For pets that require anesthesia or pain management for any procedure, Veterinary Specialty Center has two full-time Anesthesiologists on our team. Because of their advanced training, they understand the distinctive needs of each patient and are able to create unique anesthetic protocols and pain management options. Our Anesthesiologists work closely with the surgical, internal medicine, cardiology, imaging, oncology, emergency and critical care, and neurology teams to assist with their cases.
Our team creates protocols that may include injectable drugs, inhalants, or a combination of the two. Throughout the procedure, we use our up-to-the-minute paperless monitoring system to continuously observe a patient for heart rate and blood pressure as well as manage drugs, procedures, fluids, and other treatments being administered. This helps our team keep a close watch on blood pressure; respiratory and cardiac developments; organ function and neurological developments.
An important part of our anesthesia and pain management protocol is the use of local or locoregional anesthesia for your pet. Injectable pain medications are used in certain regions of the body or near specific nerves (nerve blocks) to reduce the amount of anesthesia and time required to keep the patient asleep in addition to providing immediate pain relief during recovery.
- Transversus Abdominus Plane (TAP): blocks the abdominal body wall for abdominal procedures
- Erector Spinae Plane (ESP): blocks the muscles and skin along the spine for back surgeries (hemilaminectomies) and other procedures (mass removals)
- Quadratus Lumborum (QL): blocks the innervation to many abdominal organs; great for painful pancreatitis cases
- Subscalene Brachialplexus Block: blocks the entire forelimb – best for forelimb amputations, humeral fractures, large mass removals
- Nerve Stimulator Guided (* indicates this block can also be performed using ultrasound guidance)
- Lumbosacral Epidurals and Coccygeal Epidurals: best for caudal procedures; the use of the nerve stimulator can aid in accurate needle placement, especially in obese patients or those with anatomic abnormalities
- Femoral-Sciatic Block*: used extensively for procedures involving the stifle (knee) and below (tibia/fibula fractures)
- RUMM (radial, ulnar, median, musculocutaneous nerves): blocks forelimb below the elbow – great for radial and ulnar fractures, mass removals, ulnar osteotomies, and more
- Anatomically Guided: these blocks utilize anatomic landmarks for placement of local anesthetic
- Ring Block: used for distal limb or tail procedures
Veterinarians with expertise in pain management can assist patients suffering from acute and chronic pain. Since the body handles pain through different pathways, a multimodal approach is used to treat pain in more than one area so the lowest effective dose of medication can be used. This approach allows each patient to have a customized pain plan to avoid unwanted side effects of commonly used medications but also a plan that can be molded around any additional medical conditions (problems?), such as diabetes or Cushing’s disease.
There are also protocols that can help prevent acute pain from becoming chronic pain. This can include nerve block/epidurals, constant rate infusions (CRIs) of pain medications, non-steroidal anti-inflammatory drugs (NSAIDs), steroids, and gabapentin in cases of moderate-to-severe injury/pain. Aggressively managing short-term pain can prevent the development of long-term pain and may require your pet to be on pain medication for several weeks.
Our anesthesiologists are available for in-house pain consultations as well as appointments to assess pain and develop a plan for patients requiring additional pain management.
We also specialize in assisting in the medical management of perioperative confinement – as resting your dog or cat post-operatively can be a difficult aspect of recovery. We are here to help adjust at-home anti-anxiety and sedative medications to find the right combination for your pet.
Monitoring is critical to maintaining the comfort and safety of each patient. We utilize state-of-the-art monitoring techniques, including:
- Electrocardiogram (ECG/EKG)
- Blood pressure monitoring (invasive and non-invasive)
- Temperature monitoring
- Respiratory monitoring
- Bedside point-of-care monitoring, including arterial blood gas evaluation
- Fluid and electrolyte monitoring