Veterinary Anesthesia Nerds

We've all been there...the patient comes to our surgery service with buprenorphine on board. Now what do we do? Can we give pure mu opioids? Is buprenorphine enough for pain? How long do we have to wait for efficacy?

Today we are talking with anesthesiologist Bryce Dooley about buprenorphine and why we may judge this molecule harshly. Buprenorphine is a great drug when used appropriately and a mainstay addition to many analgesic plans.

Worlds collide on this episode of the VAN podcast! We are joined by CRNA known as "AnesthesiaGawd" on the socials. We talk about becoming a CRNA, differences in human vs vet med, drug pharmacology, and why I love a Macintosh blade!

Look for Anesthesia Gawd on Instagram to follow along.

There one drug class that can strike fear into the hearts of veterinary professionals: NMBA or muscle relaxers. This drug class is often used in optho patients however can prove to be beneficial in many other patient presentations. On today's podcast we talk to Rian Ashmore a VTS Anesthesia about what NMBA's are, how they function, and how you can utilize them in your practice.

Rian graduated from Minnesota School of Business in 2012 and worked in private practice for several years before joining the University of Minnesota in 2014. In 2016 he began doing anesthesia full time and in 2021 he obtained his VTS in Anesthesia and Analgesia. Last year he transitioned to a teaching position where he works with fourth year students in their clinical anesthesia rotation by giving topic rounds, helping them work up cases, inducing and maintaining anesthesia, etc. Rian's biggest interests are in teaching and treating patients with cardiac disease, especially patients referred for interventional radiology cases.

Your mission should you choose to accept it...anesthetize this old cranky cat with kidney disease. There are many variables to consider and VTS Anesthesia Elizabeth Hart is here to help us through. What drugs should we avoid? What monitoring is the most important? Elizabeth explains what things to prepare to make anesthesia for the kidney dz patient a breeze!

Elizabeth graduated from Michigan State University (GO SPARTANS!!!!) in 2003 with her BS in Agribusiness, she obtained her VTS in 2022 and currently works for a large specialty and emergency center in Lebanon, NJ.

BP goes down and the fluids go up...that's the way it goes right?

Well it might be time to re-think those old rules of hypotension management.

Today we are joined by Michelle Albino a fantastic VTS(anesthesia) out of NYC to discuss when to bring on the fluids and when to just get your vasoactive drugs going.

Born and raised in New York, Michelle graduated from SUNY Delhi and has been an LVT since 2003. For 12 years, she was employed at the Animal Medical Center in New York City in the anesthesia and emergency departments. She served as team leader of the anesthesia department and oversaw anesthesia training and education for 5 years at the AMC. Michelle worked alongside Dr. William Muir, gathering data for his study in fluid responsiveness via the Masimo PVI for patients undergoing general anesthesia, and authored a book chapter on the topic of analgesic pharmacology for a textbook on pain management in veterinary patients.

She became board certified in anesthesia/analgesia in the fall of 2012 and started her own company where she visits hospitals to help elevate staff knowledge on anesthesia and pain management offering lectures, labs, and hands-on supervision and training. Michelle currently is employed at the ASPCA animal hospital in New York City as director of training and education. In this role she provides in-house continuing education, creates and updates medical operating procedures, provides anesthesia and pain management consults, and works to elevate onboarding and training processes utilizing adult learning techniques. In addition, she recently became virtual facilitation and training and adult learning certified.

Is Gabapentin the new Tramadol?

We see quite a many post on Veterinary Anesthesia Nerds discussing the use of Gabapentin for acute post surgical pain..but what does the evidence say?

Here Stephen breaks down how this drug works, why acute pain may not be the best use of gabapentin and what you should reach for instead.

Resources mentioned in this episode:

Pypendop B, Siao K, Lkiw J. Thermal antinociceptive effect of orally administered gabapentin in healthy cats. Am J Vet Res. 2010;71(9). doi:10.2460/AJVR.71.9.1027

Reid P, Pypendop B, Ilkiw J. The effects of intravenous gabapentin administration on the minimum alveolar concentration of isoflurane in cats. Anesth Analg. 2010;111(3). doi:10.1213/ANE.0B013E3181E51245

Johnson B, Aarnes T, Wanstrath A, et al. Effect of oral administration of gabapentin on the minimum alveolar concentration of isoflurane in dogs. Am J Vet Res. 2019;80(11). doi:10.2460/AJVR.80.11.1007

Anesthesia Machine? Check ✅

Emergency Drugs? Check ✅

Checklists are an integral part of our daily lives in the vet clinic, increasing efficiency and safety. You may use them in you OR, but do you use them in your ER?

Today Amy Newfield is here to talk to us about WHY checklists are the s**t and why we should be using them everywhere. Amy knows education. She has received speaker of the year awards, worked with translators in over four countries, has over 60 published printed works in eight countries and recently published her very own book. She is a self-described border collie.

Resources mentioned in this episode:

AAHA: https://www.aaha.org/publications/newstat/articles/2021-04/anesthesia-best-practices-prepare-compare-be-aware/

https://www.anesthesiallc.com/publications/blog/entry/checklists-as-important-as-ever-in-anesthesia-patient-safety

M&M Article: https://www.kickassvets.com/blogs/blogMNMRounds.php

https://journals.sagepub.com/doi/abs/10.1177/0018578720931752?journalCode=hpxa

Checklist Manifesto Book: https://amzn.to/3JEAXOG

Amy's website: https://www.vetteamtraining.com/

well we know cannabis has been a hot topic in vet med for a while now but it still seems like there are some inconsistencies in the information out there. Is it legal to discuss with clients? What do the laws say? Does it even work? What the heck is a COA?

These questions and more are answered by my guests, the enigmatic Stephen Cital, and the inspiring Liz Hughston both California based RVTs with extensive experience in cannabis medicine.

Resources from the show notes:

https://link.springer.com/book/10.1007/978-3-030-68317-7?fbclid=IwAR2ZPFlZBrvrdtJpVTT9-4Rqe4PsvFEm9OTNeg4fJLi-tQ3oMEqKWC4xkyE

https://www.vetcannacademy.com/?fbclid=IwAR2OYm17I91LcJL3tM_l-Ndns0cVQTgFrDgCoilkUZF5dPI9Z1GZCOn6VeQ

Sometimes you hit a point in your career where you inveitibly ask, "What's next?" Often that next is a leadership position. But what if you don't want to be a manager? Or, what if you do but you done know where to start learning about leadership and management?

In this episode we talk with RVT Senani Ratnayake as she help us understand the different oprtions, what we should do if we feel stuck, and how to become great leaders.

Senani attended Queen’s University and the University of Guelph where she completed a Bachelor of Science before pursuing Veterinary Technology at Ridgetown College, graduating in 2002.

She has been educating veterinary professionals for over 17 years and has received multiple awards for her contributions to veterinary medicine, including most recently the Founders Award from Dr. Andy Roark’s Uncharted Veterinary Community. She is a sought-after and well-respected veterinary consultant and speaker.

You can find her at https://www.facebook.com/motivatumconsulting

Resources for this episode: https://www.communivet.com/en/ca/sign-in (Join for free

Visit CommuniVET (free membership for all veterinary team members) and check out Senani's videos in the Practice Playbook section: "Implementing Ideas with Confidence" for the System Cycle explainer video and "Empowered to Lead: Where does your power come from?" for more on Leadership."

https://www.communivet.com/en/ca/tools/practice-playbook

How well can you "go with the flow"? Today we talk about oxygen flow rates, breathing systems, and when an NRB really is a wiser choice.

Courtney is originally from New Zealand where she trained and qualified, and has been working as a Veterinary Nurse since 2007. After working in a number of small animal clinics there, an anaesthesia passion took her to a large referral hospital in Australia in 2015. In 2016 she moved to the UK and is now an Anaesthesia Registered Veterinary Nurse at the Royal Veterinary College. Courtney completed her Nurses Certificate in Anaesthesia in 2017 and throughout her studies, she started Veterinary Anursethesia on various social media platforms to share anaesthesia tips. She has written a number of articles for journals and enjoys speaking to Student Veterinary Nurses and Registered Veterinary Nurses on anaesthesia

https://www.instagram.com/veterinaryanursethesia/?hl=en