Visiting Veterinarian : Can't feel a thing
As the nurses prepped my husband for surgery, I grilled the anesthesiologist. Did he know about Max's hypertension? His glaucoma? What kind of anesthesia was planned? "I'm a veterinarian," I explained, apologetically, "which means I know just enough about what you do to be scared."
The doctor patiently answered my questions, then remarked kindly, "I'm amazed by veterinarians. You have to do all the jobs - diagnostician, anesthesiologist, surgeon."
"Well, your job is the one I like the least," I admitted. Anesthesiology has been described as hours of utter boredom punctuated by moments of sheer terror. It's the terror part I don't like so much.
My very first clinical rotation as a senior at the University of Pennsylvania School of Veterinary Medicine was anesthesiology, and because UPenn cared for the animals of the Philadelphia Zoo, one of my first cases was a kangaroo undergoing cataract surgery. After assisting induction and intubation of the big marsupial, I was relegated to the role of charting heart rate, respiration, and temperature, and trying not to nod off. When one eye was completed, the surgeons informed the anesthesiology team it was time to reposition. Adjusting our tubes and wires, we rolled the kangaroo from one side to the other. As her legs flopped over, I watched and waited for her chest to rise as she inhaled so I could resume my chart-keeping. "Hey," I called out after a minute, "she's not breathing." The real anesthesiologists immediately sprang into frenetic activity all around me. Hours of boredom. Moments of sheer terror.
Anesthesiology is the art of creating a reversible and controlled loss of bodily sensation with or without loss of consciousness. It is something your veterinarian does routinely for spays, neuters, dental cleanings, and miscellaneous surgery, ranging from cut feet to emergency splenectomies.
Let's talk about your dog. Let's call him Max (because, as my husband says, we know more dogs named Max than people.) Say Max arrives at my office with a big gash on his leg that clearly needs stitches. I will often suggest a local anesthetic for such minor mishaps. After cleaning the wound, a numbing agent is injected directly into the area. The first poke is uncomfortable, but after that the numbness spreads quickly and usually makes it easy to complete the job. Local anesthetics are great for cooperative patients with superficial wounds.
Nerve blocks are another form of local anesthesia in which the numbing agent is injected at the nerve that supplies the affected area, like when the dentist gives you a shot of Novocaine. Local anesthesia is quick and easy. Side effects are very rare, and patients generally walk out of the office under their own steam in short order.
But what if Max won't hold still or needs a complicated procedure requiring him to be completely immobilized? Now we're talking general anesthesia, i.e., drugs that will cause loss of consciousness. In veterinary medicine such drugs are often administered by intramuscular or intravenous injection. Intravenous drugs may be given as a single bolus, or carefully titrated "to effect." An intramuscular shot is a good choice for easy administration to agitated or aggressive patients. Several drugs may be used in combination to achieve the desired balance of pain control, immobility, and unconsciousness. Some drugs can be chemically reversed, allowing a veterinarian to anesthetize Max briefly then wake him with a second injection. In a healthy, stable animal, injectable anesthetics are great choices for minimally invasive, routine procedures.