Drug Recalls Put Spotlight on Cat Anesthesia Safety

By Kim Boatman

When Dr. Katy Nelson, a veterinarian, received a recall notice involving the cat anesthetic drug ketamine, she promptly scoured her practice’s supplies and pulled the affected lot numbers. Nelson and other pet health specialists are on the alert because The Food and Drug Administration has issued recalls for certain lots of the commonly used drugs ketamine and butorphanol -- used to control surgery-related pain -- after the deaths of at least five cats were linked to the drugs.

Your veterinarian should be aware of the recall, says Nelson, who practices in Alexandria, Va. “If you’re going to a reputable, accredited veterinarian, you really shouldn’t have to worry about any of these lots being on the shelf,” she says.

Ketamine is often part of a “cocktail” veterinarians administer when placing cats under anesthesia. The recall, however, underscores the importance of the careful use of anesthesia in cats. “Anesthesia for any animal should be taken seriously, especially for older animals or animals that have special medical conditions,” says Dr. Tracy R. Dewhirst, a Knoxville, Tenn., veterinarian who writes a pet advice column for the Knoxville News Sentinel.

Evaluating the Risk of Cat Anesthesia
Your veterinarian should use a risk protocol before placing your cat under anesthesia. Factors such as the type of procedure and your cat’s age and health should be considered. For example, anesthesia for a young cat being neutered would rate as less risky than an elderly cat in renal failure going to a neurologist for a brain tumor section.

Bad reactions to anesthesia can range from not waking quickly to arrhythmias of the heart and full cardiac arrest, says Dewhirst. “The worst case, cardiac arrest, is pretty rare,” notes Dewhirst. “I’ve had that happen once in 10 years of practicing.”

The use of anesthesia shouldn’t prevent you from providing needed procedures for your kitty, such as spaying, neutering or dental cleaning, says Nelson. Although Nelson’s practice averages 10 to 20 anesthetic procedures a day, only two to three anesthetic reactions occurred over the entire last year.

A Cat Anesthesia Checklist
Asking the right questions can help ensure your cat’s safety when anesthesia is used. Dewhirst and Nelson say the following checklist will ensure your veterinarian is practicing safe cat anesthesia:

• Ask about anesthetics. Most veterinarians use a “recipe” or “cocktail” of drugs that work well in anesthesia. For example, ketamine is particularly valuable in the pain management of cats, says Dewhirst. Make sure your veterinarian is aware of any recalls, and ask about the mixture of drugs. Be wary of inexpensive clinics offering discounted cleanings and spaying and neutering, cautions Nelson. These clinics might simply inject your cat with an anesthetic rather than using a mixture of injectable and gas anesthetics, which works better.
• Pay for the blood work. Pre-anesthetic blood work is not just a way for your veterinarian to pad the bill. “The biggest risk with cats is if they have underlying medical problems. A lot of times we can’t know that just by looking at the animal,” says Dewhirst. Blood work and perhaps a urinalysis give us a lot of information about what’s going on inside a cat metabolically and with its organs. Some clinics allow you to opt out of blood work before a young cat undergoes anesthesia, but if you do, you’ll be taking a risk, warns Dewhirst.
• Ask about monitoring equipment. Your veterinarian should be able to watch your kitty’s blood pressure, heart rate, heart rhythms, oxygen levels and respiratory rate. “Things happen all the time under anesthesia, but because we monitor it so closely, we’re able to offset it,” says Nelson. Ask if your cat will have a tube down its mouth to secure the airway.
• Opt for pain management. Many practices will allow you to choose whether to pay for post-procedure pain medication. Make sure pain relief is provided as your kitty wakes up, advises Dewhirst.
• Know about post-procedure monitoring. Monitoring should continue after the procedure, until your cat is alert, says Dewhirst. Ask your veterinarian what you should expect as your cat recovers from both the procedure and the anesthesia.

These guidelines should alleviate any concerns about cat anesthesia. “It’s very safe as long as your veterinarian is doing the proper monitoring,” says Nelson.