While the AAHA’s guidelines for veterinary anesthesia delivery and monitoring are helpful, I was disappointed to learn that adherence to them is optional. A veterinary hospital or clinic can be accredited by the AAHA regardless of whether they have the equipment required to monitor a patient effectively or significant experience in administering anesthesia. While there are almost 100,000 practicing veterinarians in the US, the ACVA has 220 members who are accredited veterinary anesthesiologists. Unless you take your pet to a veterinary medicine center of excellence, such as the University of Pennsylvania’s Mathew J. Ryan Veterinary Hospital, there’s a really good chance that the person administering the anesthesia is not a certified veterinary anesthesiologist.
The safety of your pet is your responsibility. While ultimately, the veterinarian is doing the surgery, there is much that you can do ahead of the surgery to ensure your pet is being treated by a vet with the experience, monitoring and quality checks necessary to keep your pet safe during the procedure.
As referenced previously, I was very impressed with the quality standards of the anesthesia and dental surgery team at the University of Pennsylvania Veterinary School and the Matthew J. Ryan Veterinary Hospital. While their expertise, equipment and team size is not typical of the local veterinary clinic, some of the things they did to keep Moose safe did not require fancy equipment.
When assessing your Vet’s ability to keep your pet safe, I would recommend looking for and demanding the following:
- Thorough exam and blood work prior to the procedure
- An experienced clinician, who has performed many anesthesia-requiring procedures – the more procedures and experience, the better.
- A monitoring protocol, which consistently checks the blood pressure, pulse and peripheral oxygen levels of your pet at five-minute intervals during and after the surgery. (The majority of anesthesia-related deaths occur in the three hours post surgery. These deaths are preventable with appropriate, regular monitoring of key vital signs post surgery.)
- An audible heart monitor, which helps the surgical team quickly and passively detect any changes in heart rate during the procedure.
- A surgical plan developed for that patient, which includes a list of the most likely emergency scenarios that might develop during the procedure and the protocols for action in each of those scenarios. Protocols should include a checklist of each of the steps involved in action for that scenario, as well as the pre-calculated or measured doses required for each action in each scenario. (This is not something you want calculated on the fly as your pet’s life hangs in the balance!)
- Warming equipment, aimed at keeping your pet’s body temperature at safe levels during the procedure. (For Moose’s surgery at UPENN, they used little disposable blanket-type bags that had a hair dryer-like tubes that pumped warm air into the blanket, which was wrapped around him during the surgery.
- A technician or nurse assigned exclusively to monitor the patient post surgery, staying with the patient (who may be in an area with other post-surgery patients) throughout the three-hour post-surgical recovery period.
And most importantly, if your veterinarian is not willing to speak with you at length about the procedure, thoroughly and respectfully answering any and all questions you may have prior to the surgery, go elsewhere. The good vets will not be threatened by your questions and your willingness to do the research needed to keep your pet safe. The good vets will welcome and be encouraged by your diligence and will happily walk you through the quality steps they use to keep their patients safe. You are the only advocate your pet has. They’re trusting you to keep them safe and healthy. With a little time and research, you can be an effective pet health advocate!