Page 691 - ONLINE PROCEEDING BOOK WSAVA 2017
P. 691

a. Very short procedures: mask induction and low- maintenance monitoring
I. Pulse oximeter
II. Hands, eyes and ears (RR rate and TV, HR and rhythm)
III. +/- doppler crystal over artery, heart or eye.
IV. Note- capnography not useful in this setting
b. Longer procedures:
I. Intubate or LMA and support ventilation (see species notes)
1. Always evaluate depth of ET tube (avoid endobronchial intubation)
2. Keep tubes as short as possible to reduce dead- space
3. Very small airways are narrowed by even the smallest tube- consider Cole tubes that are wider before the airway
4.
II. ECG
III. Doppler sound or cuff when possible
IV. Arterial line in complex/specialist situations
B. Rodents- often not IV catheter amenable, so mask inductions (preferably with appropriate premedications) are typical. Tight  tting mask- consider use of plastic wrap.
Intubation is dif cult, but can be attempted (IV catheter tubes). An otoscope cone modi ed with a gap may be useful. Larger rodents (prarie dogs, squirrels) can be intubated with blind technique is often possible. Rats require direct visualization
C. Rabbits- intubation requires hyperextension of
head and neck. Nasal breathers- so must displace soft palate with either intubation or supraglottic airways. Verify placement with breath sounds or capnography wave. (can also use modi ed otoscope as with rodents)
Prefer IV induction (alfaxalone, propofol, ketamine/benzo, etomidate)
D. Ferrets- intubation is much like cats- consider gauze for jaw (high tone remains), drop of lidocaine for arytenoids, and cotton-tipped swab to retract tongue.
a. (alfaxalone, propofol, ketamine/benzo, etomidate)
b. Similar intubation to cats- consider lidocaine on arytenoids (watch total dose <4 mg/kg)
E. Guinea Pigs and chinchillas- Mask induction required due to palatal ostium and frequent regurgitation with laryngeal stimulation.
An Urban Experience
F. Hedgehogs: Direct visualization using gauze/lidocaine/ cotton-tipped swab
G. Sugar gliders: direct visualization is possible, but usually a mask approach is used
Maintenance-
1)
a.
b.
2)
Inhalant (either iso urane or sevo urane: they are basically equivalent). Run semi-closed systems at ~30ml/kg/min of oxygen or non-rebreathing at 200 mg/kg/min
Semi-closed – increase work of breathing in inspiration, better heat control, dif cult to see breath size, able to use side-stream capnograph without adapter
Non-rebreathing- increased work of breathing in exhalation, cools patient, dif cult to impossible to see breath size, capnograph non-effective.
Local anesthetics in EVERY surgery, wound, etc.
(Total dose < 2 mg/kg bupivacaine and <4 mg/kg lidocaine or mepivacaine)
3) When needed to augment inhalant to improve hemodynamics, analgesia and anesthetic plane (limiting ups and downs) the following can be used as intermittent bolus or CRI:
a. Alfaxalone
b. Ketamine
c. Fentanyl
d. Dex-medetomidine
4) Metabolic: blood glucose. Blood loss- PCV/TP. Recovery-
1) Anti-in ammatory if not contra-indicated once patient is recovering consciousness and body temperature has been maintained or corrected.
2) Repeat any narcotic doses when nearing the end of their duration of action
3) Repeat any local blocks that are nearing their duration of action (lidocaine, mepivacaine 2 hours. Bupivacaine 4 hours)
a. Consider long-acting bupivacaine- Nocita- 3 days duration
4) Utilize non-drug options- at a minimum: ice a. Acupuncture
b. Laser
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