Presurgical Premedication Protocols:

ORTHOPEDIC PROCEDURES:

  • A full Mu opioid with a sedative or tranquilizer (acepromazine, midazolam or valium)
  • Hydromorphone 0.05 – 0.1mg/kg and Acepromazine 0.03mg/kg IV or IM
  • Morphine 0.5mg/kg – 1mg/kg and Acepromazine 0.03mg/kg IV or IM

Torbugesic 0.1 – 0.5 mg/kg can be used as premedication with a sedative or tranquilizer, however, the above opioids should be given during recovery and postoperatively.

SOFT TISSUE PROCEDURES:

  • Buprenorphine 0.01mg/kg +/- acepromazine or valium for extra-abdominal procedures
  • Hydromorphone 0.05mg/kg – 0.1mg/kg and valium 0.2mg/kg IV for abdominal procedures
  • Morphine 0.5mg/kg – 1mg/kg and valium 0.2mg/kg IV for abdominal procedures

Torbugesic can be used as premedication with a sedative or tranquilizer, however, the above opioids should be given during recovery and postoperatively.

BRACHYCEPHALIC PATIENTS:

  • A lateral and VD (2 view or 3 view) thoracic radiographs pre-op (within 1 week of surgical procedure)

Before you give sedatives:

  • Metoclopramide 0.2 mg/kg SQ or Cisapride 0.1 – 0.5 mg/kg PO
  • Famotidine 1 mg/kg IV or Omeprazole 1mg/kg PO
  • Maropitant 1 mg/kg SQ or IV over 1-2 minutes or Odansetron IV

Atropine preoperatively 0.01-0.02mg/kg if our resting heart rate is 40-60 bpm to counteract vagal tone

  • Hydromorphone 0.05 – 0.1mg/kg and Acepromazine 0.03mg/kg IV or IM
  • Morphine 0.5mg/kg – 1mg/kg and Acepromazine 0.03mg/kg IV or IM
  • Buprenorphine 0.01 mg/kg and Acepromazine 0.03mg/kg IV or IM
  • Valium or midazolam 0.2mg/kg can be used in place of acepromazine, but not if an airway function exam is needed
  • Dexamethasone 0.25 mg/kg IV (airway surgery only) with premedication, then post-operatively prn

Torbugesic can be used as premedication with a sedative or tranquilizer, however, the above opioids should be given during recovery and postoperatively. If the procedure(s) are not invasive then buprenorphine is preferred to avoid more respiratory or GI side effects from full Mu agonists.

Postoperative BOAS patients should recover in ventral recumbency with their head elevated and a designated veterinary technician to monitor them during the entire recovery phase. They should be intubated as long as possible to ensure they are completely awake and able to swallow/chew. Medications to consider dispensing include anti-inflammatories, antiemetics (liquid maropitant) and proton pump inhibitors (liquid omeprazole).

Intraoperative Procedures

Fluid Therapy

Intravenous fluids will be administered during the surgical procedure. The rate of crystalloid administration is 5ml/kg/hr for dogs and 3ml/kg/hr for cats. This is our basic starting rate but may require adjustment during the surgical procedure. Other fluids may be added to maintain appropriate blood pressure during the procedure.

If needed, we provide monitoring via the PC-VetGard+…

The PC-VetGard+ is a small, battery-operated, wireless patient monitor that displays dynamic multiple monitoring parameters on my computer via Bluetooth. Bluetooth is omnidirectional and virtually free of interference, ensuring a consistent, reliable wireless connection most anywhere in the clinic. Once the surgery is finished, we will email you a pdf recording of data recorded every 5 minutes throughout anesthesia. The PC-VetGard+ has the following monitoring parameters:

  • ECG, Temperature, Respiration and SpO2, sidestream CO2
  • NIBP with systolic, diastolic, MAP and heart rate calculations
  • PDF Report of the anesthetic procedure