptive impulses as long as the drug exerts its effect.

Rigid endoscopy can be performed in many reptiles by passing the endoscope through the oral cavity and into the stomach. Endoscopy is primarily used to obtain gastric biopsies or to retrieve foreign bodies from the stomach.

In this photo gallery, Dr. Dani McVety of Lutz, Fla. guides a client through the emotional process of euthanasia.

You can reduce your patients' potential for problems by staying clear of these common pitfalls.

Veterinary internist Dr. Laura Smallwood reviews the choices for pain medication to send home with cat owners.

Pet hospice is an emerging concept in veterinary medicine.

Dallas - Almost half of veterinarians surveyed are having end-of-life discussions with pet owners more than 11 times per month.

Common errors associated with improper sample collection and storage.

Which agents are good choices for use in regional nerve blocks?

Because we want to succeed! If we want to do the best medicine possible and give our patients the best chance to heal, then we have to treat pain. Pain initiates a fairly profound stress response and a sympathetic overdrive. Stress and autonomic imbalance are not benign and the cascade of side effects include gastrointestinal (GI) ileus, GI ulceration, clotting dysfunction, hypertension, tachycardia, tachyarrhythmias, and many others.

Acute pain has an initial biological purpose in that it initiates a protective withdrawal reflex when a painful stimulus is encountered so that the tissue damage is minimized. Because of its usefulness, acute pain is often called 'physiologic pain'. Unfortunately, unlike acute pain, chronic pain serves no biological purpose.

No matter what anesthetic protocol is chosen, the addition of adequate analgesia is imperative for safe anesthesia. Most anesthetic agents, including the anesthetic gases, block the brain's response to pain but don't actually block pain. If the pain is severe enough, the brain can still respond and make the animal appear to be inadequately anesthetized.

Local anesthetic drugs are extremely effective, inexpensive and easy to use. When local anesthetic drugs are administered, pain impulses originating in the periphery are blocked and prevented from reaching the central nervous system.

The framework of effective pain management systems rests solidly on the foundation of recognition/assessment, pre-emption, and using multiple modalities. Multiple modalities allow for intervention at several different places of the nociceptive pathway, increasing effectiveness and minimizing the need for high or protracted doses of any one particular drug.

Local anesthetics were once a mainstay of pain management in veterinary medicine, and may now be one of the most under-utilized modalities. Administered locally or regionally, they are the only modality that renders complete anesthesia to a site, i.e. no transmission of nociceptive impulses as long as the drug exerts its effect.

Our patient population has changed fairly dramatically in the last 10 years as our medical skills have progressed and we have become capable of supporting patients with advanced disease and advancing age. With this new set of patients comes a new set of problems, like chronic pain.

It is now a settled matter that the adaptive capacities of animals, coupled with the innate biases of human observers, seriously impairs our ability to "know" which of our patients are in pain, how much they are in pain, and sometimes, even where they are in pain. Historically the absence of behaviors easily associated with pain (crying, whimpering, etc.) has been equated with the absence of pain.

The framework of effective pain management systems rests solidly on the foundation of recognition/assessment, pre-emption, and using multiple modalities. Multiple modalities allow for intervention at several different places of the nociceptive pathway, increasing effectiveness and minimizing the need for high or protracted doses of any one particular drug.