Dog neuter with sedation and local anaesthesia

RE: Dog neuter with sedation and local anaesthesia

grumpyoldman — Thu, 21 Jan 2016 18:43:00 GMT

[quote user="Martin Atkinson"]It worked but doesn't mean its right.[/quote]

exactly .

RE: Dog neuter with sedation and local anaesthesia

Martin Atkinson — Thu, 21 Jan 2016 17:54:24 GMT

A vet I saw practice with used to inject large animal's testicles with pentobarbitone then when they went down whipped them off thus removing the source of anaesthesia. He also castrated tom cats in a car inner tube and piglets down a welly boot with no anaesthesia at all. It worked but doesn't mean its right.

RE: Dog neuter with sedation and local anaesthesia

John Flynn — Thu, 21 Jan 2016 00:04:32 GMT

I do intratesticular lidocaine for dog/cat castrates and am quite convinced that it works.

I think the distinction is perhaps being lost in semantics between sedation and anesthetic. Think of anesthetising a dog for a VD hip radiograph and compare that to doing a castration without local, you need a deeper plane of anesthesia for the latter - add in local and you don't - I appreciate it's not for all, but I personally prefer to block the nociceptive signals when convenient to do so than deepen the plane of anesthesia to a level where the patient doesn't react to them. Ditto for dental extractions.

RE: Dog neuter with sedation and local anaesthesia

Nhombokisheni — Wed, 20 Jan 2016 22:09:53 GMT

In the remote villages of Africa where veterinary practice is done "resourcefully" (for lack of a better English word)......intact that's the only way at times.........I used to do these with no problems at all. I appreciate fully that when you have all the equipment, you have no excuse......however there are places on this earth where a bit of imagination and enterprise carries the day............when you witness human circumcision using cold water (as analgesia) and a sharp knife...and the scared victim realises it's over before they even had a chance to scream...it's a marvel. So yea sedation with local works........especially when you are the very and the nurse all in one.

RE: Dog neuter with sedation and local anaesthesia

grumpyoldman — Wed, 20 Jan 2016 21:45:25 GMT

doing horses with dom/torb or sedivet /torb and local is fine ,until the odd one drops out a chunk of mesentery or a pelvic flexure, personally I do not like things fidgeting and jumping about while i am trying to ligate things or use an emasculator, I have always knocked horses down with ketamine and gelded them, if there was a problem I could deal with it. they bled less .swelled less ,and required less/no post op input. Basically you just get a better more accurately placed cut. When Immobilon disappeared everyone jumped on the standing geldings bandwagon to make things cheaper for the penny pinching equine clients, who of course wanted it done as cheap as possible until something went wrong.

RE: Dog neuter with sedation and local anaesthesia

Michael Woodhouse — Wed, 20 Jan 2016 21:27:20 GMT

We do hip scores under sedation - there are no positioning issues.

I'm not saying I think this is the world's greatest idea, but still worthy of consideration.

I saw practice (different place to the rabbit castrates) that did PDSA Petaid (or something like that, private practice with people signed up). They did a lot of operations under local and sedation. Worked well.

Also do we have any evidence for the frequently cited "sedation more dangerous than GA"?

RE: Dog neuter with sedation and local anaesthesia

Iain Richards — Wed, 20 Jan 2016 20:58:05 GMT

That's better!

RE: Dog neuter with sedation and local anaesthesia

David Mills — Wed, 20 Jan 2016 20:57:20 GMT

[quote user="Iain Richards"]Looks like David's emoticon buttons aren't working![/quote]

Edited for you

RE: Dog neuter with sedation and local anaesthesia

Iain Richards — Wed, 20 Jan 2016 20:47:42 GMT

Looks like David's emoticon buttons aren't working!

I'm with the "why would you" folk on this. If you could get the relaxation right than local would provide good analgesia for the skin, but I have doubts about enough to reduce the pain associated with tearing the testicular ligament and pulling and clamping the cord. I've never been convinced the intra-testicular method actually allows anaesthetic diffusion enough to work. Sedation and epidural might be better, but GA still for me.

RE: Dog neuter with sedation and local anaesthesia

David Mills — Wed, 20 Jan 2016 20:32:16 GMT

It's just bizarre. I've no idea why someone would do it. All that pissing around, injecting local, waiting (and hoping) for the dog to go deep enough, unable to stretch their legs out fully. Weird. Can only think he's a large animal vet?

As others have said, it's hardly comparable to horses and cows for any number of reasons. I've known bulls to be castrated without any anaesthetic, commonly. Hardly paragons of welfare virtue these cow botherers...

RE: Dog neuter with sedation and local anaesthesia

Clive Ansell — Wed, 20 Jan 2016 16:59:22 GMT

[quote user="Michael Woodhouse"]What is fundamentally wrong with it? They are doing less human surgery under a GA now. As long as the dog is pain free and the outcomes are comparable I can't see an issue.[/quote]

There is nothing fundamentally wrong with it at all, I just cannot think of a single reason or clinical indication where it would be better or safer or offer any advantage at all in small animal practice. Surely a well planned and administered general anaesthetic in an intubated, oxygenated and monitored patient is far easier and safer than sedation alone.

Not really comparable to human surgery; one can explain to a human patient that they need to keep still and calm during a procedure - what happens when a dog starts moving around mid procedure - might have to "upgrade" to a GA mid op - would be unsafe and chaotic.

I used to locum for a chap that did a lot of minor surgeries; lump removals, biopsies etc under sedation and local. Used to scare the hell out of me; old dogs, often with heart disease flattened with high does of Domitor with no opiate, not oxygenated, cyanotic membranes etc, just so he could appease clients who wanted sedation and not ga!

RE: Dog neuter with sedation and local anaesthesia

Gillian Mostyn — Wed, 20 Jan 2016 16:53:15 GMT

[quote user="Michael Woodhouse"]If I said I'll only castrate a bull or horse with a GA people would think I am mad. It's not nasty and cruel in cattle and horses - so why should it be in dogs?[/quote]

Because we are always working on a risk vs benefit basis. We do what is safest and least stressful for the animal....which isn't going to be the same in all species.

In dogs, where GA is 'safe', choosing not to do so would presumably be for reasons of convenience/economics. I can't imagine how awareness could ever be in the dog's best interests.

RE: Dog neuter with sedation and local anaesthesia

Ashley Rubens — Wed, 20 Jan 2016 13:45:42 GMT

I think there's a big difference between human surgery under local anaesthetic and sedating an animal so heavily you can maintain it in dorsal recumbency and inject intra testicular local!

Or to putting a bull in a crush!

Clinically I would think a sedation that deep is less safe than a general anaesthetic and would cost pretty much the same and you'd still need a nurse to monitor it.

RE: Dog neuter with sedation and local anaesthesia

Michael Woodhouse — Wed, 20 Jan 2016 13:09:31 GMT

I saw practice somewhere that did rabbit castrations like that.

What is fundamentally wrong with it? They are doing less human surgery under a GA now. As long as the dog is pain free and the outcomes are comparable I can't see an issue.

If I said I'll only castrate a bull or horse with a GA people would think I am mad. It's not nasty and cruel in cattle and horses - so why should it be in dogs?

Not from any first hand experience, but no GA for a vasectomy in people. Maybe its a better way and we are all stuck in our routines with our heads down?

RE: Dog neuter with sedation and local anaesthesia

Martin Atkinson — Wed, 20 Jan 2016 11:40:23 GMT

[quote user="Seadna "]A very quick question; does anyone else neuter male dogs using just sedation? [/quote]It depends upon when sedation becomes anaesthetic, give it enough medetomidine and it will! Otherwise +1 for Clive's reply.

RE: Dog neuter with sedation and local anaesthesia

Hannah Wynne Richards — Wed, 20 Jan 2016 11:20:44 GMT

Easy way to check if pain relief is adequate - volunteer to do him under that regime. I'll bet he screeches when the intra-testicular local goes in.

Wynne

RE: Dog neuter with sedation and local anaesthesia

Seadna — Wed, 20 Jan 2016 11:17:56 GMT

Just off the top of my head, one advantage could be the reversal of sedation in case of an emergency? I'm curious to know if anyone else has heard of the practice.

[quote user="Clive Ansell"]can't think of a clinical indication[/quote]

RE: Dog neuter with sedation and local anaesthesia

Clive Ansell — Wed, 20 Jan 2016 10:53:11 GMT

Why? when general anaesthesia is quicker, easier and safer. I can't think of a clinical indication where it would offer any advantage at all ??