Wednesday, June 30, 2010

Clinic work - a note on medication





Probably the most difficult thing to witness in the clinic work was the lack of anesthesia for the animals undergoing surgery. Don't get me wrong - they are not awake, but they are not anestheticized like the animals in the US with gas. Instead they are given a large shot of Ketamine, which the US vets dislike to some extent because large doses of it causes seizures. So, in the US, an animal would typically get a small shot of Ketamine, which initally dopes them so that the gas anasthesia can be administered, plus a dose of Valium to prevent seizures, then the gas is administered throughout the surgery to give the animal a long, steady anesthesia until the surgery is over. In Peru, there is no gas or Valium because of the expense, so instead, the animals are just given a large dose of Ketamine.

The problem? They can wake during surgery and feel pain. They can also seize during surgery. Neither of these options is fun to watch. So, throughout surgery, my main job was to watch the animal and listen closely for signs of waking up, and when they did, I would alert the vet and we would administer more Ketamine. If they seized we stopped surgery and propped their mouths open until the termbling stopped. This would often wake them slightly though, so more Ketamine. Amounts of Ketamine are based on an animal's weight, so there is a science to it, but you still never know how an animal will react. It is a balance between giving them enough to stay under through the surgery and not too much to cause them to seize. This was really hard to watch - one dog I helped with wimpered during the surgery four different times, meaning she felt pain four different times, and four times we had to give her more Ketamine. The hardest part is that I really don't know if the Peruvian vets give more Ketamine like we were, or to the extent that we were, to prevent this wimpering during surgery. I honestly can't even think about it - we just have to let this go - it is their way and we can only do the surgeries we did while we were there our way. My guess is that the Peruvian vets were probably a little surprised that we kept giving more Ketamine throughout the surgeries, but I'm not certain.

No comments:

Post a Comment