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Anesthesia Techniques and Considerations in Veterinary Medicine, Exams of Nursing

An overview of various anesthesia techniques and considerations in veterinary medicine. It covers topics such as the necessary components of general anesthesia, the relative risks of different factors on spontaneous abortion, the devices and mechanisms involved in anesthesia administration, the management of hypotension and hypothermia during anesthesia, and the specific challenges associated with anesthesia in ruminants and swine. The document aims to equip veterinary professionals with a comprehensive understanding of the principles and best practices in administering anesthesia to animal patients, ensuring their safety and well-being during surgical and other medical procedures.

Typology: Exams

2023/2024

Available from 10/22/2024

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Anesthesiology Study Questions
2023 Update
tranquilization - ANS-a state of tranquility and calmness in which the animal is awake,
relaxed, and unconcerned about its surroundings. The animal is easily arousable and
will respond to painful stimuli.
sedation - ANS-more profound central nervous system depression than tranquilization
in which the animal is awake, sleepy, but still able to be aroused by stimulation. Minor
manipulations can be performed, and aggressive animals may be easier to handle.
surgical anesthesia - ANS-reversible loss of sensation to all or part of the body.
Unconsciousness, analgesia, and hyporeflexia (relaxation) are characteristic of the
anesthetic state. Additionally, lack of purposeful movement and prevention of
undesirable autonomic responsiveness are desirable anesthetic characteristics.
Anesthesia is produced by the administration of drugs that depress the central and/or
peripheral nervous systems.
balanced anesthesia - ANS-a technique of general anesthesia based on the concept
that administration of a mixture of small amounts of several neuronal depressants (for
example, narcotics and inhalational agents) maximizes the advantages, but not the
disadvantages of, the individual components of the mixture. (from medical-
dictionary.thefreedictionary.com)
dissociative anesthesia - ANS-type of general anesthesia in which the animal is
'dissociated' from its surroundings and unaware of external stimuli. These agents
interrupt neurotransmission between the thalamocortical and limbic areas of the CNS.
The animal retains some muscle rigidity (catalepsy); open eyes with palpebral reflexes;
and somewhat intact swallowing reflexes.
What are the 5 necessary components of general anesthesia? - ANS--
Unconsciousness
- Amnesia
- Analgesia (more accurately antinociception)
- Immobility
- Attenuation of autonomic response to noxious stimuli
Why is analgesia NOT a necessary component of general anesthesia? - ANS-because
when an animal is anesthetized it is unconscious and is therefore it cannot feel pain.
An animal in Stage 2 would show what kind of signs? Is this animal consciously aware
of its environment? - ANS-- Delirium or involuntary excitement
- No
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Anesthesiology Study Questions

2023 Update

tranquilization - ANS-a state of tranquility and calmness in which the animal is awake, relaxed, and unconcerned about its surroundings. The animal is easily arousable and will respond to painful stimuli. sedation - ANS-more profound central nervous system depression than tranquilization in which the animal is awake, sleepy, but still able to be aroused by stimulation. Minor manipulations can be performed, and aggressive animals may be easier to handle. surgical anesthesia - ANS-reversible loss of sensation to all or part of the body. Unconsciousness, analgesia, and hyporeflexia (relaxation) are characteristic of the anesthetic state. Additionally, lack of purposeful movement and prevention of undesirable autonomic responsiveness are desirable anesthetic characteristics. Anesthesia is produced by the administration of drugs that depress the central and/or peripheral nervous systems. balanced anesthesia - ANS-a technique of general anesthesia based on the concept that administration of a mixture of small amounts of several neuronal depressants (for example, narcotics and inhalational agents) maximizes the advantages, but not the disadvantages of, the individual components of the mixture. (from medical- dictionary.thefreedictionary.com) dissociative anesthesia - ANS-type of general anesthesia in which the animal is 'dissociated' from its surroundings and unaware of external stimuli. These agents interrupt neurotransmission between the thalamocortical and limbic areas of the CNS. The animal retains some muscle rigidity (catalepsy); open eyes with palpebral reflexes; and somewhat intact swallowing reflexes. What are the 5 necessary components of general anesthesia? - ANS-- Unconsciousness

  • Amnesia
  • Analgesia (more accurately antinociception)
  • Immobility
  • Attenuation of autonomic response to noxious stimuli Why is analgesia NOT a necessary component of general anesthesia? - ANS-because when an animal is anesthetized it is unconscious and is therefore it cannot feel pain. An animal in Stage 2 would show what kind of signs? Is this animal consciously aware of its environment? - ANS-- Delirium or involuntary excitement
  • No

Up to this point, your sophomore surgery dog has been quite stable at 1.25% isoflurane. However, when the ovarian pedicle is stretched, your dog's heart rate and respiratory rate increase. Is this dog: a) awake and feeling pain? - ANS-No Up to this point, your sophomore surgery dog has been quite stable at 1.25% isoflurane. However, when the ovarian pedicle is stretched, your dog's heart rate and respiratory rate increase. Is this dog: showing signs of autonomic stimulation? - ANS-Yes Up to this point, your sophomore surgery dog has been quite stable at 1.25% isoflurane. However, when the ovarian pedicle is stretched, your dog's heart rate and respiratory rate increase. Is this dog: purposefully responding to inadequate anesthesia? - ANS-No Medicine wishes to "sedate" a dog for percutaneous liver biopsy. Will sedation be sufficient to perform this procedure? Why or why not? - ANS-- No because a sedated animal is awake and will still be able to be aroused by this type of procedure

  • Not considered a minor manipulation, could be painful or uncomfortable past the point tolerated by a sedated animal When queried further, Medicine would prefer the dog in (5) to be unconscious, relaxed, analgesic, and nonresponsive to surgical stimulation. What specific term would best describe their request? - ANS-General anesthesia What is the minimum amount of laboratory data that should be obtained before anesthetizing a young, healthy animal? Why is this information important? - ANS-- Packed Cell Volume (PCV) and Total Protein (TP)
  • Prognostic indicators for how this patient will do under anesthesia Give an example of a type of patient that would be classified with each of the ASA physical status classes I through V. - ANS-- I- healthy puppy undergoing an OHE
  • II- mildly obese dog undergoing an uncomplicated ACL repair
  • III- Dog undergoing surgery for a HBC
  • IV- great dane undergoing surgery for a GDV
  • V- severe HBC with poor prognosis for surviving past the next 24 hours What types of abnormalities should be corrected prior to the administration of anesthetic drugs? Explain why. - ANS-- Stabilize the patient preoperatively: This may involve parenteral fluid administration, antibiotics, warmth, pain control, etc
  • Corrected in order to minimize surgical and anesthetic risk
  • These are all areas that are likely to be influenced by anesthetic drugs so you want them as close to normal as possible before you administer drugs that may alter these parameters What are the minimum physical exam findings that the anesthetist should be familiar with before administering anesthetic drugs? - ANS-- auscultate the heart and lungs
  • note any abnormal cardiac rhythms or murmurs

True or False: Exposure to trace amounts of waste anesthetic gases represents a significant risk to the pregnant veterinarian. - ANS-False What are the gas flow requirements for Mapleson-type non-rebreathing circuits based upon? - ANS-patient minute volume How is carbon dioxide removed in non-rebreathing circuits? - ANS-High fresh gas flows blow expired CO2 away during the expiratory pause What is the minimum oxygen flow requirement for circle rebreathing circuits based upon? - ANS-Patient 02 metabolic needs How is carbon dioxide removed in rebreathing circuits? - ANS-CO2 Absorber (Soda Lime) How can you decrease the time constant for an anesthetic circuit? - ANS-Increasing carrier gases flow rate What is the purpose of the flowmeter? - ANS-Deliver carrier gases to the vaporizer or patient when the vaporizer is off Your patient seems to be waking up 10 minutes after being connected to the gas anesthesia machine. Make a list of at least 6 possible reasons for this. - ANS-- Endotracheal cuff leak

  • Use of the oxygen flush valve to fill anesthetic circuit
  • Insufficient fresh gas flow rate
  • CO2 rebreathing
  • Vaporizer off, not connected, or empty
  • Stuck or malfunctioning one-way valves in circle rebreathing circuit Why would you use the oxygen flush valve? Describe an alternative method to achieve the same end? - ANS-- Bypasses vaporizer
  • Delivers large volumes of oxygen to breathing circuit (35 to 75 L/min)
  • Under high P (35-50 psi) - caution!!!
  • Used to clean and flush machine (anesthesia machine pressure/leak check)
  • Alternative- using flowmeter with vaporizer off What is the device that changes a high cylinder gas pressure to a constant lower working gas pressure? - ANS-Pressure regulator (aka pressure-reducing valve) What factors would influence your choice between using a non-rebreathing patient breathing circuit and a rebreathing patient breathing circuit for any given patient? - ANS- Patient size, cost of inhalants, patient body temperature

Why does the temperature of the anesthetic liquid fall as it is vaporized? Why is this important to vaporizer function? - ANS-- Heat is lost during vaporization and vapor pressure is related to temperature

  • Over time, the temperature, and thus, the anesthetic vapor pressure, will decrease
  • Heat can be added by using substances with high specific heat and thermal conductivity (i.e. copper, stainless steel) - temperature of the vaporizers (and therefore of the anesthetic) changes more slowly The gas flow in a Mapleson D-type circuit connected to a spontaneously breathing three KG. cat is inadvertently decreased from one liter per minute to 100 ml/min. How will this effect the functioning of the circuit? - ANS-This will impair CO2 removal and also will affect vaporizer inhalant output Your reservoir bag is continually becoming empty (every minute) and your partner suggests repeated filling with the oxygen flush. Do you foresee any potential problems with this? - ANS-This will dilute the inhalant concentration in the system and your patient will likely become too light. Describe a method to check out an anesthetic machine prior to use. - ANS-1. TURN ON CARRIER GAS CYLINDER OR CONNECT THE ANESHTESIA MACHINE TO AN INTERMEDIATE PRESSURE CARRIER GAS SOURCE.
  1. CHECK VAPORIZER FOR LIQUID ANESTHETIC.
  2. CHECK SODA LIME
  3. CHECK FOR ALL NECESSARY PARTS OF THE BREATHING CIRCUIT
  4. PRESSURE/LEAK TEST THE ANESTHESIA MACHINE WITH THE BREATHING CIRCUIT.
  • Occlude patient breathing circuit; close pop-off/APL valve; Inflate circuit with O2 (to 20- 40 CmH2O on manometer); Observe for leaks; circuit should hold pressure with < 250 ml/min flow rate; Open circuit outflow (pop-off/APL valve) valve and note that scavenger interface is not obstructed (scavenger bag not too full or too empty). The CO2 absorber in a circle system is filled with what material? - ANS-Soda Lime CO Absorbent You wander into a room to pick out an anesthesia machine for a case. The absorbent granules are white, the same color as they were when the canister was first filled 3 months ago. Are the granules still good? Explain. - ANS-No, normally will get exhaust after using for 6 hours Your patient is light, so you turn up the vaporizer. What else should you do to speed the rate of change in anesthetic vapor concentration? - ANS-- Increase carrier gas flow rate to decrease time constant Define the terms "analgesia" and "hypnosis". How do they differ? - ANS-- Analgesia- absence of pain

List 3 differentials for absence of a CO2 waveform following endotracheal intubation ("it's broken" or "it's not turned on/plugged in" are not acceptable answers!). - ANS-- Apnea

  • Esophageal intubation
  • Stuck circle circuit valve
  • Occluded device sampling tube
  • Cardiac arrest
  • Pulmonary embolism Adequacy of ventilation is defined solely by what objective parameter? - ANS-Carbon dioxide levels in the last gas exiting the lungs during normal tidal expiration (capnograph) List 7 subjective methods for assessing depth of anesthesia. Which is arguably the most useful sign? - ANS-- Reflex activity (e.g. palpebral, corneal, pedal withdrawal)- arguably the most useful sign
  • Eye position (depends on species and anesthetic in use)
  • Muscle relaxation (e.g. jaw tone)
  • Heart rate, pulse quality and strength
  • Respiratory rate, volume, character
  • Mucous membrane color and refill time
  • Response to noxious stimuli (e.g., surgical) List the 4 guidelines for monitoring veterinary patients advocated by the ACVA. - ANS-- Assessment of circulation
  • Assessment of ventilation
  • Maintenance of an anesthetic record of events
  • Assignment of a responsible person to be aware of the patient's status and prepared to intervene if necessary Describe Guedel's stage 1 of anesthesia - ANS-"Stage of voluntary movement": patient is awake or may be asleep, but can be aroused. This stage lasts until ataxia and the loss of righting reflex occurs, indicating the beginning of loss of consciousness. Describe Guedel's stage 2 of anesthesia - ANS-"Stage of delirium or involuntary excitement": this stage lasts from the loss of consciousness to the onset of regular breathing. The CNS is depressed and the patient may show signs of exaggerated reflex activity such as violent struggling, vocalization, swallowing, urination and/or defecation, dilated pupils, breath holding and/or hyperpnea, and tachypnea. Palpebral reflexes will be prominent, and vomiting can occur. It is important to realize that these patients are not conscious and not aware of what they are doing. Describe Guedel's stage 3 of anesthesia - ANS-- "Stage of surgical anesthesia": Subdivided into:
  • "Light" - spontaneous eyeball movement may be present (e.g., nystagmus in horses); may respond to toe pinch, brisk palpebral reflex present; strong jaw tone in small

animals; ruminants eyes rotated ventrally. - "Medium"- stable respiration and pulse; abolished laryngeal reflexes and response to toe pinch; sluggish palpebral reflex (may be absent in small animals), strong corneal reflex; adequate muscle relaxation as judged by relaxed jaw tone; ruminants pupil central but not dilated; no purposeful response to noxious stimuli. This is where we want our patients for surgery!

  • "Deep" - decreased intercostal muscle function and reduced tidal volume, increased respiratory rate, diaphragmatic (abdominal) breathing (Why? See tachypnea differential list below); profound muscle relaxation; weak (absent in the horse) corneal reflex; ventrally rotated pupil in ruminants (globe position depends on species and anesthetic in use); pupil sluggish or non-responsive to light Describe Guedel's stage 4 of anesthesia - ANS-"Stage of medullary depression": the CNS is extremely depressed and spontaneous respiration ceases. The heart continues to beat for only a short time. Blood pressure is low, capillary refill is markedly delayed, pupils are widely dilated and nonresponsive to light, sphincter tone is lost. Let's not go here! Why is lactated Ringer's solution a good all-purpose crystalloid fluid to give to uncomplicated cases during anesthesia? - ANS-LRS is readily available and expands both the vascular and interstitial compartments. Is an IV fluid administration rate of 10 ml/kg/hr always necessary during anesthesia? Why or why not? - ANS-- No this rate is arbitrary and not based on medical evidence
  • The fluid rate depends on your patient, ideally in's should equal out's What are the critical mean arterial pressures that describe the upper and lower limits of autoregulation of tissue blood flow? - ANS-60 and 160 mmHg Why is mean arterial pressure not necessarily a good indicator of tissue perfusion? - ANS-- MAP = Cardiac Output (CO) x Systemic Vascular Resistance (SVR)
  • Changes in MAP during anesthesia are generally assumed to track CO; this, however, is assumes an unchanging SVR (which is clearly not always the case). Anesthetics can profoundly affect vascular resistance as can changes in sympathoadrenal and autonomic activity associated with anesthesia and surgical procedures. Describe your multiple-step action plan to improve blood pressure in an anesthetized patient. - ANS-1. Check anesthetic depth and lighten the patient if possible
  1. Evaluate the HR - increasing the HR into a normal range should increase CO
  2. Give an IV fluid bolus
  3. Start an inotrope/pressor infusion (if all of the above doesn't work)
  • Inotropes improve perfusion (and blood pressure) by increasing the contractility of the heart
  • Pressors increase vascular tone (thus increased vascular resistance)

True or False: Waste anesthetic gases can contribute to the Greenhouse effect as well as deplete the ozone layer. - ANS-True True or False: The NIOSH and ACGIH concentrations were established because they were found to be attainable utilizing clinical scavenging techniques and there are no controlled studies proving exposure at these concentrations are safe. - ANS-True True or False: Scavenging techniques are not needed if you are using inhaled anesthetics in a tent in the middle of an island. - ANS-False Which anesthetic agent is MOST associated with intraoperative hypotension? - ANS- Inhaled anesthetics The intravascular residence time for isotonic crystalloid solutions like Plasmalyte M or lactate Ringer's solution is: - ANS-30 min The intravascular residence time for isotonic colloid solutions like Vetastarch or Hetastarch is: - ANS- 12 - 24 hrs (based on study, species/individual) True or False: Giving > 10 ml/kg/hr of isotonic crystalloid fluids during anesthesia will increase urine production. - ANS-False A patient with previously normal blood volume undergoes cardiac arrest during anesthesia. You should: - ANS-Administer a vasopressor A 12 yr old Golden Retriever dog arrives in the ICU on a Friday afternoon. The dog has severe inspiratory dyspnea, cyanosis, and an exaggerated, labored thoracic and abdominal breathing pattern. A quick physical exam reveals a rectal temperature of 41. C, and stridor localized to the larynx. Laryngeal paralysis is suspected. How will you initially stabilize this patient? Be specific. - ANS-- Give oxygen

  • Sedate to decrease stress - acepromazine After initial attempts to stabilize the dog, soft tissue surgery service decides to do a laryngeal exam followed by placing a laryngeal suture prosthesis to abduct one of the arrytenoid cartiledges. What is your choice of premedication agent? Why? - ANS-- Ace + Butorphanol
  • Sedation and pain control in an otherwise healthy dog After initial attempts to stabilize the dog, soft tissue surgery service decides to do a laryngeal exam followed by placing a laryngeal suture prosthesis to abduct one of the arrytenoid cartiledges. What is your choice of induction agent? Why? - ANS-- Propofol
  • Quick onset of action, safe After initial attempts to stabilize the dog, soft tissue surgery service decides to do a laryngeal exam followed by placing a laryngeal suture prosthesis to abduct one of the

arrytenoid cartiledges. What is your choice of postoperative analegesic? Why? - ANS-- NSAIDS and possibly opioids (if more painful)

  • Safe analgesia as long as there is no contraindication
  • NSAIDs- reduce swelling After initial attempts to stabilize the dog, soft tissue surgery service decides to do a laryngeal exam followed by placing a laryngeal suture prosthesis to abduct one of the arrytenoid cartiledges. What is your choice of maintenance agent? Why? - ANS-- Iso or sevo
  • Rapid onset and recovery Oncology service presents you with a 14 yr old mixed breed dog for diagnostic workup prior to placing on hyperfractionated radiation therapy (ie. multiple daily doses of XRT so that the total radiation dose can be higher without excessive normal tissue toxicity). Lung metastases are noted on the awake chest radiographs. What effect, if any, will lung metastases have on your anesthetic plan? - ANS-Need to increase the fraction of inspired oxygen (FIO2) breathed by the patient (provide more supplemental oxygen) A puppy with cleft palate has aspiration pneumonia, but has to be anesthetized anyway. What can you do to optimize its respiratory status during the anesthetic period? Be specific. - ANS-Intubate with ET tube to ensure oxygen flow. Pneumonia is a parenchymal pulmonary dz so he has a low PaO2, low V/Q ratio. We fix this by increasing FiO2 (increasing FiO2 should increase PaO2 and allow for a normal V/Q ratio). A 4kg dachshund dog is anesthetized for a myelogram prior to a hemilaminectomy. After 2 hrs in radiology, the heart rate has fallen to 49 beats/min, and multiple doses of glycopyrolate have had no effect. How will you make the definitive diagnosis? - ANS- Take a rectal temperature A 4kg dachshund dog is anesthetized for a myelogram prior to a hemilaminectomy. After 2 hrs in radiology, the heart rate has fallen to 49 beats/min, and multiple doses of glycopyrolate have had no effect. How will you treat this animal? - ANS-- For hypothermia, give him a bair hugger, warm water blanket, heater, warm lavage fluids, shorten anesthesia time, etc.
  • Glycopyrrolate likely not working because it is inactive at lower temperatures. A miniature schnauzer dog arrives in ICU on the same July day as in question 1. It was locked it in a closed car for 30 min while its owner was running some errands. The dog is unconscious and has a weak, rapid pulse. How will you make the definitive diagnosis? - ANS-Take a rectal temperature A miniature schnauzer dog arrives in ICU on the same July day as in question 1. It was locked it in a closed car for 30 min while its owner was running some errands. The dog is unconscious and has a weak, rapid pulse. How will you treat this animal? - ANS--

True or False? Technical solutions and strict procedural guidelines have completely eliminated accidents. - ANS-False What are the two type of errors committed in medicine? - ANS-- Errors of ignorance

  • Errors of ineptitude What are the two key elements which make a system vulnerable to accidents? - ANS-- Complex interactions
  • Tight coupling True or False: Systems exhibiting complex interactions and tight coupling are more likely to have accidents than systems exhibiting linear interactions and loose coupling. - ANS-True What are three proven methods to prevent or reduce accidents? - ANS-- Teamwork! Checklists!
  • Dedicated person for monitoring: Monitor intra-op and post-op
  • Better P evaluation and preparation prior to Sx or sedation What is practical drift? Give an example in veterinary medicine. - ANS-- Defined by Scott Snook as the slow, steady uncoupling of local practice from best practice: Occurs when individuals try to meet operational requirements (greater throughout, lower costs, etc) by making small adjustments in recommended procedures and guidelines
  • Example: proceeding with surgery without running bloodwork An elective OHE has a subnormal temperature prior to induction. Your advice is to: - ANS-Stop and determine what is going on True or False? "Bad" drugs/acute drug reactions are a major cause for anesthetic accidents. - ANS-False What factors act to speed uptake and increase the effect of inhalant anesthetics during pregnancy? - ANS-Oxygen consumption is increased 20% during pregnancy Why should the calculated volume of local anesthetic be decreased 30-50 percent when performing an epidural block for C-section - ANS-Epidural/CSF spaces decrease 30- 50%: Less volume needed with epidural injection to reach specific dermatome What is "Ion trapping"? - ANS-- Highly lipid-soluble drugs cross easily: Non-ionized drugs more lipophilic, cross easier than ionized drugs
  • Opioids, local anesthetics are weak bases: Low ionization, considerable lipid solubility
  • Only "free", non-ionized drug will transfer, therefore maternal-fetal concentration gradients are important: At equilibrium, similar levels in fetal and maternal circulation; In acidotic fetus, weak bases tend to be in ionized form, get "trapped", and cause drug accumulation

What was the leading cause of maternal mortality in a retrospective study of dogs undergoing caesarean section? - ANS-aspiration pneumonia What general anesthetic protocol was found to have a live pup birth rate similar to the accepted gold standard - epidural anesthesia - during caesarian section? - ANS- Propofol/isoflurane What classes of drugs are associated with worsened pup survival outcome following caesarian section? - ANS-- any inhaled

  • anesthetic ketamine
  • thiobarbiturates Atropine, a tertiary amine, crosses the blood-brain barrier as well as the placenta. Will giving atropine to a pregnant animal increase fetal heart rate? What about a neonatal pup or kitten? Why or why not? - ANS-No, ineffective at <2 weeks of age Doxapram, an analeptic used to stimulate breathing, is often given to apneic neonates. Would doxapram be expected to have an effect in a hypoxic neonate? - ANS-No Your sophomore surgery dog is 52 days pregnant. Your plan is to perform an en blocligation and resection of the uterine horns containing the fetuses along with the ovaries. Following resection, the puppies within the uterine horns have palpable heartbeats. Are these in utero puppies sentient, conscious, and able to feel pain? Why or why not? - ANS-- No
  • Fetal movement or presence of fetal heartbeat does not indicate sentience or consciousness while in utero: But if fetuses are removed from uterus and exposed to air, consciousness is possible and now you have a welfare issue Your classmates decide to remove the puppies from the uterine horns to see what they look like. Are these ex utero puppies sentient, conscious, and able to feel pain? Why or why not? - ANS-Yes, exposed to oxygen so consciousness is possible Is oxygen necessary during routine neonatal resuscitation? How might oxygen supplementation make things worse? - ANS-- No
  • May have adverse effects on neonatal breathing physiology and cerebral circulation due to free radical formation Why is neonatal respiratory rate 2-3 times higher than in adults? What effect will this have on induction with inhalant anesthetics? - ANS-- Vt is same as adult (10-15 ml/kg)
  • Must be 2-3 times greater for minute volume to meet oxygen demand
  • Induced quicker What happens to cardiac output if bradycardia occurs in a neonate? What class of drugs can be useful in preventing bradycardia? - ANS-- Decreased

General anesthesia for ruminants is not routinely performed outside academic institutions and some small animal practices. List five frequently encountered problems associated with sedation and general anesthesia in ruminants. - ANS-- Difficulty visualizing arrytenoids - unable to open mouth wide.

  • Reflex regurgitation (esp with pharyngeal stimulation) can result in aspiration pneumonia
  • Bloat likely with prolonged recumbence
  • Profuse salivation: Antimuscarinics ineffective due to endogenous atropinases
  • Inhalants preferred for prolonged procedures Why is withholding food and water important in adult ruminants prior to general anesthesia? Based on your knowledge of ruminant physiology, how could this practice be deleterious in ruminants less than 1 month of age - ANS-- Prolonged fasting reduces heart rate through increased parasympathetic tone
  • Not ruminating, monogastric Active regurgitation in ruminants is seen most often during (deep or light) anesthesia? What specific required procedure associated with induction of general anesthesia can precipitate active regurgitation in ruminants? - ANS-- Light
  • Pharyngeal stimulation True or False: Endotracheal tube placement is highly recommended when performing ruminant general anesthesia. Why? - ANS-- False
  • Hard to get back and see what you're doing: Obligate nose breathers; elevated base of tongue (torus linguae); Nasopharyngeal diverticulum; constrictive palatopharygeal arch at end of soft palate forms an ostium; Epiglottis and arytenoid cartilages protrude through intrapharyngeal ostium into nasopharynx Short term intravenous anesthesia is a relatively common practice in horses for minor surgical procedures out "in the field". What species differences make this technique more risky in ruminants? - ANS-- Unguarded airway
  • Difficulty visualizing arrytenoids - unable to open mouth wide.
  • Reflex regurgitation (esp with pharyngeal stimulation) can result in aspiration pneumonia What side effects are associated with the use of the alpha-2 agonist xylazine in ruminants? - ANS-hyperglycemia, diuresis, bloat, pulmonary hypertension, pulm edema, hypoxia Somebody suggests to you that you give atropine to a cow to decrease the amount of salivation under anesthesia. Is this a good idea? Support your answer. - ANS-No, antimuscarinics are ineffective due to endogenous atropinases. General anesthesia for swine is generally not performed outside of academic institutions and some small animal practices. List three frequently encountered problems

associated with porcine sedation and general anesthesia. - ANS-- Issues with ET tube intubation: Prone to laryngospasm (consider lidocaine spray); Long floppy epiglottis, poor laryngeal visualization; Ventral laryngeal diverticulum; Small tracheal diameter for size and weight

  • Limited IV access
  • Respiratory depression common
  • Low surface area to body mass, poor thermoregulatory function - easy to overheat
  • Variable responses to anesthetic agents Describe conditions under which extra label drug use may be considered. - ANS-- human-labeled drugs in animals(e.g., diazepam, midazolam)
  • use in a non-approved species(e.g., xylazine, dexmedetomidine, Telazol, propofol, ketamine, sevoflurane)
  • approved for a species, but used in a non-labeled indication or dosage Describe the four steps you, as a veterinary professional, must do to protect both yourself and your client. - ANS-- Make an accurate diagnosis within the context of a veterinarian-client relationship
  • Assure no labeled drug is available or appropriate for the circumstance
  • Positively identify the treated animal
  • Supply withdrawal information to the client in writing Why are swine prone to perioperative overheating? - ANS-Low surface area to body mass, poor thermoregulatory function What is malignant hyperthermia? How is it related to porcine stress syndrome? - ANS-- Single point pharmacogenetic defect in the ryanodine gene (HAL 1843 d(i)m(utant) affecting Ca2+ transport into muscle cells: recessive; only dm animals affected
  • Heavily muscled pig breeds: PSS triggered by stress, high environmental temps, exercise, mating, fighting; MH triggered by volatile anesthetics, depolarizing muscle relaxants, caffeine What are "stun" techniques applied to ruminants? Are they suitable for long surgical procedures? Why or why not? - ANS-- Basically, IV or IM induction with an injectable anesthetic
  • Short duration procedures (10-20 min)
  • Unguarded airway
  • Must use a drug that produces unconsciousness: Large doses of alpha-2 agonists do not produce anesthesia! Ruminants are known to be quite sensitive to xylazine and relatively small doses can render them recumbent. Can administration of large doses of xylazine produce a state of general anesthesia? - ANS-No A Boer Billy goat (last year's get-rich-quick species) insured for $30,000 dies while under general anesthesia to surgically repair a ruptured bladder secondary to urethral

A severely lame horse is to be donated to a local wild carnivore refuge for tiger food. Which of the following methods is most appropriate for euthanasia of this animal? - ANS-gunshot or penetrating captive bolt applied to the head Are inhaled agents ideal for euthanasia? Why or Why not? - ANS-- Acceptable with conditions: acceptable when certain conditions are met

  • Causes direct depression of neurons
  • Expensive; personnel exposure
  • CO2: works by decreasing interstitial pH and producing neural depression, not by hypoxia In your job as an USDA inspector in a slaughterhouse, you note that a pregnant cow is moving onto the kill floor. The workers are very concerned that the fetus may be drowning inside the uterus and want to rescue it. Is this a good idea? How will you explain this to the workers? - ANS-- No
  • Embryos and fetuses cannot consciously experience any sensations or feelings such as breathlessness or pain, and cannot suffer while dying in utero after the death of the dam, whatever the cause
  • All mammalian embryos or fetuses studied to date have been shown to remain in an unconscious state throughout pregnancy and birth.