Lisette fell victim to the same thing that affects all of us from time-to-time: she was asking some of the right questions, but not all of them; she didn't know that she was receiving the wrong answers in some respects; and she was not advised as to the risks of anesthesia, what could be done to minimize the risks, nor what potential problems or signs to be aware of. Lisette wrote:
After we brought Herbie home, we realized something was wrong. He was sitting upright most of the time, but we did not know if he was just dopey from not being able to get the anesthesia out of his system, from the medicine that was prescribed, or from something else. He was not coughing, but there was a little catch to his breathing, and he seemed to be taking shallow breaths. When he lost his appetite for a day and a half and the 'dopey' behavior worsened, we took him to a vet hospital. The vet there also missed the signs of that fluid was building up in his lungs until our second visit, two days later. They did all they could to repair the damage at that point, but it was too late.
I have since found out that it can be very hard to diagnose heart problems in cats because they compensate so well by limiting their activity. However, sitting upright or seeming reluctant to lie down are classic signs of fluid building up in the lungs as the heart starts to actually fail. These postures help keep the fluid away from the heart and the top of the lungs. Other signs of heart failure can include lethargy, lack of appetite, coughing, gagging, or labored, rapid, or very shallow breathing. If a blood clot forms, the clot can get lodged in an artery leading to the hind legs and cause paralysis as well as a lot of pain.
I'm very sad that we weren't able to give our vets the information that could have helped them figure out what was going on sooner. I feel if I had been able to insist more about how Herbie's behavior was 'funny' we might have been able to get him treatment sooner and save his life. If more people knew the importance of talking with their vet about minimizing the time their animal is under anesthesia, and also the importance of asking the vet about how to look for signs of heart failure and other possible problems afterwards, maybe other pets won't have to go through what Herbie did.
This article is written to further that aim, and is dedicated to the memory of Herbie, and all other cats who have died before their time due to anesthesia-related events that might have been avoided.
A Necessary Evil
To experienced cat owners, nothing is quite as frightening as being told your cat needs to be anesthetized for a procedure. The definition of anesthesia is "loss of feeling or sensation," and in the lay person's mind, anesthesia is as close to death as a body can be without actually dying. Yet, the use of anesthetics is common in veterinary practices, and provides an essential tool for surgical or other painful procedures.
Certainly no one would ever expect their cat to be spayed or neutered without benefit of anesthesia, nor undergo dental surgery, nor fracture reduction. Therefore, a better understanding of some of the commonly-used types of anesthetics and analgesics (pain relievers), how they work, and their potential drawbacks, will help us make the best decisions when it comes to sedating our cats.
Pre-Anesthetic Sedation
Cat are generally given sedatives or tranquilizers, either singly or in combination, prior to the induction of anesthesia, or as a first step to induction. These drugs sedate and calm the animal for introduction of the mask or tracheal tube required for an inhalant anesthesia; allow for a smaller amount of general anesthetic; help to minimize vomiting; and allow for a quicker recovery period. Sedating drugs are generally administered by injection, intravenously for the most part, although Ketamine can be given intramuscularly. Injectable anesthetics are also used for full anesthesia for relatively quick procedures, such as C-sections or spay/neutering.
Injectable anesthetic agents fall into three main groups: Barbiturates, Dissociative Anesthetics (DAs), and Nonbarbiturate Hypnotics. Acepromazine, the most commonly used sedative, is used in conjunction with an analgesic such as pethidine or buprenorphine to provide a reliable sedation.
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