Quiz: Feline Anesthesia Skills for Technicians

Erica Mattox, CVT, VTS (ECC), WestVet Patient Care Director, Boise, Idaho

April 2015|Clinical|Web-Exclusive

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Quiz: Feline Anesthesia Skills for Technicians
11  Questions
Multiple Choice Questions
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Feline Anesthesia Skills for Technicians

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1/11  Questions
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Fluids are administered during anesthetic procedures to maintain vascular volume and oxygen delivery to tissue, replace acute fluid losses, counteract vasodilatory effects of anesthetics, and normalize acid–base and electrolyte abnormalities. Fluid therapy administration should be monitored by assessing heart rate, systemic blood pressure, central venous pressure, oxygenation, and auscultation of heart and lung sounds. When performing anesthesia on feline patients, it is important to understand the positive and negative effects of fluid therapy.

What is the recommended fluid rate for feline patients under general anesthesia?

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Feline Anesthesia Skills for Technicians
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Every anesthetic procedure should begin with a thorough preanesthetic evaluation, which includes an in-depth history including age, breed, temperament, recent health issues, current medications, nutritional assessment, and an understanding of the presenting complaint. A physical examination is also paramount.

Which of the following can compromise an effective preanesthetic plan?

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Feline Anesthesia Skills for Technicians
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Preoxygenation reduces the risk of hemoglobin desaturation and hypoxemia during the induction process. Preoxygenation is especially beneficial if a prolonged or difficult intubation is expected, which should be anticipated in feline patients. Five minutes or more of preoxygenation replaces the lung’s functional residual capacity (FRC) with a higher percentage of oxygen. FRC is the volume in the lungs at the end of a normal (or passive) exhalation. This increase in FRC permits a lapse of up to 5 minutes before the desaturation of arterial hemoglobin occurs.

When would preoxygenation in feline patients be contraindicated?

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Feline Anesthesia Skills for Technicians
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Stress in the preanesthetic period is dangerous physiologically. The sympathetic nervous system and the hypothalamic-pituitary-adrenal axis release stress hormones that have varying effects on almost all body systems. The reason for this overall response to stress is to increase the immediate availability of energy, increase oxygen intake, decrease blood flow to areas not critical for survival, and inhibit digestion and immune function. Examples of these effects on body systems problematic to anesthesia include cardiovascular changes with an increase in cardiac output, heart rate, blood pressure, myocardial contractility, and oxygen demand. Stress-induced immunosuppression can contribute to an increase in wound infections. The release of stress hormones or catecholamines can delay anesthetic induction, resulting in the administration of more drugs, causing the patient to progress to a dangerously deep anesthetic plane that could result in death. Stressed feline patients are also extremely difficult to restrain and can lead to patient and team member injury. The goal for any anesthetic protocol should be to provide a smooth, stress-free anesthetic experience for the patient and veterinary team. There are many options for anesthetic induction of feline patients.

What induction technique would elicit the most stress and lead to the detrimental effects discussed above and should therefore not be selected?

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Feline Anesthesia Skills for Technicians
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Endotracheal intubation of feline patients can be a challenge because of their small airways and propensity for laryngospasm. A laryngoscope with a good light source and use of a stylet to keep the endotracheal tube more rigid can help with this challenge. In situations when laryngospasm must be treated for intubation, a small amount of lidocaine can be used. Lidocaine gel can be applied to the arytenoids with a cotton-tipped applicator, or a small amount of injectable lidocaine can be diluted with saline and applied using an IV catheter without the stylet.

To avoid laryngospasm at induction in feline patients, what goal should be achieved by the anesthetist?

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Feline Anesthesia Skills for Technicians
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Endotracheal intubation and maintenance is relatively safe when performed by skilled veterinary professionals, but it is not without complications. One of these complications is tracheal tears.

What is a known reason for tracheal tears in feline patients?

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Feline Anesthesia Skills for Technicians
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Recovery is a critical phase of anesthesia. Patient monitoring and support should continue beyond the conclusion of the procedure. Sixty percent of feline anesthetic mortalities have been reported to occur during the recovery period.2

For how long should feline patients be monitored after extubation?

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Feline Anesthesia Skills for Technicians
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Hypothermia is a perceivable and preventable anesthetic complication. General anesthesia in cats contributes to hypothermia because of a small body-to-mass ratio, vasodilation, lack of shivering during anesthesia, breathing cold, dry anesthetic gases from high flow anesthetic systems, and heat loss during surgery from open body cavities. Hypothermia affects almost every physiologic process. Hypothermia can be associated with a number of postoperative complications, such as cardiovascular impairment, shivering, increased oxygen consumption, delayed wound healing, coagulopathy, decreased cerebral blood flow, hypotension, depression, acid-base disturbances, altered drug action, and prolonged recovery.

When should feline patients be warmed during anesthesia?

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Feline Anesthesia Skills for Technicians
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Hypotension is a common complication during general anesthesia and can be diagnosed through blood pressure monitoring and evaluation of other physiologic parameters, such as pulse strength and quality, and capillary refill time. Monitoring parameters such as temperature, because of the predisposition of hypotension in hypothermic patients, and changes in heart rate also can indicate a change in blood pressure. Treatment of hypotension includes decreasing gas anesthetic, managing hypothermia, administering crystalloid or colloid fluid boluses, or administration of vasopressors and inotropes. Doppler or oscillometric devices are used to measure blood pressure indirectly. A Doppler device is often advantageous versus oscillometric devices in feline patients, possibly because hypothermia, hypotension, and anatomic differences (such as small extremities) can adversely affect oscillometric results.

When using a Doppler in cats, it is hypothesized that results may not represent systolic blood pressure but rather:

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Feline Anesthesia Skills for Technicians
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Regardless of the method used to monitor blood pressure, what is the most common source of clinical error while obtaining a blood pressure in a veterinary practice?

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Feline Anesthesia Skills for Technicians
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Analgesia in feline patients should be evaluated and addressed by an educated veterinary team. Pain is often left unresolved in cats due to a perceived difficulty in recognizing and assessing pain, lack of species-specific data, fear of side effects, and lack of licensed products. For example, these drugs are often underutilized in feline patients because of opioid-induced dysphoria and hyperthermia; however, they are still the best choice to treat moderate to severe pain and most of these effects are dose-dependent and manageable.

Despite the drug type administered to manage pain in feline patients, pain control begins with what important skill?

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Feline Anesthesia Skills for Technicians
11/11  Questions
Multiple Choice Questions
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Feline Anesthesia Skills for Technicians

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