KETAMINE

[Candys]

OK Guys, Gals and Sphynxies - I have an appointment tomorrow to get Dinka neutered. I asked for a discount due to the fact that he does not need to be shaved.They laughed.I asked if they used Ketamine in neuters and they said they did. The vet came in and he said, "I perform thousands of surgeries and have only had one death""but I can give him gas in the box". I told him that I did not want Ketamine at all and to please use the gas. Then the Tech asked why I didn't want Ketamine and I said that breeders suggest not to use it. Then she asked if my breeder suggested that I not use it - I said no, but it has caused deaths in this breed and I am not going to take a chance. DUHI got in the car and felt foolish for not having a GREAT answer.

 

[Mews2much]

You did the right thing.
It has caused many deaths in sphynx cats.
My vet had no problem when Wrinkles was altered not using.
I do not if you know Kay Marshall but her story of how she lost Gimmie to Ketamine is all over the internet.
She told me what t tell my vet to use and I did.
Good for you for standing up to the vet.

 

[Candys]

I know the had a recall on some of the Teva Ketamine lots in 12/2009. How many of the old school vets still have those lots in the fridge? It is not just a problem with Sphynx - it has also caused deaths in canines and other cat breeds.

 

[dreaming_in_colour]

Never ever let your vet use ketamine on a Sphynx! You did the right thing and good for you!!!!!

 

[MissMySphynxBoys]

You did the right thing. Better to feel foolish and say something than to be filled with regret for keeping your mouth shut.

Good luck to Dinka.

 

[Bella07]

That's great to know! Thank You. I had no idea about the whole Ketamine thing. See, still learning a new thing everyday! From what the others have said, you did the right thing.

 

[Hairlesslove]

Oh wow I didnt know about this. Thank you sooo very much for the info!!..We are taking Linguini to get neutered very soon...

 

[marlene]

I lost 2 Maine Coons to ketamine used during dental cleanings back in the early 90's, only then we didn't know what caused my kitties to crash and burn after a routine procedure they'd had done before. It was only years later, in retrospect, that my vet and I figured out that they were probably undiagnosed HCM kitties and suffered from the lethal combination caused by the rebound hypertension and decreased cardiac return resulting from the HCM/ketamine combination.

You did the right thing. I would never allow ketamine to be used on my kitties now that I know better. Some years ago I stepped on Little Ren and broke his right front leg. My regular vet referred me to an orthopedic surgeon to have it surgically repaired. The surgeon had a pissy attitude and told me that HE was the doctor and HE would decide what anesthesia was appropriate. I informed him that he may be a veterinary surgeon but he obviously had crappy anesthesia training if he didn't know the basic rule of not using ketamine on Sphynx cats, that even my little country vet out in the sticks knew that.

So I took Ren back to my regular vet and told him we'd fix the leg by casting it and if that didn't work we'd just amputate it, cause I figured Ren with three legs was better than the risk of no Ren at all because of a <insert swear word here> surgeon who was so stuck on himself that he'd risk killing an animal before he'd listen to someone else's suggestion. It was a lot of work and required re-casting every 2 weeks for 3 months but it did eventually mend.

 

[lawgrl]

Good for you for standing up for yourself and your kitty!

I just learned about the ketamine and ketamine/valium combo problem in sphynx recently and my vet (well, the girls at the front desk of the vet's office) acted like I was crazy when I told them that I didn't want it used on my kitties at any point in the future (I'm unsure if it's been used before, since they're both spayed and neutered already...but I figured why take a chance)...I had to play 20 questions with them until I finally resorted to telling them that they were allergic to ketamine (not true but it's the only thing I could think of at that point and I was tired of the questions) and then had to insist that I would stand there while they put the "allergy stickers" on their files. I did remain nice (it's a small town and vets are in short supply) but it was a little frustrating and scary that no one even knew what I was talking about.

 

[Candys]

WOW lawgirl - sounds like I am not the only one. When I went to pick up the Dinks after the neuter I spent 45 minutes with the vet. He only said (again) that he had performed many surgeries (my family and friends know him and he is a good vet - really) and only lost one. I brought up the topic of the bad batches in 12/2009 and also the HCM issue. He said "If a cat has HCM it is going to die immediatley" reffering to the condition, not being under sedation. He did not press me any further on that issue.:Laugh:

 

[ckutkuhn7]

Good for you for standing up for your kitty!! I would have done the samething.

 

[marlene]

He said "If a cat has HCM it is going to die immediatley" reffering to the condition, not being under sedation.

Incorrect. We all know that many cats live a long time with HCM. He's also incorrect if he's referring to an HCM kitty having ketamine - mine were fine for a couple hours after the procedure then crashed. And I've heard the same timeline from other owners who had the same thing happen. That's because the rebound hyptertension doesn't happen immediately, not with ketamine and not with any other anesthetic.

 

[ShadyLaine]

You can always ask that they use propofol instead of ketval, it's alot more gentle then having your cat "tanked" down. Putting them under using only isofluorance is a fairly traumatic experience. The gas smells funny and then they go through plane 2 of anesthesia - known as the excitatory phase - and flail around, paddling their limbs and spazzing out before they go completely down. It's not the most pretty thing to watch, but in cases of overly fractious and dangerous cats, I have seen it done.

Propofol is alot more gentle, it's a quick-down drug, meaning it takes effect VERY quickly.

The upside to preanesthetic drugs is that they cause the patient to require less inhalation anesthetic, which GREATLY depresses the respiratory and cardiac systems. Ketamine causes sedation and valium causes muscle relaxation and pain management. This is why they are so often used. They relieve some pain and allow for a greater plane of sedation and anesthesia without having to overuse inhalant anesthesia.

Propofol is a good alternative to ketval, though I hope they get Alfaxan here in canada and the states soon - it's another anesthetic drug that they have in Australia. When I volunteered at a wildlife hospital down there, it was all that they used for intubations and catheter placement before inhalant anesthetic.

 

[Candys]

I appreciate your information. What would be good to use in the case of a dental cleaning?

 

[BlueGirl]

I have a quick question on a related subject if anyone can help me out. I got my little boy nutered yesterday, I was a little worried but I made sure they wouldnt use ketamine and he was completly fine, he's back to his adorable self already. I bathed him yesterday so he would be clean for the vets but he's absouloutly filthy again, should I try to wash his wounds? I dont want them getting infected!

 

[ShadyLaine]

Candys : it's good in the case of any anesthetic. Anesthesia occurs in three stages.
Preanesthetic: usually a combination of either Butorphanol, Acepromazine and Atropine OR Hydromorphone and acepromazine. The opiods(butorphanol and hydromorphone) are for pain, Ace is the sedative and atropine helps to increase heart rate under anesthesia to ensure good blood pressure and less depression on the cardiac system.

These are given IM, which is intramuscular. They go into the muscle and take about 15 mins to reach full effect.

These sedate the patient enough to put in an intravenous catheter(IV). The inducing agent(what makes them sedate enough to put in an endotracheal tube) is usually either Ketamine/Valium or propofol. Most veterinarians use Ket/Val because it less expensive. Also propofol contains egg proteins and therefore must be refrigerated and has a set expiry date. Therefore you can use it once on a surgery, but if you don't have another surgery that requires it before the expiry datem you waste a whole bottle of propofol, which can be expensive. These go IV, through the catheter. The patient is on IV fluids by this point.

Once the patient is induced, we then use a small drop of local anesthetic called Xylazine to desensitize the epiglottis(the covering to the trachea) - this is so that we can intubate the patient and not have them gag on the tube, called a laryngospasm.

The patient is then intubated, and place on oxygen and inhalent anesthetic, known as Isofluorane. This is maintained for the duration of the surgery.

Throughout the surgery, veterinary nurses or veterinary technicians, such as myself, closely monitor the patient for signs of discomfort and adjust anesthetic depth accordingly ( we turn up the vaporizer level, or decrease it, adding more or less isofluorane to the oxygen.)

I am basically a veterinary dentist, anesthesiologist, nurse, annnnd I pretty much do everything the vet doesn't. =P

I don't know if I am allowed to link things, but here is a wiki page on veterinary anesthesia: [ame="http://en.wikipedia.org/wiki/Veterinary_anesthesia"]Veterinary anesthesia - Wikipedia, the free encyclopedia@@AMEPARAM@@/wiki/File:Cat_gassed.jpg" class="image"><img alt="" src="http://upload.wikimedia.org/wikipedia/commons/thumb/3/3c/Cat_gassed.jpg/93px-Cat_gassed.jpg"@@AMEPARAM@@commons/thumb/3/3c/Cat_gassed.jpg/93px-Cat_gassed.jpg[/ame]

Bluegirl: I wouldn't wash his wounds - Irritation to scrotal sac incisions can cause the scrotum to fill with fluid. This can be painful and requires draining to prevent infection. Your best bet is to wipe him down with a damp cloth and avoid the surgical site!

 

[Candys]

Thank you for the info Shady.

 

[lawgrl]

Candys: Ours is a good vet, too. My husband's family is from our town and has been using her for years and years, and she has even treated other sphynx before (there was a woman in town who was breeding them for a while).

But I guess, to her, it's a matter of statistics, probability, and her own experiences (as it should be, I think) but, to me, those kitties are my babies and if I know there's something I can do to prevent harm to them (even if there's a very small chance of that harm actually happening), I'm going to do it. I wouldn't be able to forgive myself if I didn't take those precautions and then something preventable happened to my babies! So, I'll continue to act the "crazy kitty-momma" role and take care of business!!!

 

[Candys]

Yup - We are the "Crazy Kitty Mommas".

 

[NakedNinja]

Good for you for standing up for yourself and your kitty!

I just learned about the ketamine and ketamine/valium combo problem in sphynx recently and my vet (well, the girls at the front desk of the vet's office) acted like I was crazy when I told them that I didn't want it used on my kitties at any point in the future (I'm unsure if it's been used before, since they're both spayed and neutered already...but I figured why take a chance)...I had to play 20 questions with them until I finally resorted to telling them that they were allergic to ketamine (not true but it's the only thing I could think of at that point and I was tired of the questions) and then had to insist that I would stand there while they put the "allergy stickers" on their files. I did remain nice (it's a small town and vets are in short supply) but it was a little frustrating and scary that no one even knew what I was talking about.

HA! I did the same thing! My cats all have "Ketamine allergy" in their records, just to save the hassle of arguing. Love it!

 

[JacksMom]

Wow! This is the first I see this Ketamine thing...fortunately, Jack was okay on his neuter, but for future kittys, now I know. What is Ketamine? Is it a pain killer or anesthesia? What should be used instead?

 

[marlene]

Ketamine is a type of anesthesia. Propofol or isoflurane are better anesthesias to use.

 

[lawgrl]

NakedNinja: Too funny! I hated to resort to being less than honest but it just got soooo frustrating! Oh well, it worked and we got the stickers, so that's all that mattered to me, lol!!!

 

[Nofuratu]

You can always ask that they use propofol instead of ketval, it's alot more gentle then having your cat "tanked" down. Putting them under using only isofluorance is a fairly traumatic experience. The gas smells funny and then they go through plane 2 of anesthesia - known as the excitatory phase - and flail around, paddling their limbs and spazzing out before they go completely down. It's not the most pretty thing to watch, but in cases of overly fractious and dangerous cats, I have seen it done.

Propofol is alot more gentle, it's a quick-down drug, meaning it takes effect VERY quickly.

The upside to preanesthetic drugs is that they cause the patient to require less inhalation anesthetic, which GREATLY depresses the respiratory and cardiac systems. Ketamine causes sedation and valium causes muscle relaxation and pain management. This is why they are so often used. They relieve some pain and allow for a greater plane of sedation and anesthesia without having to overuse inhalant anesthesia.

Propofol is a good alternative to ketval, though I hope they get Alfaxan here in canada and the states soon - it's another anesthetic drug that they have in Australia. When I volunteered at a wildlife hospital down there, it was all that they used for intubations and catheter placement before inhalant anesthetic.

I've been out of vet medicine for about 8 years....but when I was in the field...Propofol was the best i.v induction agent with the least risk. Most vets/techs didnt use it on everyone because it was (not sure if it still is)
expensive and/or they lacked training with using it. Propofol causes a few changes that take some getting used to and would normally worry you if you were monitoring a patient and didnt know what to expect.
When I used it, I loved it, but it was reserved for geriatrics, sighthounds etc because of cost.
In short, I agree with you. "Tanking" is a last resort option....an animal put under anesthesia in an excited state will wake up equally excited.

 

[Nofuratu]

Wow! This is the first I see this Ketamine thing...fortunately, Jack was okay on his neuter, but for future kittys, now I know. What is Ketamine? Is it a pain killer or anesthesia? What should be used instead?

Ketamine is an intravenous injectible short term anesthetic. (knocks your pet out)
We either use it(with valium-painkiller) to knock an animal out to perform a short surgery, or use it to knock them out long enough to insert an endotracheal tube (breathing tube) into them to hook them up to gas anesthetic (isofluorane) for longer surgeries.
cat neuters only take a minute so we use ketamine/valium injected I.V which puts them out for about 15/20 mins.
Propofol is also an injectible I.V anesthetic but can be used for short surgeries by itself like cat neuters or stitching wounds.....or can just be used to knock the animal out long enough to get the breathing tube into them. It has a quick recovery rate (withing minutes animals are up and walking around) and is safer for older pets etc.
Hope that helped.