North American Veterinary Anesthesia Society Podcast

Welcome to another episode of the NAVAS podcast! How many times in your career, after recommending a surgical or dental procedure for a dog or cat, have you been asked whether a beloved aging pet was too old to be anesthetized? Today, we’re diving into a topic that many veterinary professionals encounter but may not always feel fully prepared for: anesthesia for senior dogs and cats. Older pets can present unique challenges when it comes to sedation and general anesthesia, and understanding how aging impacts their physiology is key to providing safe and effective care. 

In this episode, we have the honor of speaking with Dr. Sheliah Robertson, a veterinary anesthesiologist who is also board-certified in animal welfare and the senior medical director at Lap of Love, a network of veterinary at-home euthanasia and hospice care providers. Dr. Robertson brings a wealth of experience and insight into the world of anesthesia for geriatric pets. We’ll be discussing everything from anesthetic risks and frailty in older animals to how aging affects vital organ function and what that means for anesthesia protocols. This conversation is guaranteed to be packed with valuable information to enhance your understanding and improve outcomes for your older patients.

 Resources mentioned in this episode:

Dr. Sheliah Robertson’s work at Lap of Love

The ERAS Society (Enhanced Recovery After Surgery)

Development of ERAS protocols for veterinary medicine

A review article on improving postoperative sleep

Research on the effect of preoperative melatonin on the propofol dose required to induce anesthesia in dogs

An article on how pre-surgery rehabilitation effects surgical outcomes in aged patients

 If you like what you hear, we have a couple of favors to ask of you:

Become a member of NAVAS for access to more anesthesia and analgesia educational and RACE-approved CE content. 

Spread the word. Share our podcast on your socials or a discussion forum. That would really help us achieve our mission: Reduce mortality and morbidity in veterinary patients undergoing sedation, anesthesia, and analgesia through high-quality, peer-reviewed education.

 As a reminder, the ACVAA Annual Meeting is happening in Denver, CO from September 25-27 later this year. Registration rates are discounted for NAVAS members. We hope to see you there! Sign up today!

Thank you to our sponsor, Dechra - learn more about the pharmaceutical products Dechra has to offer veterinary professionals, such as Zenalpha.

If you have questions about this episode or want to suggest topics for future episodes, reach out to the producers at [email protected].

 All opinions stated by the host and their guests are theirs alone and do not represent the thoughts or opinions of any corporation, university, or other business or governmental entity.

Are you having a BRAT summer, because we sure are here on the NAVAS podcast! By BRAT, we mean Best Remedies for Analgesic Therapy! We’re excited to continue our discussion on post-operative pain control for dogs and cats. If you haven’t listened to part one of this conversation, please go back and listen before diving into this episode. We’re going to finish up our conversation on surgical pain management by discussing the nuances of NSAID use in cats, confronting some controversial opinions on Gabapentin, rave about local anesthetic agents, and introduce some pharmacologic and non-pharmacological therapies to help tackle acute pain for our patients. Joining us again is Dr. Melina Zimmerman, veterinary anesthesiologist and owner of The Doggy Gym, where she provides pain management therapies for all kinds of species. Pain management is so much more than “set and forget”, and we hope to convince you of that right here on the NAVAS podcast.

References are made to the following resources in the episode:

Our previous short episode on Nocita with Dr. Tammy Grubb.

2022 ISFM consensus guidelines on managing acute pain in cats that has been endorsed by the American Association of Feline Practitioners (AAFP): 

2024 ISFM & AAPF consensus guidelines on long-term NSAID use in cats

Buprenorphine as an additive agent with bupivacaine for certain dental blocks in dogs

If you like what you hear, we have a couple of favors to ask of you:

Become a member of NAVAS for access to more anesthesia and analgesia educational and RACE-approved CE content. 

Spread the word. Share our podcast on your socials or a discussion forum. That would really help us achieve our mission: Reduce mortality and morbidity in veterinary patients undergoing sedation, anesthesia, and analgesia through high-quality, peer-reviewed education.

As a reminder, the ACVAA Annual Meeting is happening in Denver, CO from September 25-27 later this year. Registration rates are discounted for NAVAS members. We hope to see you there! Sign up today!

Thank you to our sponsor, Dechra - learn more about the pharmaceutical products Dechra has to offer veterinary professionals, such as Zenalpha.

If you have questions about this episode or want to suggest topics for future episodes, reach out to the producers at [email protected].

All opinions stated by the host and their guests are theirs alone and do not represent the thoughts or opinions of any corporation, university, or other business or governmental entity.

In this episode, we're focusing on a critical aspect of post-surgical care: creating a plan to control postoperative pain once our canine or feline patients leave the hospital. We know that managing pain effectively during this period is vital for the recovery and well-being of our patients. With so many medications to choose from, costs to consider, and non-compliance to worry about, how can we optimize our patients pain control at home when there are so many variables to balance? In this episode, we're thrilled to have Dr. Melina Zimmerman lead us through this important discussion. As a veterinary anesthesiologist with additional training in companion animal rehabilitation, Dr. Zimmerman specializes in pain management for surgical and non-surgical conditions at her clinic, The Doggy Gym. In the first part of this two-part episode, we will focus our discussion on opioids and NSAIDs, with an emphasis on ancillary medications and non-pharmaceutical treatment options in our next episode. Have you ever wondered: What oral opioid options do we know are effective analgesics for dogs and cats? Is buprenorphine a great opioid or the greatest opioid? How do you get a fentanyl patch to stick? What’s with all this hype about Galliprant and Tylenol for dogs? If you’re curious about leveling up your analgesia game, we hope you give this episode a listen.

References are made in this episode to analgesic and sedative agents from previous NAVAS episodes. Check out our episode on Zenalpha and Zorbium for more information.

If you like what you hear, we have a couple of favors to ask of you:

Become a member of NAVAS for access to more anesthesia and analgesia educational and RACE-approved CE content.

Spread the word. Share our podcast on your socials or a discussion forum. That would really help us achieve our mission: Reduce mortality and morbidity in veterinary patients undergoing sedation, anesthesia, and analgesia through high-quality, peer-reviewed education.

As a reminder, the ACVAA Annual Meeting is happening in Denver, CO from September 25-27 later this year. Registration rates are discounted for NAVAS members. We hope to see you there! Sign up today! 

Thank you to our sponsor, Dechra - learn more about the pharmaceutical products Dechra has to offer veterinary professionals, such as Zenalpha.

If you have questions about this episode or want to suggest topics for future episodes, reach out to the producers at [email protected].

All opinions stated by the host and their guests are theirs alone and do not represent the thoughts or opinions of any corporation, university, or other business or governmental entity.

In this episode, we are going to shine the spotlight on a species that doesn’t always get the limelight on this podcast: the horse! Horses pose a unique challenge for anesthetists, especially when we turn off the vaporizer at the end of anesthesia and ask these rather large animals to stand up while under the influence of medications designed to cause sedation and muscle relaxation. In equine anesthesia, the recovery period is a time of considerable risk and has been the focus of prolific research, with many studies attempting to pinpoint risk factors that increase the risk of adverse events occurring in the recovery period and identify pharmaceutical protocols and recovery techniques that will mitigate these risks. 

Lucky for us, we have an exceptional guest joining the podcast to delve into this particularly challenging aspect of veterinary anesthesia. Dr. Stuart Clark-Price is a renowned expert in the field, boasting board certifications in both Large Animal Medicine and Anesthesia, and recently ascended to the role of full Professor of Anesthesia at Auburn University College of Veterinary Medicine. Together, with host  Dr. Bonnie Gatson, we'll explore why recovery from general anesthesia poses such a significant challenge for the horse, shed light on the various risk factors that can increase the likelihood of undesirable recoveries, and share evidence-based recommendations for interventions that can enhance the quality of recovery for equine patients.

If you like what you hear, we have a couple of favors to ask of you:

1. Become a member of NAVAS for access to more anesthesia and analgesia educational and RACE-approved CE content.
2. Spread the word. Share our podcast on your socials or a discussion forum. That would really help us achieve our mission: Reduce mortality and morbidity in veterinary patients undergoing sedation, anesthesia, and analgesia through high-quality, peer-reviewed education.

As a reminder, the ACVAA Annual Meeting is happening in Denver, CO from September 25-27 later this year. Registration rates are discounted for NAVAS members. We hope to see you there! 

Sign up at https://vetvacationce.com/product/acvaa-annual-meeting-denver-co-2024/

Thank you to our sponsor, Dechra - learn more about the pharmaceutical products Dechra has to offer veterinary professionals, such as Zenalpha.

If you have questions about this episode or want to suggest topics for future episodes, reach out to the producers at [email protected].

All opinions stated by the host and their guests are theirs alone and do not represent the thoughts or opinions of any corporation, university, or other business or governmental entity.

In our last episode, we introduced a new class of drugs that have recently hit the veterinary market for treating pain associated with osteoarthritis: nerve growth factor monoclonal antibody therapy. Just over one year ago, Librela (bedinvetmab) entered the North American veterinary market, shaking up our traditional pharmaceutical approach to osteoarthritis pain management in dogs. However, Librela has been available in the United Kingdom and Europe for years  Zoetis, the pharmaceutical manufacturer and distributor of Librela, reports that millions of doses of Librela have been administered to dogs since its introduction in 2021, with veterinarians rating their overall satisfaction with the product at about an 8 out of 10. 

What can veterinarians in America learn from the experience of European vets about effectively incorporating this novel drug into an overall pain management plan for dogs with osteoarthritis?

Host Dr. Bonnie Gatson chats with UK veterinary anesthesiologist and internationally recognized expert on companion animal pain management, Dr. Matt Gurney. Dr. Gurney is past president of the European College of Veterinary Anesthesia & Analgesia and now works as an anesthesiologist and pain management expert at Eastcott Referrals in the UK. He is also co-founder of Zero Pain Philosophy, an educational resource for veterinary professionals around the globe with a mission to help achieve excellence in veterinary pain management. Together, they discuss how Librela has changed the way European vets manage osteoarthritis pain in dogs, clinical pearls on using Librela in practice, and side effects observed by European vets compared to anecdotal adverse events that have been reported out of the United States.

Resources mentioned in this episode:

 The Canine Brief Pain Inventory for dogs

The European and American data sheets on Librela (bedinvetmab)

A comprehensive review of nerve growth factor antibody therapy for the treatment of osteoarthritis pain in humans by Dr. Schmelz 

If a patient experiences an adverse event associated with use of Librela, please contact product support at Zoetis at 1-888-963-8471.

 Learn more about achieving analgesic excellence at your clinic with Dr. Gurney’s Zero Pain Philosophy. You can check out Zero Pain Philosophy Podcast, wherever you get your podcasts. 

Become a member of NAVAS for access to more anesthesia and analgesia educational and RACE-approved CE content.

Our mission: Reduce mortality and morbidity in veterinary patients undergoing sedation, anesthesia, and analgesia through high-quality, peer-reviewed education.

Thank you to our sponsor, Dechra - learn more about the pharmaceutical products Dechra has to offer veterinary professionals, such as Zenalpha.

All opinions stated by the host and their guests are theirs alone and do not represent the thoughts or opinions of any corporation, university, or other business  or governmental entity.

Special thanks to Chris Webster, Saul Jimenez, and producer Maria Bridges for making this podcast a reality.

From subtle tail twitches to silent yowls, cats have mastered the art of hiding their discomfort, leaving us humans scratching our heads feeling somewhat purr-plexed when it comes to decoding the mysteries of recognizing and managing pain in this stoic species. In this episode, we are going to sink our claws into feline osteoarthritis pain management by discussing the newest drug to hit the market designed to diminish feline osteoarthritic pain: Solensia. Solensia (frunevetmab) is a monthly injection administered at a veterinary clinic that can help control pain from osteoarthritis in cats. Our guide to understand this new and revolutionary medication is Dr. Kristin Kirby-Shaw, a board-certified veterinary surgeon and animal rehabilitation specialist who currently serves as a Pain and Osteoarthritis Specialist at Zoetis. Together with host Dr. Bonnie Gatson, they will discuss tools that can help veterinarians and pet owners recognize osteoarthritis pain in cats, summarize how Solensia provides pain control in this population of cats, and review important clinical trial and safety information to ensure we are using this innovative drug efficaciously to its full potential in our feline companions. Listen now to learn how Solensia helps our cats feel-ine good!

 We want to inform our listeners about important safety information regarding Solensia (frunevetmab). Solensia is for use in cats only. Women who are pregnant, trying to conceive, or breastfeeding should take extreme care to avoid self-injection. Hypersensitivity reactions, including anaphylaxis, could occur with self-injection. Solensia should not be used in breastfeeding cats, or in pregnant or lactating queens. Solensia should not be used in cats with a known hypersensitivity to frunevetmab. The most common adverse events reported in a clinical study were vomiting and injection site pain. Review important safety information and prescribing information on the Zoetis website. 

Resources mentioned in today’s episode:

Learn more about Solensia.

Screening tool for osteoarthritis pain in cats.

If a patient experiences an adverse event associated with use of Solenia, or if inappropriate human exposure occurs, please contact product support at Zoetis at 1-888-963-8471.

If you like what you hear, we have a couple of favors to ask of you:

Become a member of NAVAS for access to more anesthesia and analgesia educational and RACE-approved CE content.

Spread the word. Share our podcast on your socials or a discussion forum. That would really help us achieve our mission: Reduce mortality and morbidity in veterinary patients undergoing sedation, anesthesia, and analgesia through high-quality, peer-reviewed education.

Thank you to our sponsor, Dechra - learn more about the pharmaceutical products Dechra has to offer veterinary professionals, such as Zenalpha.

If you have questions about this episode or want to suggest topics for future episodes, reach out to the producers at [email protected].

All opinions stated by the host and their guests are theirs alone and do not represent the thoughts or opinions of any corporation, university, or other business or governmental entity.

The NAVAS Podcast is published monthly on or near the 15th of the month.

Special thanks to Chris Webster for editing, producer Maria Bridges, and Saul Jimenez for IT support in making this podcast a reality.

Are you someone who doesn’t feel confident in your anesthesia skills or knowledge? 

Are you seeking resources beyond this podcast to improve your anesthesia expertise? 

Veterinary professionals often find themselves crunched for time, so finding resources that will guarantee rapid results in training is crucial to advancing anesthesia knowledge. How can we integrate effective training modalities into veterinary practice that will provide meaningful educational opportunities, improve skill levels, and heighten overall job satisfaction? 

With so many options out there for continuing education, how can you effectively evaluate training programs to know what educational resources to use that will produce the most meaningful results for you? 

In this episode, we talk with Dr. Erik Hofmeister, a professor of veterinary anesthesia at Auburn School of Veterinary Medicine with over 20 years of experience teaching veterinary students. With his guidance, we will discuss what causes individuals to lack confidence in their anesthesia skills, evidence-based recommendations for effectively learning skill sets related to anesthesia, and how to appraise existing anesthesia training programs to ensure that you get a fulfilling education experience.

 Resources mentioned in today’s episode:

Read 2023 AAHA Technician Utilization Guidelines or watch a quick summary of these guidelines.

Understanding How We Learn: A Visual Guide

If you are creating an anesthesia training program, consider reviewing the book Understanding by Design recommended by Dr. Hofmeister

Not mentioned in today’s episode, but we encourage listeners to review Dr. Hofmeister’s and Dr. Love’s JAVMA article on patient safety culture in veterinary medicine (Open Access).

If you are looking for more information on veterinary education, please check out Dr. Hofmeister’s podcast, Reflections in Veterinary Education (RIVE), and his blog The Vetducator - Help for every stage of your veterinary career.

As a reminder, the NAVAS Virtual Spring Symposium is taking place next month on April 27th and 28th. Registration is free!

If you like what you hear, we have a couple of favors to ask of you:

Become a member of NAVAS for access to more anesthesia and analgesia educational and RACE-approved CE content.

Spread the word. Share our podcast on your socials or a discussion forum. That would really help us achieve our mission: Reduce mortality and morbidity in veterinary patients undergoing sedation, anesthesia, and analgesia through high-quality, peer-reviewed education.

Thank you to our sponsor, Dechra - learn more about the pharmaceutical products Dechra has to offer veterinary professionals, such as Zenalpha.

If you have questions about this episode or want to suggest topics for future episodes, reach out to the producers at [email protected].

All opinions stated by the host and their guests are theirs alone and do not represent the thoughts or opinions of any corporation, university, or other business or governmental entity.

The NAVAS Podcast is published monthly on or near the 15th of the month.

Special thanks to Chris Webster for editing, producer Maria Bridges, and Saul Jimenez for IT support in making this podcast a reality.

Here at NAVAS we spend a lot of time educating veterinary professionals on safe anesthetic practices, but what about the safety of the anesthetist? In today’s episode, we are going to explore a mental health phenomenon known as second victim syndrome. Second victims are health care providers who are involved in an unanticipated adverse patient event, in a medical error, or in a patient-related injury and begin to feel personally responsible for the patient outcome, causing the provider to become traumatized by the event. As a result, veterinary professionals experience a tremendous amount of professional and personal suffering following these unanticipated clinical events. Anesthesia is a high-stakes field driven almost entirely by human decision making, and it is not surprising that errors, complications, or unexpected outcomes, although unintended, will occur and the patient may suffer. This makes anesthetists vulnerable to the second victim syndrome when medical errors occur. How can we help support ourselves and our peers following an adverse patient event and how can we learn to thrive after experiencing such a traumatic event? To help guide us through this important, but difficult topic, is Dr. Luiz Santos. He is a Senior Clinician of Veterinary Anesthesia at the University of Glasgow and he is currently obtaining his PhD in topics related to patient safety culture, burnout, and second victim syndrome as they relate to veterinary anesthetic practice.

Dr. Santos will be one of the featured speakers at our NAVAS Virtual Spring Symposium on April 27th and 28th, 2024. Registration is free! 

As a warning, there will be mention of mass casualty events and suicide in this episode. Timestamps for these discuss are as follows:

Discussion on gun violence/mass casualty event: 16:30-17:30

Mention of suicide: 46:15-47:26

Resources mentioned in today’s episode: 

Dr. Hoffmeister’s and Dr. Love’s JAVMA article on patient safety culture in veterinary medicine

Dr. Ludder’s book on medical errors in veterinary anesthetic practice

The Second Victim Experience: Caring for our Own a presentation by Dr. Susan Scott

If you or someone you know is experiencing trauma related to second victim syndrome, please reach out to the US National Suicide Hotline (or dial or text 988).

If you like what you hear, we have a couple of favors to ask of you:

Become a member of NAVAS for access to more anesthesia and analgesia educational and RACE-approved CE content.

Spread the word. Share our podcast on your socials or a discussion forum. That would really help us achieve our mission: Reduce mortality and morbidity in veterinary patients undergoing sedation, anesthesia, and analgesia through high-quality, peer-reviewed education.

Thank you to our sponsor, Dechra - learn more about the pharmaceutical products Dechra has to offer veterinary professionals, such as Zenalpha.

If you have questions about this episode or want to suggest topics for future episodes, reach out to the producers at [email protected].

All opinions stated by the host and their guests are theirs alone and do not represent the thoughts or opinions of any corporation, university, or other business or governmental entity.

The NAVAS Podcast is published monthly on or near the 15th of the month.

Special thanks to Chris Webster for editing, producer Maria Bridges, and Saul Jimenez for IT support in making this podcast a reality.

What fasting recommendations are you making for your elective anesthetic procedures? Are you recommending that all your patients be fasted overnight? This has been recommended by veterinarians to countless dog and cat owners for years. However, our human counterparts have changed these recommendations in recent years to shorter episodes of fasting before general anesthesia. The most recent anesthesia guidelines provided by American Animal Hospital Association have suggested a different fasting protocol for small animal patients prior to general anesthesia that look awfully similar to the updated human recommendations. What is the evidence that veterinarians should follow suit, especially given the intricate differences between the human and animal gastrointestinal systems?

To help us digest this huge topic is Dr. Ioannis Savvas, Professor of Veterinary Anaesthesia, Analgesia, and Intensive Care at School of Veterinary Medicine, Aristotle University of Thessaloniki and dedicated researcher specializing in the complex details of how general anesthesia impacts the gastrointestinal tract of dogs and cats. With host Dr. Bonnie Gatson, they will discuss the impact of general anesthesia on gastrointestinal motility, how often reflux and regurgitation occur in anesthetized companion animals, and strategies to mitigate these gastrointestinal complications. And of course, they will discuss what we know and don’t know when it comes to preanesthetic fasting protocols for dogs and cats.

We invite our listeners to check out articles mentioned in today’s episode: 2020 AAHA Anesthesia and Monitoring Guidelines for Dogs and Cats

If you like what you hear, we have a couple of favors to ask of you:

Become a member at North American Veterinary Anesthesia Society (NAVAS) for access to more anesthesia and analgesia educational and RACE-approved CE content.

Spread the word. Share our podcast and FB/IG posts, re-tweet, post something on a network or a discussion forum, or tell a friend over lunch. That would really help us achieve our mission: Reduce mortality and morbidity in veterinary patients undergoing sedation, anesthesia, and analgesia through high-quality, peer-reviewed education.

We also ask our listeners to save the date for the NAVAS Virtual Spring Symposium on April 27th and 28th, 2024. For more information about the program, visit the NAVAS Spring Symposium website. Dr. Savvas will be one of our featured speakers during the symposium talking more about adverse gastrointestinal effects of general anesthesia.

Thank you to our sponsor, Dechra - learn more about the pharmaceutical products Dechra has to offer veterinary professionals, such as Zenalpha.

If you have questions about this episode or want to suggest topics for future episodes, reach out to the producers at [email protected].

All opinions stated by the host and their guests are theirs alone and do not represent the thoughts or opinions of any corporation, university, or other business or governmental entity.

The NAVAS Podcast is published monthly on or near the 15th of the month.

Special thanks to Chris Webster for editing, producer Maria Bridges, and Saul Jimenez for IT support in making this podcast a reality.

The holiday season is in full swing and you may be asking yourself if it’s time to invest in something new for your clinic. A new anesthetic agent, perhaps? If that’s the case, then Alfaxalone may be the new drug to help shake up your old anesthetic drug protocols. Although it has been around on the veterinary market for a few years now, Alfaxalone is the newest anesthetic induction agent and with it come several interesting and intriguing potential benefits. Our guide to explore this newfangled drug is Dr. Lane Johnson, a boarded veterinary anesthesiologist, Clinical Assistant Professor of Anesthesia and Pain Management at the University of Florida, reptile enthusiast and Alfaxalone researcher. Together we will discuss how Alfaxalone came to be in its current formulation, it’s unique pharmacokinetic properties and side effects, why it’s such a great drug for sedating and anesthetizing cats and bearded dragons, and why alfaxalone has gotten its recent reputation as the best induction agent for small animals with cardiac disease. Should you purchase alfaxalone to use in your clinic? How do you use alfaxalone in the most effective and safest way possible? We hope this episode will be your guide to answering these complicated questions.

This episode is an expansion on our previous episode on Induction Agents with Dr. Xander Thomson. 

In addition, check out this article by previous NAVAS podcast guest, Dr. Lydia Love, Should I Be Using Alfaxalone.

If you like what you hear, we have a couple of favors to ask of you:

Become a member at North American Veterinary Anesthesia Society (NAVAS) for access to more anesthesia and analgesia educational and RACE-approved CE content.

Spread the word. Share our podcast and FB/IG posts, re-tweet, post something on a network or a discussion forum, or tell a friend over lunch. That would really help us achieve our mission: Reduce mortality and morbidity in veterinary patients undergoing sedation, anesthesia, and analgesia through high-quality, peer-reviewed education.

If you are feeling generous this holiday season, consider donating to the NAVAS Education fund, whose mission is to improve anesthetic and analgesic care of veterinary patients by providing continuing education to veterinary professionals and caregivers. All donations help to support continuing educational efforts for veterinary professionals.

We also ask our listeners to save the date for the NAVAS Virtual Spring Symposium on April 27th and 28th, 2024. For more information about the program, visit the NAVAS Spring Symposium website. Registration starts Feb. 1.

Thank you to our sponsor, Dechra - learn more about the pharmaceutical products Dechra has to offer veterinary professionals, such as Zenalpha.

If you have questions about this episode or want to suggest topics for future episodes, reach out to the producers at [email protected].

All opinions stated by the host and their guests are theirs alone and do not represent the thoughts or opinions of any corporation, university, or other business or governmental entity.

The NAVAS Podcast is published monthly on or near the 15th of the month.

Special thanks to Chris Webster for editing, producer Maria Bridges, and Saul Jimenez for IT support in making this podcast a reality.