Pre-anesthetic Counseling

Understanding Anesthetic Risk Levels and Pre-Procedure Care for Your Pet

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Anesthetic Risks Anytime we anesthetize or even sedate a patient for a procedure, there is some risk. We assign all patients a category of green (minimal risk), yellow (some acceptable risk) and red (high risk). Please be aware of your pet's assigned level of risk. When administering anesthesia, we will continuously monitor your pet, we will address their pain levels and make sure their heart and lungs are working well. Even with all possible precautions, there is a risk of death any time anesthesia is given. This risk is less than 1 in 1,000 in "green" risk patients, but higher if a pet is "yellow" or "red." In addition to the risk of anesthetic death, there are a few other risks to consider. Tracheal tears or esophageal stricture from intubation are very rare but possible complications, as are small blood clots, corneal abrasions, low blood pressure possible leading to renal issues post-surgery, and thermal burns. We do shave on the leg for a catheter placement, as well as the surgery site itself. There will sometime be a bandage in place after the procedure - most likely this needs to be removed when you get home unless otherwise specified. Failure to remove a bandage on the leg can lead to circulation issues. If your pet has been assigned a "red" risk assessment, it is important that we have discussed potential complications with you verbally! Please contact us prior to the procedure if we have not yet talked. A referral hospital may be ideal for patients assigned a red risk assessment.

Low Risk (Routine Anesthesia)

Typical patients: young, healthy, stable.

Notes:
  • Standard anesthetic monitoring appropriate.
  • Lowest anesthetic complication risk.

Moderate Risk (Caution/ Additional Monitoring)

Typical patients: mild disease, age-related changes, or manageable risk factors.

Criteria:
  • Age: middle age to early senior (~4-10 years, depending on species/breed).
  • Mild systemic disease.
  • Slight abnormalities on bloodwork (e.g., mild liver enzyme elevation).
  • Overweight or mildly obese.
  • Mild dental disease or localized infection.
  • Stable chronic conditions (e.g., early kidney disease, controlled diabetes).
Notes:
  • Pre-anesthetic diagnostics typically required (CBC, chemistry +/- imaging).
  • Adjust drug protocols as needed.
  • Increased monitoring during and after anesthesia.

High Risk (Significant Concern/Advanced Planning Required)

Typical patients: significant disease, unstable, or anatomical risk.

Criteria:
  • Geriatric animals with systemic compromise.
  • Moderate to severe systemic disease.
  • Abnormal diagnostics affecting anesthesia safety.
  • Emergency procedures.
  • History of anesthetic complications.
  • Severe obesity or cachexia.
  • Cardiovascular, respiratory, or metabolic instability.
  • Aggressive patients that may require more pre-medications/drugs and pre-anesthetic diagnostics may not be possible.
Always included: Brachycephalic airway syndrome patients (e.g., Pugs, Bulldogs, Persian cats).

Notes:
  • Full diagnostics required (only exception may be young brachycephalic).
  • Tailored anesthetic protocol required.
  • Advanced airway management planning (especially brachycephalic).
  • Referral may be encouraged due to risk of potential complications.
  • Although anesthesia as a high-risk patient will include extensive monitoring, owner must accept risk of potential complications, that in rare instances can lead to death.

Pre Veterinary Procedure Prescriptions ("PVP") We strongly recommend that you pick up and administer medications to your pet prior to your upcoming procedure. Instructions will be on the label, but we often request that you give medications the night before and the morning after the procedures. It is OK to give the medication(s) in a small treat (not a full meal) even the morning of the procedure. Below please find a description of each of the medications we will frequently prescribe. We may prescribe these to be given all at once. They work well and safely together.
  • Gabapentin – Controls anxiety and pain, especially nerve related pain. Acts as a mild sedative.
  •  NSAID – non steroidal anti-inflammatory, decreases inflammation and therefore pain. Do not mix nsaids with one another or with steroids.
  • Trazadone – Serotonin Uptake Inhibitor – decreases anxiety. Acts as a mild sedative.
  •  Cerenia – Molecularly similar to Substance P, which is involved in multiple inflammatory conditions: binds to NK-1 receptor to outcompete Substance P, thereby decreasing nausea and inflammation. Especially effective for surgeries involving the gut.

Pre Veterinary Procedure Prescriptions ("PVP") We strongly recommend that you pick up and administer medications to your pet prior to your upcoming procedure. Instructions will be on the label, but we often request that you give medications the night before and the morning after the procedures. It is OK to give the medication(s) in a small treat (not a full meal) even the morning of the procedure. Below please find a description of each of the medications we will frequently prescribe. We may prescribe these to be given all at once. They work well and safely together.
  • Gabapentin – Controls anxiety and pain, especially nerve related pain. Acts as a mild sedative.
  •  NSAID – non steroidal anti-inflammatory, decreases inflammation and therefore pain. Do not mix nsaids with one another or with steroids.
  • Trazadone – Serotonin Uptake Inhibitor – decreases anxiety. Acts as a mild sedative.
  •  Cerenia – Molecularly similar to Substance P, which is involved in multiple inflammatory conditions: binds to NK-1 receptor to outcompete Substance P, thereby decreasing nausea and inflammation. Especially effective for surgeries involving the gut.