Perioperative care of exotic mammals (Proceedings)

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Perioperative care of exotic mammals (Proceedings)

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Aug 01, 2011

State-of-the-art improvements in how we feed and provide medical and surgical care for exotic mammals has resulted in a greater lifespan for these beloved family pets. Many exotic mammal owners are dedicated to the health and well-being of their pets and expect the best in medical care including perioperative care. Utilizing the practice team to provide superior medical and surgical care is the goal. All team members including the veterinary assistant, veterinary technician and the veterinarian in charge need to understand the peculiarities of exotic mammal care when a patient is presented for a surgical procedure. Using the wealth of knowledge available on small animal anesthesia and peri-surgical support as a foundation, the exotics veterinarian needs to include awareness of physiological parameters unique to the exotic mammal. All team members need to understand that these small species have high metabolic rates, are prone to anesthetically related hypothermia, are in some cases catecholamine driven prey animals (the rabbit) that stress easily, and many have an anatomy that makes intubation difficult. As a result of the small thoracic size in comparison to body mass exotic mammals are more predisposed to cardiovascular and respiratory complications when anesthetized. Team organization and readiness is essential at minimizing anesthetic and surgical time and thereby limiting perioperative complications and hospitalization time. All equipment needed for anesthesia and patient support as well as the surgical suite and post op recovery area needs to be in place prior to proceeding with any surgical procedure. Drugs anticipated for sedation, analgesia, anesthesia and potential emergencies need to be calculated and ready to use. Anesthetic monitoring equipment needs to be functioning properly and the anesthetist needs to understand how they function, what parameters they are measuring, what these measurements mean and what to do if things go awry. The bottom line is that good overall preparation and a knowledge of appropriate perioperative options available for patient care will maximize success in before, during and after the exotic mammal goes to the operative suite.

Instrumentation

In general the surgeon can use a feline spay pack for most routine exotic mammal surgeries such as ovarian hysterectomies, castrations and lumpectomies. A separate pack of fine, delicate instruments, preferably developed for microsurgery is added to aid in the tissue handling of these small patients and are prerequisite for more detailed surgery such as ferret adrenalectomies, GI surgery, or exotic mammal cystotomies. In choosing microsurgery instruments, consider: length (5-7 inches standard), rounded handle so they can be rolled between surgeon's thumb and first finger, and counter balancing which allows the instrument to rest comfortably in the surgeon's hand, thus reducing muscle fatigue. The microsurgery pack used for small exotic mammals should consist minimally of a microsurgical needle holder, scissors and thumb forceps. The author prefers a ring-tipped microsurgical forceps (Sontec Instruments, Centennial, CO). The fine ring tip provides for better holding power with minimal tissue damage. Other instruments that aid in exotic mammal surgery include the Statinsky vascular clamp used with right sided ferret adrenalectomies and a Hemoclip® applicator for application of ligation / hemostasis clips.

Magnification

Some form of magnification is of great benefit to the exotic mammal surgeon. In patients weighing less than 100 grams, such as hamsters, gerbils, or mice, an operating microscope should be considered, however, in many cases, loupes can provide adequate magnification. For those on a budget, hobby loupes provide an inexpensive form of magnification. Surgical magnification loupes such as the Surgi-Tel® (General Scientific Corporation, SurgiTel, Ann Arbor, MI) are essential for surgeons (especially those over the age of 40!) looking for surgical field clarity and magnification. They have the added benefit of allowing the surgeon to look through the lenses with the head held in an upright, ergonomically correct position.