When I inform a pet owner that I recommend a prophy, or teeth cleaning, I’m often asked, “Do you have to put him under anesthesia to do that?” But the REAL question they’re asking is, “Is it safe to put my pet under anesthesia?”

If there’s one thing I could effectively convey to the general pet-owning public, it would be the difference in quality of anesthesia drugs, monitoring equipment, and trained staff. Not all anesthesia is the same. I’ve heard plenty of stories of friends, relatives, and neighbors who’ve had a pet die under anesthesia when it came in for a simple routine procedure such as a prophy (or spay or neuter).

Since I joined Olathe Animal Hospital in 2004, I cannot think of ONE anesthetic death that occurred in association with a dental procedure.  And trust me, we remember major events like that. Out of curiosity, I ran a report to see just how many dental procedures (under anesthesia) we’ve performed in the last 5 years. In that time frame, we have performed 1,611 teeth cleanings under anesthesia, and have had NO anesthetic deaths.

While that should ease your mind a bit, what you really need to know more about are the safety precautions we take. Every patient undergoing an anesthetic dental procedure receives an IV catheter for IV fluid support (helps keep blood pressure up). Blood work is performed prior to the procedure to check internal organ function. A physical exam is performed on the day of the procedure to check heart health and hydration status. Monitoring equipment monitors the patient’s heart rate and oxygen levels. A technician is with the patient the whole time, watching breathing, temperature, and heart rate.

These precautions I described above are more than half the battle in terms of having a safe anesthetic event. Obviously the drugs used also play a significant role. Patients are premedicated (made sleepy) with an injection of hydromorphone (a sedating narcotic) and sometimes acepromazine (a sedative), depending on the patient’s anxiety and activity level. To induce a state of anesthesia, we use propofol IV. To maintain anesthesia, we use isoflurane gas, which is widely used in human medicine as well. The gas anesthesia is delivered through an endotracheal tube, which also allows assistance with ventilation if needed and prevents aspiration. Watch the video above to see the process of a dog undergoing anesthesia at Olathe Animal Hospital.

Radiograph of Milo's right stifle prior to surgery

Dr. Mark Romain has had special surgery training for a procedure called Tibial Tuberosity Advancement, or TTA. This surgery is performed on dogs who have sustained a cranial cruciate ligament injury (the “ACL” in people). Recently, Dr. Romain performed bilateral TTA on a beagle named Milo. This means both of Milo’s cruciate ligaments were injured, so he had the procedure done on both stifles at the same time.

The cranial cruciate ligament plays a crucial role in making sure the tibia bone does not slip out and forward from the stifle joint. ACL rupture in dogs is one of the most common causes of hindlimb lameness, and it almost always requires surgical correction.

Veterinarians can diagnose ACL rupture in dogs with a physical exam and radiographs (xrays). While stabilizing the femur in one hand, the other hand manipulates the tibia, and if the tibia slides forward like a drawer, this is indicative of cruciate ligament injury.

Radiograph of Milo's right stifle after surgery

The goal of TTA surgery is to limit this tibial thrust, which can be quite painful. Surgery begins by inspecting the stifle joint and removing the damaged cruciate ligament. The goal is to transfer the load of the joint from the patellar ligament to the quadriceps muscle. To achieve this, the veterinary surgeon makes a cut into the tibial tuberosity (bone). The tibial tuberosity is advanced into a position perpendicular to the tibial plateau, thus removing the load from the ruptured cruciate ligament. To keep this newly positioned tibial tuberosity in place, a titanium implant is secured to the bone, and a spacer and bone graft material is placed into the cleft between the bones. This helps stabilize the joint.

Post-operative care involves:

• Limited exercise
• Restriction of play
• Care of the surgical site
• Administration of medications
• Suture removal

Follow-up radiographs are usually taken 2 months after the surgery to ensure proper healing.

Milo had TTA surgery on both stifles, which is why he has bandages on both legs. This is taken the day after his surgery.

Milo’s surgery included an epidural to numb his hind limbs for 12-24 hours post-op, and he received a continuous IV infusion of hydromorphone, lidocaine, and ketamine (referred to as an HLK CRI in vet talk) for the next 48 hours to help control pain and provide optimum pain management.

• difficulty chewing food or dropping food while eating
• weight loss
• pawing at the mouth or facial swelling and/or pain

Similar clinical signs may occur with other ferret health problems such as oral tumors or insulinoma, which is why consultation with a veterinarian is helpful.
Veterinarians at Olathe Animal Hospital are well trained in dental care and routinely examine the ferret’s mouth for an assessment of overall oral health during the annual physical exam. If plaque and tartar have built up, a routine cleaning and polishing of the teeth may be recommended. This procedure is performed under general anesthesia so that a complete oral health assessment and dental cleaning can be thoroughly and safely performed. The soft tissues of the mouth including tongue, gums and the mouth lining are examined for evidence of infection or ulceration. A dental probe is used to examine all teeth for evidence of gingivitis and periodontal disease where pockets of infection exist between the tooth and gum. The teeth are examined for evidence of odor, pain, fractures, discoloration and root exposure. All healthy teeth are then scaled and polished. Fluoride treatment is available to help strengthen enamel and reduce any pain associated with unhealthy teeth. Dental radiographs (x-rays) may be necessary to assess the roots and surrounding bone for abnormalities.

In the event of a serious dental problem, such as a tooth crown fractures or tooth infections and abscesses, our doctors may recommend procedures such as surgical extractions, bonded sealants or root canals. A detailed treatment plan can be provided to discuss what will be involved.

It is important for you to know that not all veterinary hospitals approach surgery in the same way.  Advancements in veterinary medicine have allowed surgical procedures to be much safer than ever before.  You can rest assured that your pet will be provided the highest quality of care including pre-anesthetic testing (blood work), advanced monitoring from nurses, pain management, body temperature control, and the safest gas anesthesia.

When your pet is admitted to our hospital for surgery, several steps are taken before the actual surgery.  First, your pet’s attending doctor will do an examination to determine if there are any current issues that would prevent us from proceeding with surgery.  We normally will have run a blood panel prior to the day of the procedure.  If not, we will draw blood to run the panel in our lab on the morning of the procedure.  This important step tells us if the liver, kidneys, blood count, etc., are within normal limits.  If all is well, a nurse will administer pre-medications to reduce pain, calm your pet and reduce the amount of anesthesia needed.  Later, a short acting drug is given to allow your pet to fall asleep.  At that point, a breathing (tracheal) tube will be placed and a gas anesthesia/oxygen mix will be administered directly into the lungs. Isoflurane gas anesthesia is also used in human hospitals and is one of the safest on the market. Monitors will be attached to your pet showing heart rate, blood pressure, carbon dioxide exhaled and oxygen saturation.  Anesthesia can be adjusted accordingly, and the monitors also indicate if the pet is having any difficulties during the procedure before serious problems occur.

Our surgeries are performed in a sterile surgery suite with the doctors and nurses masked and gowned, and your pet’s surgery site is prepped and scrubbed.  Your pet is constantly monitored by an attending nurse during the procedure and when the surgery is complete, the gas anesthesia is turned off and only oxygen is administered.  Because the gas anesthetic is delivered directly to the lungs and exhaled rapidly, your pet will wake up fairly quickly with a nurse present.  At that point the breathing tube is removed, and the pet will be breathing on its own. Heating pads, warm air blankets and, in some cases, incubators are used to keep your pet warm and comfortable during and after the surgery.

Your pet continues to be monitored by our trained staff during the recovery period, and your pet can usually be released later the same day!  Owners are often amazed that their pet walks out to greet them on their own with little indication that they have been under general anesthesia. Your pet will even be sent home with a pain medication to maintain comfort levels at home!

Be assured that the health of your pet is our highest concern and we will do everything possible to maintain that health.

We are proud to be accredited by The American Animal Hospital Association (AAHA) and only 17% of the small animal practices throughout the United States can claim this distinction.

Things weren’t looking good for this Double-yellow headed Amazon parrot–she was 40 years old, had eaten seeds (sunflower seeds are her favorite!) her whole life, and she had just broken her wing (complete fracture of the right radius and ulna) after falling off her perch. The fact that she has not been on a healthy avian diet for such a long time can seriously affect her body’s ability to heal bone.

Surgery was the only hope of saving her broken wing. After checking blood work, which was delightfully normal, veterinarian J.C. Burcham performed surgery and placed an external fixator placed on her wing to stabilize the broken bones. Birds have some special requirements to ensure a safe anesthetic procedure. We placed an endotracheal tube to ensure an open airway and facilitate regular breathing. Birds also need to be kept warm so she on a circulating water blanket. We placed an intraosseous catheter in the ulna (on the opposite wing) so we could administer a balanced fluid solution during her surgery. This helps keep her blood pressure up, a crucial step in avian surgery.

Broken wing before surgery

An intramedullary pin joins the fragments of ulna together, while the fixator makes the wing more stable during recovery

Radiographs (xrays) were taken post-operatively to ensure correct placement of the pins, and she was sent home the following day. In all, she stayed in the hospital 3 days and received pain medication to help with the pain of surgery.

Six weeks after her surgery, she came back for her routine check-up. She was briefly anesthetized again so we could repeat xrays and the news was good! Adequate callus formation was holding the bones together and the fixator was removed. (The fixator was removed after the xray was taken, which is why you still see pins in this xray.)

6 week post-op recheck shows adequate callus formation and bone healing

Her wing has a slight droop to it, and probably always will, but she’s laughing and singing up a storm (like an Amazon should!), and her owners are pleased.

Did you know Olathe Animal Hospital offers free wellness exams and services for school pets?  Many school pets fall into the “exotics” category—i.e. not dogs and cats! They may include rabbits, guinea pigs, rats, birds, snakes, turtles, and others. The doctors at Olathe Animal Hospital have additional training in exotic animal medicine, and love treating and helping a wide variety of animals. By helping our area schools provide quality care for animals with unique needs, we can help not only the animals, but the students who learn from them and the schools who rely on them.  Usually this means routine health checks and educating students about proper husbandry, but occasionally it means saving an animal’s life—as was the case with Tank, the Argentinean Tegu from Olathe North High School .

Tank’s care-taker for the summer was concerned about his loss of appetite. After numerous x-rays, repeated trips to our office, and forced tube-feeding, it became apparent that Tank needed surgery. On June 12, 2009, Tank underwent an abdominal exploratory surgery. This surgery revealed a foreign body lodged in his intestines. It was removed uneventfully, and Tank made a full recovery. Thanks to Tank’s astute care-giver, and the caring doctors and staff at Olathe Animal Hospital , Tank is doing great!