Re: Toby has a bad tooth

Pugsaunt on 11/14/2011, 2:49 pm

MommaJones wrote:
Pugsaunt wrote:Propofol is used in both humans and dogs (cats, too) for induction of anesthesia. Technically, it is a short acting hypnotic, which means that it knocks you out for a short while. It is given in the IV, and is known in the medical biz as Milk of Amnesia. It is used for induction of anesthesia - that means it puts you out before they put the breathing tube in - and for anesthesia in short procedures. Onset in about 30 seconds, and lasts about 20 minutes. When I had my carpal/ulnar tunnel surgery, the last thing I remember is the anesthesiologist injecting it into my IV line. The next thing I remember is waking up with a cast on my arm, thinking "What the hell happened?" They probably use it in older dogs because it works well with heart problems and it metabolizes pretty completely, so it is out of the system and the patient is generally wide awake and good to go when it is over. It also helps prevent vomiting.

You will hear that this is the drug that killed Michael Jackson, and, yes, it did. But the problem was not the drug but how it was given. It should never be given outside the hospital and without close monitoring. And given that it wears off quickly, it is a puzzlement to me why Conrad used propofol for sleep. I was on an EKG and had a pulse oximeter (clips on the finger and measures the oxygen level in the blood) when it was given to me, and that is how it should be given. Yes, one of the side effects is respiratory depression, and that is why the patient should be on a monitor. Period. There is no such thing as a drug that is 100% safe (aspirin has a bunch of side effects, and a tylenol overdose is one of the worst). That being said, I'd far rather be given propofol than some of the other drugs that are used.

The bottom line is that you want to be sure that there is someone in the OR while they are doing the dental who does nothing but watches Toby's monitors. With that precaution, and if it were Penny, I'd still be a mess, but I would be more of a confident mess. I know how we worry about our furkids!

And I'll say a prayer for Toby on Wednesday. Hugs to you, too.

Nancy, So you are fairly confident with them using the propofol? (I do realize that nothing is 100% safe. I'm just trying to make sure they are doing the best thing for him.) The respiratory depression scared me, but if he's intubated and being monitored, that shouldn't be an issue. Correct?

And yeah, the Michael Jackson thing doesn't faze me at all. In fact, after my dad's propofol experience, we kind of had a laugh when all of that came out.

Yes, if he is intubated and monitored, the respiratory depression shouldn't be an issue. And if it were Penny and they told me that they were going to use propofol, I would be ok with it. Now would I be a quivering nervous wreck until I knew she was out of the anesthesia and ok? Of course. Just more confident of a nervous wreck.

And Renee is absolutely right on the pain med issue. And Becky on the IV.

thminis on 11/14/2011, 4:47 pm

Echoing Nancy here on the use of Propofol. I'm 99.9% sure use it for all of our surgery pets. They get a combo of pre meds about 30 mins before we aim to intubate. The propofol is drawn up to the max dosage, but the pet does not usually receive it all. It relaxes them so they can be easily tubed, and then the pet is immediately hooked up to oxygen and isoflurane or sevoflurane.

If a pet becomes bradycardic (where their heart rates drops too low) during the procedure, there are multiple drugs that can be given IV to increase the heart rate. I know for a fact that when Reggie had his dental that lasted at least an hour, he needed 2 doses of these drugs (meaning it's fairly common). So as others have said, as long as they monitor him closely (which I am positive they will), he should do just fine.

I agree that you shouldn't have to leave him overnight. I would let them keep him during the day as long as they want. Basically as soon as they think it's safe to pull his catheter and his temp is high enough is when it should be safe for him to go home. Just keep him away from stairs and jumping, and also don't fill his water bowl high.

Ask if they can maybe give an injection of pain meds if that means they'll let him go home and not stay the night? We've done dentals with 11 or 12 extractions and sent pets home with adequate pain medication.

Sorry for all the random comments. I'll pop back in if I think of anything else. You've been given great support and advice from Nancy and everyone. I'll keep you and Toby in my thoughts these next few days! Let us know if you have any more questions.

Edit to add: We put an IV catheter in every pet during any anesthetic procedure (even cat neuters!). Granted we keep all pets on fluids, but everyone's right that it's a direct line for any needed meds, so request one if they don't do it automatically!

MommaJones on 11/14/2011, 4:53 pm

Nancy and Theresa, I feel better about the propofol after hearing what you've had to say. I'm still a nervous wreck, but at least now I know what they are doing is not some off the wall thing!

thminis wrote:

Sorry for all the random comments. I'll pop back in if I think of anything else. You've been given great support and advice from Nancy and everyone. I'll keep you and Toby in my thoughts these next few days! Let us know if you have any more questions.

Please, keep the 'random' comments coming. I love having your perspective on this. It is a great help (and comfort).

LisaIzzyAggy on 11/15/2011, 5:46 am

Think of you and Toby Love. I'm praying that all goes well.

ayleash on 11/15/2011, 7:31 am

paws crossed... watching for an update.

MommaJones on 11/15/2011, 9:42 am

I called this morning, and they have someone else in the room to watch vital signs while the procedure is being done. I forgot to ask about an IV, but I will do that tomorrow when I take him in. I also asked about giving his metacam. I give it with supper and wanted to be sure that was okay. They said it would be fine. Obviously no food/water after 10pm, but metacam with sup at 6pm is okay.

PS: I think they think I'm crazy...which is fine by me.

lisamak on 11/15/2011, 5:10 pm

Good thoughts from all of us for dear sweet Toby tomorrow.

Aussie Witch on 11/15/2011, 5:20 pm

Isn't this the best place for the best advice? Nothing to add to the wonderful advice given, other than to send love and good wishes for everything to go smoothly for your precious senior citizen.

Mel on 11/15/2011, 6:03 pm

Sending good vibes for Toby's dental tomorrow.

and hugs for you!

I'd be a mess too.

MommaJones on 11/15/2011, 7:03 pm

Aussie Witch wrote:Isn't this the best place for the best advice?

It absolutely is, Rona. I'm so thankful to everyone here!

Usually FJ is my velcro pug...today, I've been Toby's velcro person. The poor guy can't get a moment of peace from me. I just can't quit loving on him.

Snifter&Toddy on 11/16/2011, 3:03 am

It's gonna go just fine for Toby today. However, a few extra good vibes can't hurt so there's some coming across the Pond.

LisaIzzyAggy on 11/16/2011, 6:39 am

You and Toby are in my thoughts and prayers today Christy. I'll be watching for an update.

akc0104 on 11/16/2011, 8:21 am

Good luck to Toby and you today!

Mel on 11/16/2011, 12:09 pm

keeping watch for updates as well..