Exotic animal dentistry (Proceedings)

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Exotic animal dentistry (Proceedings)

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Aug 01, 2011

Anesthesia

Limitations

For small pets, such as most domestic rabbits, guinea pigs, chinchillas, and hedgehogs (the exceptions being ferrets and large rabbits), intubation is generally not an option given the equipment available at most veterinary hospital. Pre-anesthetic blood panels, or at least a PCV/TP, should be run on those patients large enough to perform venipuncture. These same patients should also have intravenous catheters placed for emergency access +/- fluid administration. However, the great majority of pocket pets do not have veins large enough to allow this access. Pre-anesthetic fasting should be avoided, as these small patients are at a higher risk for hypoglycemia.

Pre-medication

Most pocket pets benefit from pre-medication to reduce the stress associated with induction, and to provide pain management. Some procedures, such as oral examinations, can be done using only chemical restraint. Drugs such as ketamine, hydromorphone, midazolam, medetomidine, and glycopyrrolate are commonly used to provide sedation.

Induction

A small cat or kitten anesthetic mask on a non-rebreathing system can be used to induce general anesthesia with isoflurane and O2 administration. For hedgehogs and small rodents, chamber induction must be used. In the absence of a chamber, a large canine anesthetic mask places over the patients with the mask's d diaphragm pressed firmly against the table will do.

Maintenance

Maintaining your patient once induced, while still allowing access to the oral cavity, can be challenging. In larger patients where intubation is unsuccessful, a small anesthetic mask can be placed over the pet's nose only. In tiny patients, stretching a dental dam or the palm of an examination glove over the end of the Bain system anesthetic hose, and cutting a "X" into the stretched rubber with a scalpel blade, then placing the patient's nose through the "X" will allow anesthetic and oxygen delivery while freeing the mouth. This improvised "mask" will require one person dedicated to holding it onto the nose to keep it in place. This person can also be dedicated to anesthetic monitoring.

Monitoring

Monitoring can be done via pediatric stethoscope, Doppler blood pressure monitor (crystal can be taped directly over the fur of the chest in most patients), or a lingual SPO2 sensor places on the foot, ear, or scrotum. Visualization of the mucous membrane color (tongue is especially useful) and the chest movements of respirations is essential. Special care must be taken to ensure that the patient's body temperature is maintained. Circulating warm water blankets, microwavable oat bag, and exam gloves filled with warm water can all be used.