RE: Have you ever had a cat regurgitate or vomit during a GA?

Kate Richardson — Sun, 31 May 2020 17:09:12 GMT

Thanks Carl, sorry for the delayed response! Good points about reflux and potential for oesophagitis as are all the other points.
Do you think any sign of nausea following medetomidine is a potential concern and could indicate reflux? Should we consider administering an antacid treatment pre op?

RE: Have you ever had a cat regurgitate or vomit during a GA?

Carl Bradbrook — Thu, 21 May 2020 14:03:10 GMT

It certainly appears that cats are less prone to show visible signs of regurgitation during anaesthesia, and this is something I think we notice clinically compared to dogs. There is some literature on this topic, with a couple of studies measuring oesophageal pH to detect reflux. These studies concluded the risk of reflux was about the same as in dogs. Maybe we just don't see the consequences, and less cats actually regurgitate (so we don't observe this). Oesphageal stricture formation and nasopharyngeal stricture formation are reported, and may be due to reflux.

There are other reasons that I think about as to why we fast our patients, and aim for an empty stomach: Ventilation may be impeded may a full or partially full stomach due to cranial displacement of the diaphragm, particularly in dorsal recumbency, and there may be compression of vessels in the abdomen, leading to a reduction in venous return and increased risk of hypotension.

Volume and hydration status is definitely a concern, particularly in cats with comorbidites or our geriatric felines, but this may be managed with fluid therapy following admission if needed.

I still advise for cats being admitted to the clinic to be starved, and give fluids if indicated by the individual prior to anaesthesia (either overnight or during the day depending on the situation).

Carl