Since it's an emergency vet - are they rabbitsavvy? Do they know about the correct anesthetic to use forrabbits? I will have to look it up but I know one kind isbetter than others for bunnies (isoflourane)... just before they doanything, make sure they are familiar with treating rabbits on aregular basis.
If not, is it an optionto wait until your regular rabbitsavvy vet opened in the morning, just keep her on the pain killers...
Edit:
ANESTHESIA AND SEDATION[/b]
DEFINITION: Anesthesia is achieved when there is a loss ofsensation to either a part or all of the body.
Generalanesthesia renders the patient completely unconscious.
Sedation is similar to general anesthesia but the patientremains semi-conscious.
Anesthesia and sedation are used in a variety of situations inveterinary practice including diagnostic sample collection (X-rays,blood work, urine, biopsies), examination (calming difficult to handleor painful animals, thorough examination of the oral cavity), andsurgical procedures.
TYPES OF ANESTHESIA
- Local or topical anesthesia is applied on top of or injectedinto the skin to remove the sensation from a small area. The anesthesiadoes not extend more than the thickness of the skin nor wider than thearea that the anesthetic is applied. The rabbit remains fullyconscious. Local anesthesia might be used for minor skin surgeries orbiopsies, placement of intravenous (IV) or intraosseous (IO) catheters,or for ophthalmic procedures. We commonly use a topical anesthetic inthe eyes to allow flushing of the tear duct in the conscious pet.
- Regional anesthesia is where a larger and deeper area of thebody is anesthetized. The anesthetic agent is injected into the spinalfluid, which numbs all sensation from that point of the spine to theback of the animal. The agent can also be injected into a specificnerve, which anesthetizes all the tissues that the nerve reaches.During regional anesthesia the rabbit remains fully conscious. Thistype of anesthesia has been successfully used in the rabbit, howevermany veterinarians are still unfamiliar with the technique.
- General anesthesia circulates through the bloodstream to allareas of the body, including the brain, and causes a complete loss ofconsciousness. There are basically two ways to administer generalanesthetic agents, by injection or inhalation.
- Injectable anesthetics can be given IV intramuscular (IM),intraperitoneal (IP) or subcutaneously (SC). Injectable anestheticagents are often used for short surgical procedures, (particularlythose in the mouth), or used as a preanesthetic to an inhalant agent.Preanesthetic drugs are used to calm the patient to allowhandling for the administration of the inhalation agent or to allowpassage of an endotracheal (ET) tube. The biggest drawback toinjectable anesthetics is that there is no control over the dose onceit has been injected (except in the case of reversible drugs). There istremendous variation in dosages amongst different rabbits. Injectableanesthetics are not suitable as the only anesthetic agent for prolongedsurgical procedures. The recovery period varies with the agent used. Inaddition, some of the injectable anesthetics are not appropriate in thepresence of certain disorders, such as cardiac or kidney disease.Currently, the most commonly used injectable anesthetic agents inrabbits include any of the following (some are used in combination toimprove their anesthetic properties); ketamine, diazepam (Valium),butorphanol, propofol, medetomidine and opiods.
- Inhalant (gas) anesthesia is the first choice for any majorsurgical procedure. As mentioned, it is common to use a sedative orpreanesthetic agent of some type to relax the rabbit before using aninhalant anesthesia. The anesthetic gas is administered either througha mask placed over the rabbit's face, or through an ET tube. Withinhalant anesthesia the patient is connected directly to a machine thatdelivers the anesthetic agent in a flow of oxygen. The advantages ofgas anesthesia are that the concentration of the anesthetic agent andtherefore the level of anesthesia can be quickly adjusted, the patientis always connected directly to an oxygen source and recovery isusually rapid and smooth. In addition, isoflurane, the mostcommonly used gas anesthetic, can be used safely in rabbits with a widevariety of illnesses. Isoflurane is safe not only for the rabbit, butfor the humans who are exposed to it in the surgical suite.Methoxyflurane and halothane have been used in rabbits in the past,however, they hold a higher risk of causing medical problems in humansexposed. In addition, methoxyflurane is dangerous to use on overweightrabbits.
RISKS OF GENERAL ANESTHESIA[/b]
With careful preparation and monitoring, the risks of generalanesthesia in the rabbit are minimal. However, we would not be truthfulif we told you there were no risks at all. Medicine is not an exactscience because we are dealing with complex individuals and it isimpossible to know every conceivable outcome to every situation.
The complications of general anesthesia range from temporary orintermittent changes in respiration, heart rate and blood pressure tobrain damage to death. In experienced hands, anesthetic deaths arerare. The most common causes of anesthetic death include respiratory orcardiac arrest, hypothermia (low body temperature), hypovolemia (lowblood volume) and embolism (blood clot). Respiratory or cardiac arrestcan be caused by a variety of factors including pre-existing disease ofthe thorax, (including the heart or lungs), other systemic disease(particularly involving the liver and/or kidneys where anesthetics mustbe cleared from the body), blockage of the air passageway (blocked ETtube, regurgitation of material from stomach, blood) and overdose ofthe anesthetic agent(s).
Some degree of
hypothermia occurs naturally during generalanesthesia because the metabolic rate drops and the body cools. Inaddition if large areas of the internal surface of the body areexposed, more heat is lost. Anyone who has ever had general anesthesiawill probably remember waking up shaking and feeling very cold. Rabbitshave a small body mass compared to the surface area of the skin whichallows heat to be released even more quickly than in humans. A rabbit'sbody temperature can drop very quickly to dangerous levels particularlyif the abdominal cavity is opened or the procedure is lengthy.
Hypovolemia occurs if the patient loses a critical amount ofblood or other body fluids during a surgical procedure or a state ofdehydration presurgically is not corrected. An
embolism (bloodclot), although fortunately rare, can occur anytime, particularly ifthe surgery involves manipulation of a large blood vessel, bone tissueor if the rabbit had a serious bacterial or fungal infection prior tothe procedure.
FACTORS AFFECTING ANESTHETIC RISK[/b]
Fortunately there are many things that can be done to greatly reducethe anesthetic risk in rabbits.
Factors that increase anestheticrisk include; no presurgical physical exam, pre-existing disease(particularly respiratory, heart, liver or kidney disease, dehydrationor obesity), inappropriate anesthetic agent or dose, absence of regularanesthetic monitoring, and absence of adequate postanestheticmonitoring and care.
Here are some things that the veterinary staff can do to minimize anesthetic/surgical risk:
- Perform thorough preanesthetic/surgical examination including diagnostics if appropriate.
- Stabilize/treat pre-existing conditions
- Use anesthetic agents/dosages appropriate for rabbits. Obtain accurate body weight.
- Continuously monitor the patient during the anesthetic/surgical procedure.
- Closely monitor the patient during the recovery period until awake and moving.
_________
Nadia
.
