This self-quiz reviews 5 different aspects of anesthesiology in the small animal patient. For a complete discussion, refer to the linked article in the correct answer of each question.
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This self-quiz reviews 5 different aspects of anesthesiology in the small animal patient. For a complete discussion, refer to the linked article in the correct answer of each question.
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What adverse effect is not seen with propofol administration?
Arterial hypotension
Respiratory depression to the point of apnea
Local inflammatory reaction when injected perivascularly
Heinz body anemia with repeated administration in cats
The correct answer is C.
Some animals may withdraw their limb in response to propofol administration (presumably from a burning or painful sensation), but perivascular injection does not cause a local inflammatory reaction.
Cardiovascular depression may be observed when propofol is administered as an IV bolus. Arterial hypotension, the most common cardiovascular effect reported, primarily results from a decrease in systemic vascular resistance, although negative inotropic effects have also been reported. Slow administration of the drug and prior administration of IV fluids (5–10 mL/kg balanced electrolyte solution over ≤5–10 minutes) can help reduce these effects.
Respiratory depression to the point of apnea is the most common effect reported after administration and may be minimized by slow administration.
While propofol may be used repeatedly in dogs, cats respond less predictably, presumably because of hepatic enzyme saturation (leading to limited ability to glucuronidate). Prolonged recoveries following propofol infusion, Heinz body anemia, general malaise, anorexia, and diarrhea have been reported with sequential daily administration in cats.
Read more: Propofol: An Overview by Khursheed Mama, DVM, DACVA Colorado State University
The correct answer is C.
Some animals may withdraw their limb in response to propofol administration (presumably from a burning or painful sensation), but perivascular injection does not cause a local inflammatory reaction.
Cardiovascular depression may be observed when propofol is administered as an IV bolus. Arterial hypotension, the most common cardiovascular effect reported, primarily results from a decrease in systemic vascular resistance, although negative inotropic effects have also been reported. Slow administration of the drug and prior administration of IV fluids (5–10 mL/kg balanced electrolyte solution over ≤5–10 minutes) can help reduce these effects.
Respiratory depression to the point of apnea is the most common effect reported after administration and may be minimized by slow administration.
While propofol may be used repeatedly in dogs, cats respond less predictably, presumably because of hepatic enzyme saturation (leading to limited ability to glucuronidate). Prolonged recoveries following propofol infusion, Heinz body anemia, general malaise, anorexia, and diarrhea have been reported with sequential daily administration in cats.
Read more: Propofol: An Overview by Khursheed Mama, DVM, DACVA Colorado State University
Some animals may withdraw their limb in response to propofol administration (presumably from a burning or painful sensation), but perivascular injection does not cause a local inflammatory reaction.
Cardiovascular depression may be observed when propofol is administered as an IV bolus. Arterial hypotension, the most common cardiovascular effect reported, primarily results from a decrease in systemic vascular resistance, although negative inotropic effects have also been reported. Slow administration of the drug and prior administration of IV fluids (5–10 mL/kg balanced electrolyte solution over ≤5–10 minutes) can help reduce these effects.
Respiratory depression to the point of apnea is the most common effect reported after administration and may be minimized by slow administration.
While propofol may be used repeatedly in dogs, cats respond less predictably, presumably because of hepatic enzyme saturation (leading to limited ability to glucuronidate). Prolonged recoveries following propofol infusion, Heinz body anemia, general malaise, anorexia, and diarrhea have been reported with sequential daily administration in cats.
Read more: Propofol: An Overview by Khursheed Mama, DVM, DACVA Colorado State University
The correct answer is C.
Some animals may withdraw their limb in response to propofol administration (presumably from a burning or painful sensation), but perivascular injection does not cause a local inflammatory reaction.
Cardiovascular depression may be observed when propofol is administered as an IV bolus. Arterial hypotension, the most common cardiovascular effect reported, primarily results from a decrease in systemic vascular resistance, although negative inotropic effects have also been reported. Slow administration of the drug and prior administration of IV fluids (5–10 mL/kg balanced electrolyte solution over ≤5–10 minutes) can help reduce these effects.
Respiratory depression to the point of apnea is the most common effect reported after administration and may be minimized by slow administration.
While propofol may be used repeatedly in dogs, cats respond less predictably, presumably because of hepatic enzyme saturation (leading to limited ability to glucuronidate). Prolonged recoveries following propofol infusion, Heinz body anemia, general malaise, anorexia, and diarrhea have been reported with sequential daily administration in cats.
Read more: Propofol: An Overview by Khursheed Mama, DVM, DACVA Colorado State University
Geriatric patients require special considerations during anesthesia because of the widespread changes caused by age.
Which of the following age-related changes must be considered in geriatric patients?
Reduced cardiovascular functional reserve caused by myocardial fibrosis and ventricular free wall thickening
Total requirement for anesthetics declines as cognitive and sensory functions diminish
The rate of drug metabolism and excretion significantly decreases as hepatic function decreases
Widespread pulmonary changes cause a decline in the arterial oxygen concentration
All of the above
The correct answer is E.
To compensate for decreased cardiac output, geriatric patients increase stroke volume more than heart rate. This increase is accomplished mainly through increased preload and atrial kick. Increased incidence of heart disease (most notably valvular disease), as well as various arrhythmias, may also be seen in geriatric patients.
The central nervous system of geriatric patients is also more affected by anesthesia than that of younger patients. The exact cause of this apparent increased sensitivity to anesthetics is unknown, but theories include neuron loss, depletion of neurotransmitters, decreased receptor affinity, and changes in myelination.
Geriatric patients may have a decrease in liver mass of up to 50%, which leads to decreases in available hepatic enzymes. Additionally, the age-related decrease in cardiac output decreases blood flow to the liver. Products of the liver, such as coagulation factors, plasma proteins, and glucose, may also be decreased.
Mechanically, the geriatric patient loses thoracic compliance, has atrophy of the intercostal muscles, and loses alveolar elasticity, resulting in decreased pulmonary function. These changes cause a decline in the arterial oxygen concentration. The response to decreased oxygen or increased carbon dioxide is also blunted, creating a slower ventilatory response to respiratory depression or apnea.
Read more: Geriatric Anesthesia & Analgesia by Courtney L. Baetge, DVM, & Nora S. Matthews, DVM, Diplomate ACVA, Texas A&M University
The correct answer is E.
To compensate for decreased cardiac output, geriatric patients increase stroke volume more than heart rate. This increase is accomplished mainly through increased preload and atrial kick. Increased incidence of heart disease (most notably valvular disease), as well as various arrhythmias, may also be seen in geriatric patients.
The central nervous system of geriatric patients is also more affected by anesthesia than that of younger patients. The exact cause of this apparent increased sensitivity to anesthetics is unknown, but theories include neuron loss, depletion of neurotransmitters, decreased receptor affinity, and changes in myelination.
Geriatric patients may have a decrease in liver mass of up to 50%, which leads to decreases in available hepatic enzymes. Additionally, the age-related decrease in cardiac output decreases blood flow to the liver. Products of the liver, such as coagulation factors, plasma proteins, and glucose, may also be decreased.
Mechanically, the geriatric patient loses thoracic compliance, has atrophy of the intercostal muscles, and loses alveolar elasticity, resulting in decreased pulmonary function. These changes cause a decline in the arterial oxygen concentration. The response to decreased oxygen or increased carbon dioxide is also blunted, creating a slower ventilatory response to respiratory depression or apnea.
Read more: Geriatric Anesthesia & Analgesia by Courtney L. Baetge, DVM, & Nora S. Matthews, DVM, Diplomate ACVA, Texas A&M University
The correct answer is E.
To compensate for decreased cardiac output, geriatric patients increase stroke volume more than heart rate. This increase is accomplished mainly through increased preload and atrial kick. Increased incidence of heart disease (most notably valvular disease), as well as various arrhythmias, may also be seen in geriatric patients.
The central nervous system of geriatric patients is also more affected by anesthesia than that of younger patients. The exact cause of this apparent increased sensitivity to anesthetics is unknown, but theories include neuron loss, depletion of neurotransmitters, decreased receptor affinity, and changes in myelination.
Geriatric patients may have a decrease in liver mass of up to 50%, which leads to decreases in available hepatic enzymes. Additionally, the age-related decrease in cardiac output decreases blood flow to the liver. Products of the liver, such as coagulation factors, plasma proteins, and glucose, may also be decreased.
Mechanically, the geriatric patient loses thoracic compliance, has atrophy of the intercostal muscles, and loses alveolar elasticity, resulting in decreased pulmonary function. These changes cause a decline in the arterial oxygen concentration. The response to decreased oxygen or increased carbon dioxide is also blunted, creating a slower ventilatory response to respiratory depression or apnea.
Read more: Geriatric Anesthesia & Analgesia by Courtney L. Baetge, DVM, & Nora S. Matthews, DVM, Diplomate ACVA, Texas A&M University
The correct answer is E.
To compensate for decreased cardiac output, geriatric patients increase stroke volume more than heart rate. This increase is accomplished mainly through increased preload and atrial kick. Increased incidence of heart disease (most notably valvular disease), as well as various arrhythmias, may also be seen in geriatric patients.
The central nervous system of geriatric patients is also more affected by anesthesia than that of younger patients. The exact cause of this apparent increased sensitivity to anesthetics is unknown, but theories include neuron loss, depletion of neurotransmitters, decreased receptor affinity, and changes in myelination.
Geriatric patients may have a decrease in liver mass of up to 50%, which leads to decreases in available hepatic enzymes. Additionally, the age-related decrease in cardiac output decreases blood flow to the liver. Products of the liver, such as coagulation factors, plasma proteins, and glucose, may also be decreased.
Mechanically, the geriatric patient loses thoracic compliance, has atrophy of the intercostal muscles, and loses alveolar elasticity, resulting in decreased pulmonary function. These changes cause a decline in the arterial oxygen concentration. The response to decreased oxygen or increased carbon dioxide is also blunted, creating a slower ventilatory response to respiratory depression or apnea.
Read more: Geriatric Anesthesia & Analgesia by Courtney L. Baetge, DVM, & Nora S. Matthews, DVM, Diplomate ACVA, Texas A&M University
To compensate for decreased cardiac output, geriatric patients increase stroke volume more than heart rate. This increase is accomplished mainly through increased preload and atrial kick. Increased incidence of heart disease (most notably valvular disease), as well as various arrhythmias, may also be seen in geriatric patients.
The central nervous system of geriatric patients is also more affected by anesthesia than that of younger patients. The exact cause of this apparent increased sensitivity to anesthetics is unknown, but theories include neuron loss, depletion of neurotransmitters, decreased receptor affinity, and changes in myelination.
Geriatric patients may have a decrease in liver mass of up to 50%, which leads to decreases in available hepatic enzymes. Additionally, the age-related decrease in cardiac output decreases blood flow to the liver. Products of the liver, such as coagulation factors, plasma proteins, and glucose, may also be decreased.
Mechanically, the geriatric patient loses thoracic compliance, has atrophy of the intercostal muscles, and loses alveolar elasticity, resulting in decreased pulmonary function. These changes cause a decline in the arterial oxygen concentration. The response to decreased oxygen or increased carbon dioxide is also blunted, creating a slower ventilatory response to respiratory depression or apnea.
Read more: Geriatric Anesthesia & Analgesia by Courtney L. Baetge, DVM, & Nora S. Matthews, DVM, Diplomate ACVA, Texas A&M University
What parameters correspond to mild hypoxemia?
SaO2, 98%–96%; PaO2, 90–100 mmHg [12-13.33 kPa]
SaO2, 94%–96%; PaO2, 70–90 mm Hg [9.33-12 kPa]
SaO2, 91%–94%; PaO2, 60–70 mm Hg [8-9.33 kPa]
SaO2, <91%; PaO2, <60 mm Hg [<8 kPa]
The correct answer is B.
Mild hypoxemia causes increased heart rate, cardiac output, and systemic vascular resistance; mild hypertension may occur. If allowed to progress, severe hypoxemia allows local depressant effects to dominate; blood pressure falls rapidly, the heart rate slows, shock develops, and ventricular fibrillation or asystole follows.
Tissue hypoxia can also be inferred when the pulse oximetry reading is less than 97%. False hypoxemic readings are common with pulse oximeters, so any value less than 97% should prompt an immediate assessment of the patient's clinical signs before deciding whether a reading is spurious.
Read more: Detection & Correction of Hypoxia During Anesthesia by Christine M. Egger, DVM, Diplomate ACVA
Mild hypoxemia causes increased heart rate, cardiac output, and systemic vascular resistance; mild hypertension may occur. If allowed to progress, severe hypoxemia allows local depressant effects to dominate; blood pressure falls rapidly, the heart rate slows, shock develops, and ventricular fibrillation or asystole follows.
Tissue hypoxia can also be inferred when the pulse oximetry reading is less than 97%. False hypoxemic readings are common with pulse oximeters, so any value less than 97% should prompt an immediate assessment of the patient's clinical signs before deciding whether a reading is spurious.
Read more: Detection & Correction of Hypoxia During Anesthesia by Christine M. Egger, DVM, Diplomate ACVA
The correct answer is B.
Mild hypoxemia causes increased heart rate, cardiac output, and systemic vascular resistance; mild hypertension may occur. If allowed to progress, severe hypoxemia allows local depressant effects to dominate; blood pressure falls rapidly, the heart rate slows, shock develops, and ventricular fibrillation or asystole follows.
Tissue hypoxia can also be inferred when the pulse oximetry reading is less than 97%. False hypoxemic readings are common with pulse oximeters, so any value less than 97% should prompt an immediate assessment of the patient's clinical signs before deciding whether a reading is spurious.
Read more: Detection & Correction of Hypoxia During Anesthesia by Christine M. Egger, DVM, Diplomate ACVA
The correct answer is B.
Mild hypoxemia causes increased heart rate, cardiac output, and systemic vascular resistance; mild hypertension may occur. If allowed to progress, severe hypoxemia allows local depressant effects to dominate; blood pressure falls rapidly, the heart rate slows, shock develops, and ventricular fibrillation or asystole follows.
Tissue hypoxia can also be inferred when the pulse oximetry reading is less than 97%. False hypoxemic readings are common with pulse oximeters, so any value less than 97% should prompt an immediate assessment of the patient's clinical signs before deciding whether a reading is spurious.
Read more: Detection & Correction of Hypoxia During Anesthesia by Christine M. Egger, DVM, Diplomate ACVA
Alpha-2 agonist drugs can be used in obese patients in most cases.
True or False?
True
False
Obese patients are considered at higher risk for anesthetic-associated complications; alpha-2 agonists are best avoided, particularly in those patients that have compromised physiologic functions, because of the significant cardiovascular-depressing effects of these drugs.
Read more: Anesthesia Tips for the Obese Patient by Stuart Clark-Price, DVM, MS, Diplomate ACVIM & ACVA, University of Illinois
Obese patients are considered at higher risk for anesthetic-associated complications; alpha-2 agonists are best avoided, particularly in those patients that have compromised physiologic functions, because of the significant cardiovascular-depressing effects of these drugs.
Read more: Anesthesia Tips for the Obese Patient by Stuart Clark-Price, DVM, MS, Diplomate ACVIM & ACVA, University of Illinois
Hypothermia is one of the most common anesthetic complications in small animals.
Which patient would you most anticipate would exhibit hyperthermia during the recovery period?
A cat that received ketamine as a sedative before anesthesia
A dog that received propofol during induction
A cat that received a local ring block with lidocaine and bupivacaine for an onychectomy
A dog with Addison’s disease undergoing a routine dental prophylaxis
Some cats become hyperthermic during the recovery period, especially if they received a dissociative drug (eg, ketamine) or an opioid (eg, hydromorphone). Temperatures exceeding 106º F (41º C) have been recorded in cats hours after receiving a μ-agonist opioid. Supportive care (eg, IV fluids, a fan, a sponge bath) is effective in restoring normothermia.
Read more: Promoting Smooth Anesthetic Recovery by P. K. Hendrix, DVM, PhD, Diplomate ACVA, Mississippi State University
The correct answer is A.
Some cats become hyperthermic during the recovery period, especially if they received a dissociative drug (eg, ketamine) or an opioid (eg, hydromorphone). Temperatures exceeding 106º F (41º C) have been recorded in cats hours after receiving a μ-agonist opioid. Supportive care (eg, IV fluids, a fan, a sponge bath) is effective in restoring normothermia.
Read more: Promoting Smooth Anesthetic Recovery by P. K. Hendrix, DVM, PhD, Diplomate ACVA, Mississippi State University
The correct answer is A.
Some cats become hyperthermic during the recovery period, especially if they received a dissociative drug (eg, ketamine) or an opioid (eg, hydromorphone). Temperatures exceeding 106º F (41º C) have been recorded in cats hours after receiving a μ-agonist opioid. Supportive care (eg, IV fluids, a fan, a sponge bath) is effective in restoring normothermia.
Read more: Promoting Smooth Anesthetic Recovery by P. K. Hendrix, DVM, PhD, Diplomate ACVA, Mississippi State University
The correct answer is A.
Some cats become hyperthermic during the recovery period, especially if they received a dissociative drug (eg, ketamine) or an opioid (eg, hydromorphone). Temperatures exceeding 106º F (41º C) have been recorded in cats hours after receiving a μ-agonist opioid. Supportive care (eg, IV fluids, a fan, a sponge bath) is effective in restoring normothermia.
Read more: Promoting Smooth Anesthetic Recovery by P. K. Hendrix, DVM, PhD, Diplomate ACVA, Mississippi State University
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