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Original printed byline: Stephen A.Brammeier
Historical October–November 1996 article. Dates, prices, services and contacts describe the source period; current availability has not been established.
It is professionally reassuring when case comes along that follows the rules.
When a patient gets sick they donit pull down the medical textbook to make sure they exhibit all the classical signs of their disease. Much of the diagnostic approach to figuring out a problem-or preventing a problem-involves following a standard protocol through a logical process of elimination based on gathering information from, and about, the patient.
The rules of the protocol begin with general, simple problems and work towards the more unusual or complex. What this means for the veterinarian is that he, or she, spends a lot of time warning people about the problems that could possibly be, and ultimately defines a, specific problem less frequently. Now, if I haven’t lost you completely, I will attempt to tie all this into the point of this article. Three or four years ago we began offering a pre-anesthetic blood screen to our surgical patients.
The screens consist of four tests on a blood sample drawn from the patient just prior to administering the anesthesia.
We check one kidney function test (BUN), one liver function test (SGPT), measure total cellular components (PCV), and total protein content of a whole blood sample.
The purpose of the screen is to detect possible problems that are not notable on a physical exam; problems that would either change the type of anesthetic drugs used, or require that anesthesia be postponed for further investigation into the abnormal test results. Performing the pre-anesthetic screen does not guarantee a safe anesthetic experience but it reduces the risk.
Most pet owners worry when their pet undergoes anesthesia and want to reduce the risk whenever possible. Luckily, 95% or more of the time there are no problems detected on the pre-anesthetic tests. So, I find myself answering questions for clients about how “necessary” are these preop tests.
As I mentioned in the opening paragraph, I work from the generalities to the specifics.
I tell people, “Generally, there are no problems, especially with young, healthy pets. But, these screening test are designed to help prevent the unexpected problem patient from receiving anesthesia.” This week we had the perfect example of why the pre-anesthetic tests are important. Carl, a 7 month old Rott-weiller was to be neutered.
We have seen Carl since he was about 3 months old.
He has had an uneventful puppyhood.
He was robust, had grown to 66 pounds, and his owners had not noticed any problems. Fortunately, or unfortunately, depending on your perspective, Carl’s pre-anesthetic blood screen showed an elevation in his BUN.
We repeated our test to make sure our first reading was accurate and then pursued other tests: a creatinine and a urinalysis. Long story short, we are doing further tests on Carl and it appears he may have been born with deficient kidneys.
It is not a good diagnosis for Carl, but with medical management he may get along well for a while. Carl may have had serious problems during or after anesthesia because of his impaired kidney function.
The next time I explain why we do pre-anesthetic blood tests, I will remember Carl.
Originally published in The Times of Skinker-DeBaliviere, October–November 1996.
Read this article in the original newspaper issue.
Original source: SD_Times1996_10.pdf, printed page(s) 6; PDF page(s) 6.
