Pregeneral anaesthetic blood screening of dogs and cats attending a UK practice

[Common veterinary practice in small animal anesthesia - an online survey among small animal practitioners in Europe]

OBJECTIVES

Survey concerning the situation of small animal anesthesia in Europe and assessment of the compliance with the guidelines of the AVA (American Society of Anesthesiologists) and the DVG specialty group VAINS (Veterinary Anesthesia, Intensive Care, Emergency Medicine, and Pain Management).

MATERIAL AND METHODS

A link to an online survey with questions concerning anesthesia management (topics include demographics, equipment, monitoring, thermal management, pre-anesthetic examination, anesthetic protocol, and others) was sent to small animal practitioners in several countries.

RESULTS

A total of 767 evaluable questionnaires came from Germany (n = 343), Austria (n = 216), Switzerland (n = 83), the United Kingdom (n = 38), France (n = 25), Hungary (n = 25), Scandinavia (n = 23), and "other countries" (n = 11). On average, 91 % of respondents complied with the AVA guideline and 58 % complied with the VAINS specialty group guideline even before its publication. Practices/clinics with higher staff possessed superior equipment, and practices/clinics performing higher numbers of anesthesias per week were more likely to implement "good preliminary examination."

CONCLUSION AND CLINICAL RELEVANCE

Although the guidelines were found to be implemented to a certain degree, the presented study reveals a potential for optimization of the anesthesia regime in many practices/clinics, e. g. by improving the equipment or allowing for better use of present apparatus.

Preanaesthetic blood tests in cats and dogs older than 8 years: anaesthetists' prediction and peri-anaesthetic changes

OBJECTIVE

To evaluate the anaesthetist's ability to predict abnormalities in preanaesthetic blood test results obtained from cats and dogs older than 8 years and to describe the impact of these preanaesthetic blood test results on the American Society Anesthesiologists (ASA) physical status classification, anaesthetic protocol and procedures.

STUDY DESIGN

Observational, prospective, clinical multi-centre study.

ANIMALS

A total of 333 cats and dogs.

METHODS

After a clinical examination and review of the animal´s clinical history the anaesthetist completed the first part of a set of questions including ASA status and anticipated abnormalities in blood tests. After this, blood results were presented, and the anaesthetist completed the second part of the set of questions, including changes in ASA status or anaesthetic protocol, and procedure delay or cancellation. Preanaesthetic blood tests included: haematocrit, total proteins, electrolytes, glucose, lactate, urea and creatinine. Examiners were classified as senior clinicians, clinicians, anaesthesia residents or nurses, and interns. For statistical analysis, the chi-square test was used. A p value < 0.05 was considered significant.

RESULTS

The ASA status increased in three dogs and one cat (1.2%); in two of them abnormalities were not expected by the examiner. The anaesthetic protocol changed in seven animals (2.1%); the most common change related to fluid therapy. Anaesthesia was delayed in two dogs (0.6%) to administer intravenous fluid therapy. No cases were cancelled. Abnormalities were more commonly found [37 out of 58 assessments (approximately 64%)] when the anaesthetist predicted them compared to when they were unexpected [49 of 275 assessments (approximately 18%); p < 0.001].

CONCLUSIONS AND CLINICAL RELEVANCE

Routine non-targeted blood tests in cats and dogs older than 8 years led to few changes in the anaesthetic management, and anaesthetists correctly predicted blood test results in most cases.

Pre-anaesthetic clinical examination influences anaesthetic protocol in dogs undergoing general anaesthesia and sedation

OBJECTIVES

Identify whether pre-anaesthetic clinical examination influences anaesthetic and analgesic agents and techniques protocol in dogs presented for general anaesthesia and sedation at a large referral hospital.

MATERIALS AND METHODS

In this prospective clinical audit, 554 dogs, undergoing general anaesthesia or sedation for surgical, diagnostic or imaging procedures were included. Multiple attending anaesthetists completed a questionnaire divided into four sections (American Society of Anesthesiologists physical status classification, anaesthetic and analgesic agents and techniques protocol, pre-anaesthetic clinical examination findings and changes made to the anaesthetic protocol). The attending anaesthetist was able to review the patient's history before planning the anaesthetic and analgesic agents and techniques protocol. The patients were examined and changes in American Society of Anesthesiologists physical status classification or anaesthetic protocol were recorded.

RESULTS

The initial anaesthetic and analgesic agents and techniques protocol was altered in 23.3% (n=129/554) of cases following a pre-anaesthetic clinical examination, but American Society of Anesthesiologists physical status reclassification occurred in only 8.0% (n=37/464) of cases. Multivariable logistic regression analysis showed that pre-anaesthetic clinical examination performed by European College of Veterinary Anaesthesia and Analgesia diplomates (odds ratio 5.8, 95% confidence interval 2.0 to 17.2), compared to anaesthesia interns, and the presence of an audible heart murmur (odds ratio 2.4, 95% confidence interval 1.4 to 4.4) were factors linked to changes in anaesthetic and analgesic agents and techniques protocol, whereas for each one kilogram increase in patient's weight, the odds of a change in anaesthetic and analgesic agents and techniques protocol to occur decreased by 1.7% (odds ratio 0.98, 95% confidence interval 0.97 to 1.0).

CLINICAL SIGNIFICANCE

Pre-anaesthetic clinical examination has impact on American Society of Anesthesiologists physical status classification, therefore estimation of patient's anaesthetic risk, and influences anaesthetic and analgesic agents and techniques protocol choice.

Readability and content of online pet obesity information

OBJECTIVE

To assess the readability of pet obesity information, document the presence and absence of types of pet obesity information, and perform comparisons between dog and cat obesity information content on websites.

SAMPLE

68 websites containing pet obesity content.

PROCEDURES

Websites were systematically retrieved with a search engine and predefined search terms and phrases. For each website, pet obesity information was scored by use of 2 established readability tools: the simple measure of gobbledygook (SMOG) index and Flesch-Kincaid (FK) readability test. A directed content analysis was conducted with a codebook that assessed the presence or absence of 103 variables across 5 main topics related to pet obesity on each website.

RESULTS

The mean reading grade levels determined with the SMOG index and FK readability test were 16.61 and 9.07, respectively. Instructions for weight measurement and body condition scoring were found infrequently, as were nonmodifiable risk factors. There was a greater focus on addressing obesity through dietary changes than through increasing physical activity. Few websites recommended regular follow-up appointments with veterinarians. Weight management information and the emphasis on owners' commitment to achieve their pet's weight loss targets differed among dog- and cat-focused websites.

CONCLUSIONS AND CLINICAL RELEVANCE

Results indicated that pet obesity information on the studied websites was largely inaccessible to pet owners owing to the associated high reading grade levels. Readers of that information would benefit from clarification of information gaps along with provision of guidance regarding navigating online information and counseling on the importance of nutritional and dietary reassessments for individual pets performed by veterinarians.

2019 AAHA Canine Life Stage Guidelines*

The guidelines are an update and extension of the AAHA Canine Life Stage Guidelines published in 2012. A noteworthy change from the earlier guidelines is the division of the dog’s lifespan into five stages (puppy, young adult, mature adult, senior, and end of life) instead of the previous six. This simplified grouping is consistent with how pet owners generally perceive their dog’s maturation and aging process and provides a readily understood basis for an evolving, lifelong healthcare strategy. The guidelines provide the following recommendations for managing 10 health-related factors at each of the first four canine life stages: lifestyle effect on the patient’s safety, zoonotic and human safety risk, behavior, nutrition, parasite control, vaccination, dental health, reproduction, breed-specific conditions, and a baseline diagnostic profile.

AAFP Feline Anesthesia Guidelines

AIM

The overarching purpose of the AAFP Anesthesia Guidelines (hereafter referred to as the 'Guidelines') is to make anesthesia and sedation safer for the feline patient. Scope and accessibility: It is noteworthy that these are the first exclusively feline anesthesia guidelines authored by an expert panel, making them particularly useful as an extensively referenced, practical resource for veterinary practice teams. Because much of the key content is presented in tabular or visual format, the Guidelines have a high level of accessibility and convenience that invites regular usage. While the recommendations in the Guidelines focus primarily on client-owned cats, the content is also applicable to community-sourced animals with an unknown medical history.