Anesthesiologists - The OTHER surgical MVP
It’s a loving pet parent’s “perfect storm” — being caught between a pet’s need for a medical procedure and his or her risk of complications with anesthesia.
“One thing that always surprises me is that people don’t know specialist-level anesthesia is an available option,” says Dr. Heidi Shafford, DVM, board-certified veterinary anesthesiologist. It’s Shafford’s business to provide anesthesia care for medically-fragile patients.
A veterinarian may consider a pet high-risk with anesthesia for various reasons, including age, breed sensitivities, liver, heart, or kidney disease, previous anesthesia reaction, or a littermate who died under anesthesia.
“It’s not necessarily that their pet can’t undergo anesthesia, and it isn’t necessarily that their vet is wrong, but that it isn’t within their vet’s comfort level,” Shafford explains. “I’m not contradicting what that vet is saying, but here’s an analogy for what I do. Some people have compared me to a river 'bar pilot' — like those who help captains cross the difficult Columbia River Bar between the river and the ocean. Instead I help medically fragile pets navigate anesthesia.”
Shafford’s expertise helps enable high-risk pets to have procedures that can increase quality of life. A toothache is no longer life-threatening.
Veterinary anesthesiologists are sticklers for detail, crafting special anesthesia plans for each pet. For example, older pets require lower drug doses, benefit from extra support and monitoring during and after anesthesia, and need to quickly resume eating. Pets with liver disease are safer with an anesthetic that doesn’t involve liver metabolism. For kidney patients, extra pre-anesthetic fluid support and special attention to preventing and treating low blood pressure can help support fragile kidneys during anesthesia.
“Most of my patients have heart disease, kidney disease or both!” Whatever the challenge, Shafford faces each with specialized training and thorough preparation, along with a formidable team.
“I want owners to know that I take what I do — improving anesthesia safety for pets — very seriously. I gather detailed information about each pet ahead of time, both the focused medical picture and overall background. I get a grasp of the main concerns from the primary vet, and also talk with owners about their pet’s energy level, appetite, any coughing, sneezing, and other various details.”
Dr. Shafford also explains the upcoming procedure to pet parents. “For example, with hypertrophic cardiomyopathy, there is a risk of low blood pressure and irregular heartbeats, and my anesthetic plan would include steps to minimize stress and prevent low blood pressure. I would be monitoring from before the anesthesia begins and intensively throughout, to immediately pick up on any changes, if any, to support the patient early and well.”
According to Shafford, recovery is too often an overlooked danger zone.
“During a procedure, the pet is getting extra oxygen, is often being warmed, and someone is close at hand. They are often getting IV fluids. When many clinics finish anesthesia, there is a misperception that the anesthesia is 'finished,' that the pet is out of harms’ way, and people move on to something else.”
But, says Shafford, the majority of pets lost to anesthesia-related deaths actually pass away during recovery.
“In recovery I monitor closely,” she says. “They are recovering from medications, may be a little cold, and not fully in control of their systems. It’s that first one to three hours after surgery that's so critical.”
That extra assurance is one reason Shafford’s schedule is full of return clients.
“A big piece of what I do is assure you that your pet is looked after, that they are warm, that their heart is beating strong, and that they are comfortable and well.”
On site two to three days a week at the Animal Dental Clinic in Tigard, Shafford says, “The dental specialists and technicians are very skilled, fast and efficient, and it truly minimizes anesthesia time. We team up for patients that are the most at-risk. I know if I ask them for help during an anesthesia emergency, they are there for me. We’ve worked together through some very challenging cases.”
Also working alongside other veterinarians, the doctor says, “The majority of vets in the Portland Metro area are familiar with me, and there are times when I’m available to come to their location. Some procedures are best performed at certain clinics.”
Neutering a dog may be a routine surgery, but for a high-risk patient with serious heart disease, anesthetizing demands her skills. “And I’ll be doing that next week for a kitty cat. There’s just this wide range of things I do for so many pets — I anesthetized a cat for cataract surgery last week — never a dull moment! I absolutely love what I do.”
Christy Caballero writes from the heart about all things pet-related, from a couple deer trails off the beaten path, typically juggling a cat (or two) on her lap as black kitty AsTar teeters on her shoulder and Mojo the retired Greyhound quietly calls for einforcements!!