Dr. Phil Zeltzman’s Blog
Rosalina, a 3 month old kitten.
Lukas, a 2 month old coyote.
Pup, a 3 WEEK old puppy.
What do these tiny patients have in common? They all needed a broken bone repaired. And they all super young.
Rosalina the kitten had a broken femur (thigh bone).
Lukas the coyote had a fractured humerus (arm).
Pup the puppy had a broken tibia (shin bone).
Their surgery was definitely challenging because of their soft bones. But the biggest challenge is really anesthesia.
Why is the risk of anesthesia in pediatric patients higher than in other patients?
Younger patients are at risk for hypoglycemia (low blood sugar), hypothermia (low temperature) and hypotension (low blood pressure).
Younger patients have very little body reserves on board. So they are at risk for hypoglycemia (low blood sugar).
Patients who are old enough are often fasted at 8 pm the day before anesthesia.
In young puppies and kittens, we can’t do that, precisely to prevent hypoglycemia. Babies are typically allowed a small meal the morning of surgery.
Their blood sugar should then be monitored before, during and after anesthesia. If it’s too low, we can give sugar IV (in the form of dextrose) or by mouth (in the form of Karo syrup).
Another struggle is keeping very small patients warm. All patients rapidly loose body heat under anesthesia. Super young patients are an even bigger challenge.
Of course, the solutions are well-known: warm air blankets, warm water blankets, IV fluid warmers etc.
These warming devices actually need to be put in action early and systematically to keep your pet safe.
Our pediatric patients may also have trouble with low blood pressure as a side effect of anesthesia.
Low blood pressure can be very dangerous if not corrected. Blood needs to appropriately move through the body to carry oxygen to all vital organs, such as the kidneys.
Decreased oxygen makes just about everything unhappy. It’s so important, that we monitor all of our patients’ vitals, including blood pressure, so changes can be identified early and corrected.
Another way to decrease the risk of anesthesia is to run blood work. This helps us ensure that vital organs like the kidneys and the liver are healthy, and your baby can safely go under anesthesia. Of course, this applies to adults as well, and especially to seniors.
If the blood work does uncover an abnormality, it does not necessary mean that surgery will be canceled. However, it will often mean changing the anesthesia medications & postop pain medications used.
One specific thing we look for in young patients is abnormal numbers that could indicate an important condition called a liver shunt.
None of this information should change your mind about doing surgery. What it should do is educate you to make sure you and your vet can come up with the best plan for your baby, with the safest anesthesia and the smoothest recovery possible.
Hypoglycemia, hypothermia and hypotension are pretty straightforward to prevent when you are working with an experienced team. So don’t be shy about asking questions, so your super young pet is safe during anesthesia and surgery.
Phil Zeltzman, DVM, DACVS, CVJ, Fear Free certified