Dear Shelter Vet,
Can you share your recommendations for pediatric anesthesia protocols?
–Starting a Pediatric Spay Program
Dear Starting a Pediatric Spay Program,
Thank you for your inquiry regarding pediatric anesthesia protocols.
Selecting the best anesthetic protocols for your organization is based on many factors including the availability of technical assistance, volume and species of animals served, and financial considerations. According to the ASV Veterinary Medical Care Guidelines for Spay/Neuter Programs, anesthetic protocols must fulfill four criteria for providing safe and humane anesthesia: adequate analgesia, stress reduction, immobility, and safe depression of the CNS resulting in unconsciousness. Pain management should always be included in the anesthetic protocol.
Additionally, preventing hypothermia and hypoglycemia are especially important in pediatric patients. Because of this, patients are not fasted more than 2 to 4 hours, and many practitioners give Karo syrup or Nutrical at the time of pre-med and again post-op. It is recommended to offer a small meal once they are sternal post-op. Keep them with littermates prior to surgery to keep them warm, keep them warm through prep by using no alcohol during prep and by warming prep solutions, keep them warm during the surgical procedure, then recover them with littermates following the surgery.
Common protocols to choose from include premedication with a combination of acepromazine and an opoid administered SQ. Anticholinergics are not recommended. A combination of ketamine/diazepam or Telazol administered IV, or dexdomitor/ketamine/opiod combinations given IM, can be used to induce anesthesia. The patient can then be intubated and anesthesia maintained by isoflurane gas inhalation. Non-rebreathing systems should be used for inhalant anesthesia. Local anesthetic blocks can also be used in pediatric patients.
ASPCA has more materials on spay/neuter available on their website.
For more information on veterinary anesthetic protocols in general, I would encourage you to visit the Veterinary Anesthesia and Analgesia Support Group.
There are also many resources regarding spay/neuter, including sample drug protocols, on the Association of Shelter Veterinarians website.
Check out the 2015 AAHA/AAFP Pain Management Guidelines for Dogs and Cats at this website.