Anesthesia Recommendations
Veterinarians must assess the individual risks and benefits for each individual patient before creating an anesthetic plan. There is no one-size-fits-all anesthesia that should be asked for at a veterinary hospital, there are many factors that go into creating a safe anesthetic plan that meets the guidelines. The following items should be considered for each patient before each procedure:
Physical Exam findings (objective and subjective):
1. Weight, Age, Gender (castrated/intact), Breed, Body Condition Score
2. Underlying health issues, concomitant disease or compromise
3. Metabolic function health (kidney, liver, hormonal, electrolyte, white blood cell/red blood cell function)
4. Behavior of the individual animal (fearful, timid, reactive, apathetic, painful, aggressive, etc)
5. Historical experiences with sedation and anesthesia for the individual dog
6. Is the dog on any medications or supplements that can affect anesthesia or sedation
7. MDR1 gene status (if applicable to the breed)
Procedural requirements:
1. Does the procedure require sedation or anesthesia?
2. What level of sedation or anesthesia is required to accomplish the procedure?
3. How long will the procedure take?
4. Is immobilization necessary or just relaxation?
5. What pain level is anticipated associated with the procedure?
6. Can local anesthesia techniques be applied in this procedure to minimize the use of analgesics and anesthetics?
All of these things need to be considered to create a safe and effective anesthesia or sedation plan for every animal.
Specific considerations for Giant breed dogs (Kangals included):
As a rule, giant breeds of dogs have a smaller body surface area to volume ratio, and, as such, require much lower doses of sedative/analgesic drugs on a mg/kg basis. It is always important to get an accurate weight and to estimate lean body weight from that. These breeds are usually tractable and do not require heavy sedation. This is the most specific problem with Kangals regarding sedation and anesthesia. Veterinarians will use a standard dosage calculation that they successfully use in 98% of patients based on safe guidelines, and see significantly different results with giant breed dogs and sighthounds.
If the body condition score of a giant breed dog is 3/5 or higher - then drug doses should be calculated significantly lower than average dosing. There is a Body mass index chart, that can be referenced to safely calculate doses, that takes into consideration lean muscle mass, fat stores, and metabolism considerations. Dosages should be calculated on the ideal lean body weight of a giant breed, versus their actual weight.
Best anesthesia protocols are multi-drug protocols that combine, in smaller doses, the beneficial effects of each drug, minimizing the negative effects of drugs used in single-drug protocols. The goal should always be to safely accomplish each procedure with safety for the animal and the humans handling the animal, minimizing pain, stress, and discomfort. Of course, appropriate monitoring and anesthesia management are required for the best outcomes. Here are the AAHA Anesthesia and Monitoring Guidelines: https://www.aaha.org/globalassets/02-guidelines/2020-anesthesia/anesthesia_and_monitoring_guidelines_final.pdf
The only drug that I would say to specifically avoid (in all breeds) is Acepromazine. It is an out-of-date drug, that is slow to be metabolized, has a large range of negative side effects, and is unnecessary in this day and age. We have much better sedation, analgesic, and anesthetic drugs available in our pharmaceutical cabinets.
If an anesthetic/sedation protocol is necessary for your dog, you can always request an individual anesthesia consult from a board certified anesthesiologist, which your general practitioner can readily access.
https://acvaa.org/pet-owners/care-for-your-pet/
Anesthesia and sedation is a complicated topic and should never be dismissed as a simple subject with one simple answer. It is best for pet owners and breeders to be educated and engage in discussions with their attending veterinarian about what anesthetic plans will be used for each individual procedure.
Heather Steyn, DVM
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