Anaesthesia for diabetics

RE: Anaesthesia for diabetics

David Mills — Sat, 04 Aug 2018 20:26:35 GMT

[quote user="Beats"]

Similar to Rob and Lucy.

I think the anesthetic benefits of fasting an adult dog are vastly overstated. Pre-GA Cerenia should largely prevent vomiting if wish. Regurgitation and aspiration is an uncommon concern in my experience in the absence of obvious risk factors

[/quote]

I read an article by Mark Hedberg of this forum

Recently in a publication that suggested it was more common than we realise. It was sponsored by v-gel though...

I agree very few issues with it, and I think starving for as long as we do (midnight in our case) is over egged, and a cross over from humans whose anatomy is more prone to regurg when lied down - if you think of quadripeds compared to us, they're always lied down.

RE: Anaesthesia for diabetics

Silvia Maldonado — Sat, 04 Aug 2018 12:10:58 GMT

I like Richard's plan for diabetic pets.Would you change the feeding/insulin protocol depending on the surgical procedure? For example, in a short procedure we would expect the pet to start eating soon after recovery, but in a long surgery, in GIT surgeries, painful procedures, or others, the pet may not want to eat that soon?

RE: Anaesthesia for diabetics

Beats — Fri, 03 Aug 2018 08:34:35 GMT

Similar to Rob and Lucy.

RE: Anaesthesia for diabetics

Rob Davis — Wed, 01 Aug 2018 22:06:17 GMT

I generally starve overnight, half dose of insulin in morning then do as first op with monitoring of glucose and feeding as soon as awake enough, but would be comfortable with the other variations suggested above.

RE: Anaesthesia for diabetics

Richard Carter — Wed, 01 Aug 2018 13:08:50 GMT

I would have owners feed and inject am if op going to be midday or later, no food or injection if early am but then as soon as awake, feed and inject. Prefer to be sl diabetic than run risk of hypo.

RE: Anaesthesia for diabetics

Lucy Fleming — Wed, 01 Aug 2018 08:54:13 GMT

Basically, what Rob said! I might get the owners to feed late at night and do the op first thing instead, depending on timings. If the owners can/ do measure blood glucose at home, get them to check BG when they would normally give insulin. Some figures I have heard bandied about are:

BG over 15, give the full dose of insulin

BG 8-15, give 1/2 dose

BG under 8, do not give insulin

RE: Anaesthesia for diabetics

Rob Loxley — Tue, 31 Jul 2018 18:17:32 GMT

Make sure they are stable if possible, regarding insulin I'm sure you'll get many answers but I'd give half dose insulin with small bit of food at home 1st thing and op late morning so to have 4hr fast, monitor BG pre/intra/postop to guide insulin/glucose needed, ensure fluid inputs (and monitor for hypotension), early postop feeding, manage nausea/pain to encourage eating. Importantly, prepare to be flexible rather than fixed protocol...