Anesthesia by Pathology

Heart Disease

Diagnostic tests and surgical interventions can be delicate moments for our patients, especially when they are out of their usual environment and without the company of their family or loved ones. This situation can lead to increased nervousness, which complicates both the professionals' work and the patient's own health status.

Diagnostic tests and surgical interventions can be delicate moments for our patients, especially when they are out of their usual environment and without the company of their family or loved ones. This situation can lead to increased nervousness, which complicates both the professionals' work and the patient's own health status.

To ensure the well-being of our patients and to tailor the procedure to each individual, the chosen anesthetic protocol is based on various factors, such as the physical condition, the type of intervention to be performed, and the age of the animal.

 

In this regard, it is essential to conduct a pre-anesthetic consultation to get to know each patient who will undergo anesthesia in detail.

At IVeM, we take pride in providing comprehensive care for our patients, and the pre-anesthetic consultation is a fundamental part of our approach. We are committed to delivering the highest quality of veterinary care, ensuring that every patient feels cared for, comfortable, and safe before, during, and after any medical or surgical procedure.

Congenital and Acquired Heart Disease

During any anesthetic procedure, cardiovascular objectives focus on maintaining adequate oxygen and nutrient supply to all tissues, as well as removing waste products and maintaining overall homeostasis. However, achieving these goals can be a real challenge in patients with underlying cardiovascular disease.

In patients with cardiovascular disease, optimizing oxygen supply requires an understanding of the specific pathophysiology of the heart condition they present. Each heart pathology has particular clinical characteristics, as well as different degrees of severity, which can lead to compensated and decompensated patients.

In cardiac patients, it is crucial to master the use of anesthetic drugs and the available monitoring tools to balance the disease's pathophysiology with the effects of anesthetic drugs. Ultimately, an anesthetic plan must be individualized for each patient to minimize cardiovascular compromise.

Before anesthetizing animals with heart disease, it's important to obtain a complete medical history, paying special attention to signs of decompensation and the medications they are taking. If the disease has not been previously diagnosed, it is recommended to perform an echocardiogram to identify the specific problem and assess the animal's cardiac reserve.

In cases of left heart failure, the presence of pulmonary edema should be checked through a chest X-ray. Additionally, it is advisable to conduct an electrocardiogram before anesthesia to detect potential arrhythmias, which can often be identified during the physical examination.

If the procedure is not urgent, it is recommended to stabilize patients showing signs of congestive heart failure before anesthesia using medications such as diuretics, ACE inhibitors, pimobendan, beta-adrenergic blockers, and calcium channel blockers.

In animals with congestive heart failure or those receiving cardiac medication, it is advisable to determine blood pressure before administering any anesthetic drug. Cardiac medications can intensify the cardiovascular depressant effects of anesthetic drugs, so balanced anesthesia techniques should be used to allow for lower dosages.

Cardiac Arrhythmias

Arrhythmias in dogs and cats are disorders of the heart rhythm that affect the frequency or regular pattern of heart contractions. Under normal conditions, the heart beats regularly, allowing efficient blood pumping throughout the body. However, in the presence of arrhythmias, these contractions can become irregular or uncoordinated, potentially affecting heart function and adequate blood flow.

There are different types of arrhythmias, such as tachycardia (increased heart rate), bradycardia (decreased heart rate), and ventricular arrhythmias, among others. These arrhythmias can be caused by various underlying conditions, such as heart disease, electrolyte imbalances, stress, or even certain medications.

When considering a surgical procedure or any intervention requiring anesthesia in a dog or cat with arrhythmias, it is important to take additional precautions to ensure the animal's safety.

Precautions to take from an anesthesia perspective in dogs and cats with arrhythmias include:

  1. Pre-Anesthetic Cardiac Evaluation: Conduct a thorough examination of the heart before anesthesia.
  2. Pre-Stabilization: Stabilize the arrhythmia before the procedure if necessary.
  3. Constant Monitoring: Monitor heart rhythm, heart rate, and blood pressure during anesthesia.
  4. Safe Anesthetic Agents: Use drugs that have fewer negative effects on the heart and are safe in cases of arrhythmias.
  5. Emergency Preparedness: Have an action plan and the necessary equipment to address any cardiac complications during anesthesia.
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