Fichas
Anaesthesia of Exotics
Fichas del conjunto (44)
- 1Emergency Drugs Bradycardia:Atropine: i/v, some rabbits have atropinesterase, i/m as premed to reduce mucus production
- 2Intubation - Small MammalsRabbits - blind technique or direct visualisation, intubeaze, pre-O2, 3 attempts - risk laryngospasm/oedema
Ferrets - direct visulation of larynx - 3Maintenance - BirdsVolatile agents
Always intubate unless v short procedure
Mechanically ventilate - reduces mortality
Maintain temp - 4Maintenance - BirdsAir sac cannula
Useful if working around head/beak
Ventilates abdominal or caudal thoracic air sac
Maintained in short term post op - 5Maintenance - ReptilesVolatile agent
Intubate
Always mechanically ventilate
Maintain temp - 6Maintenance of Small MammalsVolatile agents
Intubate if poss
Close fitting mask
O2 flow rate 1-3.5l/min
Raise upper body - 7Maintenance - Small MammalsMaintain body temp
Bubble wrap
Ensure scrub solution at body temp - 8Monitoring - BirdsCorneal reflex, resp rate & depth
Heart rate – Doppler ultrasound
Mechanical ventilator - Resp arrest precedes cardiac arrest
Capnograph, Pulse ox
Bp, body temp - 9Monitoring - ReptilesMuscle relaxation from head to tail during induction, reverse on recovery (especially snakes)
Jaw tone, toe/tail pinch
Heart rate - Doppler ultrasound on thoracic girdle
Capnography, body temp - 10Monitoring - Small MammalsWithdrawal reflex - toe pinch
Palpebral reflex = misleading
Heart rate - doppler/stethoscope
Pulse ox, capnography
Bp - 11Emergency Drugs Cardiac Arrest:Adrenaline - i/v, intratracheal, intracardiac
Cardiac massage - 12Induction - Small Mammalsiv catheter if poss
Iso by mask in small rodents
Premed herbivores with metoclopramide
Inj agents - med & ket +/- butorphnl, propofol, alfaxan - 13Emergency Drugs Respiratory Arrest:Stop volatile agents
Check ET tube position
Ventilate
Doxapram - 14Recovery - BirdsWarmth
Support in sternal - towel in donut shape
O2 if needed
Fluid therapy
Analgesia - 15Recovery - ReptilesSLOW!!!
Ventilate with room air - ambu-bag
Maintain at optimal temp for species
Fluids
Analgesia - 16Recovery - Small MammalsReverse alpha-2 agonists - atipamezole
Warmth - propagator ideal
Fluids
O2 if needed
Analgesia
Gut motility drugs if needed - 17Post-Operative CareAnalgesia
Wound care
Ongoing fluids/nutritional support
Monitor bw at least once daily
Return to normal function - 18Nutritional Support - BirdsCrop tubing
Self feeding - usual recognised diet - 19Nutritional Support - ReptilesHerbivore/Carnivore?
Omnivore
Insectivore
Gavage tube
Oesophagostomy tube - 20Nutritional Support - HerbivoresRegular feeding, maintain gut function, rabbits prone to hepatic lipidosis
Gut stasis tx - force feeding, analgesia, prokinetics (metoclop, ranitidine, cisapride), exercise - 21Nutritional Support - Small CarnivoresOxbow Carnivore Support
Hills a/d or convalescence support
Ferrets prone to GI ulceration when stressed
Ferrets also get insulinomas - prone to hypoglycaemia - 22Clinical AuditWhat went wrong?
What went right?
How/What can we improve next time? - 23Parental Fluids - ReptilesHypotonic (saline + 5% dextrose)
s/c or epicoelomic - 10/kg over several sites
Intracoelomic - air sacs, 1-2% bw/day
i/v - jugular, ventral tail vein
Intraosseous - prox femur, plastrocarapacial bridge (chelonians) - 24Restraint - BirdsDarkened room
Wrap in towel to secure wings
Pillowcase can be useful - swans
Avoid pressure over thorax
Care re talons & beak - 25Restraint - ReptilesZoonotic disease risk - salmonella
Bite/constrict/whip tails
Multiple operators for large animals
Some species can shed tails - 26Vasovagal reflex in LizardsRestraint for minor procedures - b/s, xrays
No analgesia!
Cotton wool over eyes
Apply firm, even pressure using vetwrap - 27Restraint - Small Mammals Hazards:Rabbits - lumbar spine trauma (Ca deficit)
Chinchillas - fur slip
Gerbil - tail deglovning injuries
Hedgehogs - shallow water bath, hold back legs once uncurled - 28Patient Prep/StabilisationWarmth, O2, Fluids, Analgesia, Nutritional support
- 29WEIGH PATIENTSmall grams out with make huge difference - overdose
- 30Fluid Therapy - BirdsMaintenance = 50-100ml/kg/day
Assume 10% dehydrated
Replace 50% deficit in first 24hours
Remainder over 2-3days
Oral fluids - crop tube, Vetark critical care, Lectade, 3-5% bw per feed - 31Parental fluids - BirdsLactated Ringers/Glucose saline
Colloids if needed
s/c - inguinal or between scapulae, +/- hyaluronidase, 1% bw per site
i/v - medial tarsal vein, basilic, cutaneous ulna vein - 32Intraosseous Fluids - BirdsAvoid pneumatised bones & air sacs in proximal humerus
Distal ulna
Proximal tibia - 33Fluid Therapy - ReptilesMaintenance = 10-30mls/kg/day
Warm baths - encourages drinking, water absorption via cloaca
Oral fluids - gavage tube, Vetark critical care, Lizards=10-20ml/kg, Snakes=15-30ml/kg, Chelonians=5-15ml/kg - 34Patient AssessmentInitially assess from distance
Clinical history
Signs of illness? - prey species
Immediate O2 or further exam - 35Parental Fluids - ReptilesHypotonic (saline + 5% dextrose)
s/c or epicoelomic - 10/kg over several sites
Intracoelomic - air sacs, 1-2% bw/day
i/v - jugular, ventral tail vein
Intraosseous - prox femur, plastrocarapacial bridge (chelonians) - 36Fluid Therapy - Small MammalsMaintenance = 80-120ml/kg/day
Assume 10% dehydrated if sick
Replace 50% of deficit in 12hours, remainder over 2-3days +maint
Oral - water, lectade, vetark cc, rabbits/large rodents=10ml/kg, smaller=5-10ml/kg - 37Parental Fluids - Small Mammalss/c - painful, scruff/scapulae, flanks/over thoracic wall, 10ml/kg
Intraperitoneal - lower lateral abdo
iv - EMLA, cephalic, saphenous, marginal ear vein, lateral tail vein
Intraosseous - prox femur/tibial crest - 38PreAna Considerations - BirdsComplete tracheal rings
No diaphragm - rely on keel movement
Air sac system
Dive reflex in waterfowl
High metabolic rate
Do not starve for long period - remove food 1h before GA, starve raptors O/N - 39PreANA Considerations - ReptilesNo diaphragm, Use short ET tube in Chelonians
Low metabolic rate, capable of breath holding - mech vent, Stimulus for breathing is high CO2
Environmentall dependent (temp affects drug efficacy)
Starve for 24h if fed live prey, snakes-2-3days - 40PreANA Considerations - Small MammalsRabbits/rodents can't vomit - starve 1h
Rabbits/rodents = obligate nasal breathers - avoid blocking nares
Ferrets can V+ so starve for 4h - insulinoma
Herbivores - heavy abdominal contents
High metabolic rate, Prone to hypothermia - 41Induction - BirdsClose fitting mask - modified with vetwrap
Pre-O2
5% iso/8% sevo
Ayre's T-piece
O2 flow rate = 1-1.5l/min - 42Intubation - BirdsIntubate as soon as possible with uncuffed tube
Cook tubes have ‘shoulders’ to sit snugly around glottis
Blue and gold macaws - prone to tracheal stricture - 43Induction - ReptilesConscious intubation of snake
Iso via facemask/chamber
i/m drugs - medetomidine & ketamine, alfaxalone
i/v drugs - alfaxalone, propofol - 44Intubation - ReptilesRostrally positioned glottis
Tortoises & lizards have large tongues
Uncuffed tube, mech vent
Can use iv catheters as tubes for smalls
V. small lizards maintained with tight mask
Información
- Descripción
- Advanced Veterinary Nursing Fichas sobre Anaesthesia of Exotics, creado por serenacutbill el 21/05/2013.
- Creado por
- serenacutbill · may 2013
- Actualizado
- 17 dic 2016
- Visitas
- 175
- Etiquetas
- Valoración