In the last post we looked at why surgery ends up often being a good option for malignant dog tumors.
Of course, this is a simple answer, but it may not be all that simple in reality. Why? Well, aside from the cost-benefit considerations, surgery itself varies from vet to vet.
I have worked with a number of colleagues, and have seen quite a spectrum of different skill sets in different people.
One of the challenging thing about being a vet, especially those of us living outside metropolitan locales, is one has to be competent in many different facets of medicine and surgery.
In urban areas, one can refer to a specialist. Otherwise, it is sink or swim. This leaves the veterinarian with quite a bit of data to keep abreast of.
And it may produce gaps in the fabric of this knowledge that, truth be told, may have impact on the well being of your dog. The outcome of this is different veterinarians having different levels of ability, or knowledge, in dealing with anesthesia.
This brings us to a fact that not all dog lovers know: most veterinarians, at least in private practice, also are their own anesthetists.
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This is a departure from surgery done on human patients, where there is an anesthetist as well as the surgeon. What are some things to consider? Anesthetic safety, for one. It can help if the veterinarian uses different ways of maintaining anesthesia (such as a quick-clearing gas like isoflurane or sevoflurane, along with an epidural or local nerve blocks).
This way they all act together, with less side effects to worry about, because you can use less of a given anesthetic. Another is pain control during and following anesthesia, which is the topic of another post. Monitoring is so important.
When your veterinary surgeon is operating, blood pressure, heart rate, oxygen saturation, respiratory rate, and ECG trace should all be monitored, at a minimum. An IV catheter should be placed for rapid emergency drug delivery, IV fluids to help maintain blood pressure, and to deliver high blood concentrations of drugs.
Just to name a few. I like a circulating hot water pad to maintain body temperature during surgery. Finally, the avoidance of certain anesthetics should be considered. There was an illuminating article published in the journal Anesthesia and Analgesia in 2003 which showed that Ketamine, a common anesthetic and pain control drug, may be a bad choice for tumor surgery.
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Why? Well, rats were injected with tumor cells and then given different anesthetic drugs. When ketamine was used, the rates of metastsis (cancer spread) were much higher than the others. Thiopental and halothane had the same effect but less so.
These two drugs are rarely used anymore. Propofol was the best of these 4 that were tested in rats. Don’t be afraid to talk to your veterinary surgeon, before the procedure. Be your dog’s primary health advocate!
Dr. Demian Dressler is internationally recognized as “the dog cancer vet” because of his innovations in the field of dog cancer management, and the popularity of his blog here at Dog Cancer Blog. The owner of South Shore Veterinary Care, a full-service veterinary hospital in Maui, Hawaii, Dr. Dressler studied Animal Physiology and received a Bachelor of Science degree from the University of California at Davis before earning his Doctorate in Veterinary Medicine from Cornell University. After practicing at Killewald Animal Hospital in Amherst, New York, he returned to his home state, Hawaii, to practice at the East Honolulu Pet Hospital before heading home to Maui to open his own hospital. Dr. Dressler consults both dog lovers and veterinary professionals, and is sought after as a speaker on topics ranging from the links between lifestyle choices and disease, nutrition and cancer, and animal ethics. His television appearances include “Ask the Vet” segments on local news programs. He is the author of The Dog Cancer Survival Guide: Full Spectrum Treatments to Optimize Your Dog’s Life Quality and Longevity. He is a member of the American Veterinary Medical Association, the Hawaii Veterinary Medical Association, the American Association of Avian Veterinarians, the National Animal Supplement Council and CORE (Comparative Orthopedic Research Evaluation). He is also an advisory board member for Pacific Primate Sanctuary.