Anesthesia and thunderphobia

Dear Dr. Forsythe:  I have a very old cat that suffers from a heart ailment and is very delicate.  Thank God she has not needed to be put under anesthesia for any reason, but I am really worried if she ever needed a surgery what would happen.  Is there any special way to provide anesthesia for 15-year-old cat with a heart disease that would give her at least a fighting chance? – P.E., Sonoma

Dear P.E. Yes.  The key to dealing with high risk pets is to have a special plan for anesthesia that takes into account their delicate needs, and to work steadily, swiftly, and not to “dilly dally” around.

Seriously compromised patients are challenging to anesthetize but the outcomes can be successful.  The main guidelines are quite simple and include five important steps.

IV fluid therapy during the procedure is important to maintain heart rate, blood pressure and urine production.

Supplemental oxygen to ensure the blood/organs are well perfused.

Vigilant monitoring with cardiovascular support with positive inotropes (an inotrope such as dobutamine increases the strength of a muscle’s contraction).

Keeping a pet WARM by using a heated surgery table, a warm heating pad, warm towels or a combination of the above.  Many scientific studies show that consequences of prolonged low body temperature during procedures or recovery can result in irregular heartbeat, lower cardiac output, increased infection, and increased blood loss.  All this means that simply keeping a high risk patient warm and comfortable during and after an operation will reduce complications.

Use Balanced Anesthesia: minimize the use of anesthetic agents that cause cardiovascular depression.  Since the response to anesthesia is more unpredictable in older, compromised animals, use of reversible agents is preferred.

You would be surprised how well these old and delicate cats actually do under anesthesia using these precautionary measures.  Thanks for your terrific question and good luck with your senior cat.  Thank goodness she hasn’t needed any operations up until now – but if she does, you are fully informed and well prepared. – Dr. F.

Dear Dr. Forsythe:  My Bassett Hound is really scared of thunder, and I was wondering if you had any tips on how I can help her get over this.  She is already a loud girl but during a thunderstorm, her response is to make more noise than usual.  This is all making my neighbor a little cranky.  In fact, my nosey neighbor used to be friendly, but ever since my dog (Lola) started getting more vocal – and worse during storms – my neighbor is downright angry with me.  She used to bring me jam, now she blocks my driveway with her car.  I need advice on how to help Lola, but I can’t afford a fancy trainer.  Any quick fix I can do?  – Robin, Santa Rosa

Dear Robin:  If your pet is only afraid of thunder, then this would be a phobia.  A phobia is a fear response that is persistent over time, consistent in terms of what causes the fear, is learned, irrational, maladaptive and may be intense, (hysteria, catatonia, panic).  My mother had a phobia of snakes.  When I once put a little garter snake in the pocket of her Mu-Mu, she fainted!!

To treat a phobia, you want to minimize Lola’s exposure to the event if possible.  Behavior modification is the most important aspect of treatment, especially desensitization and counter-conditioning whenever feasible.  Medication to eliminate the anxiety such as Valium may be helpful as well.

The only stimulus that is easily manipulated for thunderstorm phobias is the sound of thunder.  First, test to confirm that the animal shows fear with the artificial stimulus.  Then begin at a minimum volume, and reward Lola as long as she remains calm.  Gradually increase the volume.  DO NOT CONSOLE HER DURING A STORM.

You could order a tape to use for your gradual conditioning called “Thunderphobia in Dogs” from The Special Music Co., Electrifying Thunderstorms, 560 Sylvan Ave., Englewood Cliffs, NJ 07632

Good luck with your girl – and your neighbor.  If you fix this phobia, you’ll be getting out of a jam – and maybe your neighbor will start bringing you some again. – Dr. F.