Anesthesia and the Mastiff - By Robin M. Smith, DVM
Anesthesia and the Mastiff
By Robin M. Smith, DVM
I thought that I would talk about anesthesia concerns and the mastiff
since that is the most frequently asked question I get from mastiff
owners.
First off, you MUST have a veterinarian that is willing to listen to
you and who is not afraid to be questioned about their anesthesia
methods and how they monitor the pet once they are under anesthesia.
If they do not want to discuss this or if they have a comment like,
"well, I have always done it so and so way and I am not going to
change", find yourself another veterinarian. I think that the public
needs to be aware of exactly what is happening to their dogs and the
risks that are possible. ALL anesthesias are putting the dog at risk...
BUT there are some that are much safer than others and I will discuss
these.
To start, I want to mention a few anesthesias that I would avoid if at
all possible. In the past, most of these drugs were used exclusively,
but with the advent of the new drugs and safer ones, they should not
be used in the mastiff. Mastiffs are not just big chihauhas. The
mastiff generally has a slower heart rate than smaller dogs and they
also have inherently a lower blood pressure. They also, as you know,
have a larger body mass. These things add to the risk of anesthetizing
them.
I never use acepromazine anymore as a pre-anesthetic or tranquilizer.
Acepromazine lowers blood pressure and dilates blood vessels thereby
making the blood pressure even lower. It also is metabolized (gotten
rid of by the body) very slowly and tends to accumulate in fatty
tissues. Therefore, larger dogs and fatter dogs usually have to be
given a larger dose than normal in order to have effect, and because
of this, it takes these dogs sometimes days to get back to normal. I
have used it a lot in the past... In fact, it was the "gold standard"
for pre- anesthetic sedation, but not anymore. Many people have used
it in tablet form for tranquilization during stressful periods, i.e.
thunderstorms. Again, I used to use it for this, but do not now,
especially in giant breeds... It is too unpredictable. Just to let you
know, I use Benadryl for thunderstorms at a dose of 1 mg./lb but not
to exceed 100 mg. and find it works very well to make the dog tired
and rest better.
Xylazine (Rompun) is another drug I avoid. I haven't used it in about
5 years. It makes the heart more susceptible to the effects of
epinephrine (adrenalin) that is in the body and therefore, making the
dog more susceptible to heart abnormalities. It is a difficult drug to
dose in giant breed dogs.
Acepromazine and Xylazine are the two drugs that I try to avoid if
possible. If your veterinarian is also a large animal (cow, not
mastiff) veterinarian, he may very well use the two drugs as they are
used in farm animals a lot.
If for some reason, your veterinarian must use these two drugs, I
think it is mandatory that the dog be monitored by an EKG machine
during surgery and immediately post-operatively.
Other drugs that I do not use much although they are still used are
the thiopentals. These are like sodium pentathol. They work very
rapidly to knock the dog down, but are very powerful and stay in the
system a long time. Also if the drug gets out of the vein (like if the
dogs jump) the thiopentals can irritate the surrounding area and
completely slough the area (all the tissue dies).
The drug(s) that I use the most in mastiffs are valium, ketamine,
telazol, and propofol.
A combination of valium and ketamine given intravenously will be
enough to knock the dog down in order to insert the endotracheal tube.
Both of these drugs are very safe and I use them a lot in the older
dogs. Neither one effect the heart much.
Telazol is very similar to valium and ketamine and also works well for
anesthesia so that an endotracheal tube be place (I use .1 cc/lb and
do not exceed 1.5 cc total).
I do use propofol (deprivan) for short procedures, i.e. OFA
radiographs. Propofol is a fairly new drug in the veterinary field but
has been used for a long time in the human field. It is a milky
solution that after opening a vial cannot be stored. It gets
contaminated with bacteria very easily. Because it is expensive, the
veterinarian may try to cut corners and use old leftover propofol that
is sitting in the fridge. It is given to effect or in other words, it
is given IV until the dog goes down and then the dog is intubated and
put on gas. The GREAT thing about this drug is that as soon as the
animal is taken off the gas, the dog is awake and can walk out without
assistance. I have also used the drug in C-sections to sedate the dog
long enough to insert the endotracheal tube. It is a very top of the
line drug. I do find the dosages of propofol to be a lot lower than
the manufacturers literature dosage. One added thing: Propofol can
lower blood pressure so the pet needs to be monitored while on that.
I also use oxymorphone for sedation and sometimes as the sole sedative
for simple procedures like biopsy. It is an opiod and therefore it can
cause respiratory depression, which means that the dog needs to be
constantly monitored. There is a reversal agent called Naloxone that
will reverse the effects of the drug and works quite well.
I will always put the dog on gas for a fairly short procedure.
Isoforane is a gas of choice since it has fewer side effects.
Halothane is still being used by some veterinarians. I do not use it
since it (just like xylazine) sensitizes the heart which can cause
irregular beats. But, as long as the dog is properly monitored, there
should be no problem.
Prior to ANY anesthesia in any aged animal, I require a pre-anesthetic
blood work up. I get a PCV (monitors whether anemic or dehydrated), a
BUN (monitors liver and kidney function), Creatinine (monitors kidney
function), ALT (monitors liver function), Alkaline phosphates
(monitors liver and the biliary system), Total protein (monitors the
immune system and hydration status), glucose and the electrolytes
(sodium, potassium and chloride). I get these as I said even in young
animals... It is just good medicine to know where the dog is prior to
surgery and anesthesia so we will know how they will tolerate
anesthesia. It is the base line. These test also guide me to my use of
anesthesia. For example, if there is kidney damage I know to avoid
drugs that have to go through the kidney to be eliminated from the
body. The temperature is also monitored along with the heart by an EKG.
Atrophine was a drug that was used all the time as a pre-medication to
dry up the saliva in dogs and cats and to keep the heart rate up. It
is not used much anymore, or shouldn't be used in large and giant
breeds. I don't use it in any breed anymore. Atrophine causes the gut
to slow down and this is not good especially in the mastiff. I believe
slowing the gut down predisposes the mastiff to bloating.
Anesthetic Protocols:
- Routine spay or neuter. I hate the word ROUTINE used here
because no surgery is routine. I used valium at .3 mg/kg and ketamine
at 10 mg/kg IV and then I put the tube down the trachea and start the
dog on isoforane gas anesthetic. I have not had problems with these in
the mastiff.
- OFA radiographs. I know many of you try to get OFA radiographs
while the animal is awake. An unsedated animal is very hard to
position correctly, but even more importantly OFA asks you to sedate
the dogs. OFA believes that by not sedating the dogs, we're not
getting good representative x-rays. I believe if the OFA radiographs
are done with sedation, it would be very hard to miss a dysplastic
animal. Depending on if the dog is going to go right home or stay in
the hospital. I will use 2 anesthetics for each case. If the dog is
staying, I use the valium/ketamine mixture and if the dog is not
staying, then I use the propofol and then the dog is intubated. Just
another added note. I always put an IV catheter in for a quick access
to the blood stream in case something does happen and I need to give
drugs quickly.
- Cesearean Sections. The main goal here is to obtain the least
sedation possible in the puppies. For the Ceaserain section, I
utilize Propofol at a dose of 3 mg./ lb. or until I can get an
endotracheal tube down the dog. If I had to choose a second choice I
would give the bitch torbutrol and valium as a preanesthetic as
described next and then intubate after masking down. I use torbugesic
at .45 mg/kg and give it to the muscle. Then I give valium (.45 mg/kg) intramuscularly.
We prep the bitch on the floor by shaving her belly and then when
done, we put her on the table and mask her down. We put a large mask
over her muzzle and turn the gas all the way until she is alseep
enough to put the endotracheal tube in. While masking the bitch down,
she may struggle since the dog thinks it is not getting oxygen, even
though it is. The trick here is to get in and the puppies out ASAP.
Propofol can also be used and I have had good results with it. The
bitch is wide awake as soon as the last staple is in. I am comfortable
with either one.
Those are probably the three most common surgeries I do on mastiffs.
Don't let the anesthesia scare you. Where there is some risk has been
lowered by doing all the blood work and the pre-op exams that I
mentioned above.
If you have any questions regarding anesthesia or just anything,
please feel free to contact me.
Robin M. Smith, DVM
Westminster Veterinary Emergency/Trauma Center
269 W. Main St., Westminster, MD 21557
Work 410-848-3363
(Fax) 410-848-4959
E-mail: RocknRob56@aol.com
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