Anesthesia for dogs with liver issues
 

After reading the sticky from May 2009 regarding anesthesia protocol, I am a bit nervous about Daisy having to undergo the mask anesthesia, which the vet said we would have to use due to her liver issues. I am hoping this is not as controversial as it was in 2009 and it is safer. She needs a loose tooth pulled and a dental cleaning. Does anyone have any good info on this or a good web site that I can look at? My vet told the mask anesthesia was safe.

The good news is that Daisy's new blood test showed her liver enzymes were significantly improved over her last one 30 days ago. Her ALT was only 10 units over the normal range. She will need to stay on a prescription diet and we are phasing her down on Denamarin and having a follow-up blood test in 60 days.

Thanks to everyone who prayed for her. I was so worried about her. She is now acting like her old normal self. She is sleeping peacefully through the night...what a relief. Now I just have to get through this dental procedure.

My Daisy has liver AND kidney issues. She is not masked down. She is induced with propofol and is maintained on isoflourane gas. An IV catheter is placed and fluids are run. The only real contraindication for liver compromised dogs is any valium drug or valium derivative which some vets still use to induce because it is cheaper. If your vet doesn't have propofol on hand then masking down to induce can be used but it's stressful on the dog and isn't necessary when liver dogs can do just fine clearing propofol. My guess is that your vet doesn't have it on hand and is just preferential toward valium. Propofol is immediatley reversible while valium is not and it is more expensive. I think all vets should be using it, but they might disagree with me :). I would be asking the vet how my dog would be monitored during the procedure and by whom. There should be one person doing the dental while another person is sitting there babysitting all the vital signs. I would want to know that an IV catheter is placed and fluids run during the procedure. It is good you are having her teeth cleaned and the diseased tooth removed. My girl is having hers next week also. Both Daisys will be like new!

Thank you so much for your response. I will definitely ask them about propofol and the other things you mentioned.

Is your Daisy taking Denamarin? Is she on a prescription diet? Daisy is on Royal Canine Hepatic but the vet we are going to now sells Hills Science Diet liver diet. Do you know if either one is better than the other?

Also the vet feels that Daisy is having pain in her hip due to arthritis. We tried Tramadol 50 mg. and I'm not sure if it is helping much. He wants her to try daily pain injections. She is showing stiffness when walking. He assured me that it will not hurt her liver. Any thoughts about this?

Thank you for the confidence that both of our Daisy's will be fine. Wishing you and your baby the best.

I have one other question. Can propofol be given by mask? The vet did tell me that as soon as the mask is removed and Daisy takes a breath, she will be fully awake with no lingering effects from anesthesia. That makes me wonder if propofol is given by the mask. Is that possible?

Masking diwn is fine when needed. Propofol is also fine. Propofol is given by IV only. When masking down the oup falls asleep, the mask is removed, a tube delivering Iso is placed.

Masking is controversial because it leaks anesthetic to the technicians, it is stressful for some dogs, adding other drugs can be helpful, and the flow has to be stronger at first. On the other hand it is a nice alternative for pups who do best with fewer types of drugs.

My dog is masked. We could use Propofol but choose not to.

No daily pain injection is good for the liver. Maybe he meant monthly Adequan?

Thank you for explaining, Crystal. I feel a little more at ease with the mask process after you explained it. I emailed the vet for some clarification and it is Adequan he is talking about. I don't know how well she will take to injections, but it sounds like it might be good for her and they start out with 12 injections over two months, so it's not quite as bad as a daily injection. Gosh these little ones will worry you so much. Thanks again.

No, my girl is not taking demararin but in the past has used these drugs. Our internist feels that denamarin isn't needed with the mild elevations Daisy has (her ALT runs around 170). We home cook but years ago did use the Hill's L/d. The issue with that food is the high fat. My Daisy is currently eating white meat chicken, green peas and sweet potatoes.

I don't know about the adequin. A friend of mine had a large breed dog who had severe hip dysplasia at the end of her life and the adequin was a miracle for her. With your girl, why don't you ask your vet about a therapeutic dose of fish oils. I have found that using salmon oil for my dogs has really helped with ortho issues and allergies too. It takes a couple of weeks for the tissue levels to catch up when using fish oil.

Since Crystal explained masking down, I won't. Surprisingly, my youngest dog is the slowest to get back to normal after anesthesia. He is groggy for hours after.

I am happy to hear Daisy's liver enzymes are improved and that she is doing well. Keeping her in my thoughts and prayers for all to go well with her dental work.

Kristin

Thank you so much Kristin. That means so much to me.

Keeping you and Daisy in my thoughts and prayers.

Thank you for mentioning the fish oils. I will ask about them. It would sure beat having to give her injections. I can't even imagine. I only hope that I can get to the point where I can cook a meal like that for her because she isn't really enjoying the canned food that much. I am happy that your Daisy is doing well. Thank for all of the info and advice.

Thank you so much, Cindy. I am just floored at all that is going on. She seemed fine one day then she became nervous, scared and confused. She couldn't sleep through the night, she was pacing and panting. Now that her liver values are better and she does not seem scared and confused and she is sleeping peacefully through the night but I am still watching her closely. Arthritis seems to be bothering her more now and then we have that loose tooth to deal with. I lost so much sleep sitting up with her at night. I was so afraid she would continue to decline and I blamed myself for bad food, treats...whatever I could dream up. I feel so much hope now after hearing of other pups who have gone through this and are doing so well now.