How to learn how to spay a dog, Part 2: Anesthesia

Monday evening, at 5 pm, eight of us arrived at the spay clinic. The anesthesia tech who is in charge of the clinc hadn’t arrived yet, but we found that each of the eight dogs in the clinic had one of our names on the front of her cage. We took our dogs outside to let them stretch their legs and pee. Mine was a sweet mid-size dog of a few years of age. My partner, Lily, was assigned a six month old who had the normal energy level of a six month old puppy — she was a handful. Lily was scheduled to spay her puppy (we quickly started referring to them as “our” dogs) on the first day of the lab, and I was scheduled to spay my dog on the second. I would perform anesthesia for Lily on the first day, and she would perform anesthesia for me on the second.

The anesthesia tech and veterinary intern arrived, and helped us draw blood on our dogs. (This was my third time drawing blood. I am still terrible at it.) We tested the blood to make sure that all the dogs were good surgical candidates. Any dog with any medical problem at all would be ineligible for the spay lab program; that dog would need to be spayed by someone with more experience.

Then we gave our dogs physical exams and wrote up our SOAPs (Subjective/Objective Assessment and Plan). We presented our dogs to the veterinary intern. A typical presentation would sound something like: “This is a two year old intact female dog, presenting to the spay clinic for ovariohysterectomy. Her heart rate was...” And so on. The intern was helpful, explaining things to me like “don’t say you found a lesion on her tail, say you found an area of alopecia on the dorsal caudal aspect of her tail.”

Around 7:30 pm we were done. We fed our dogs. Lily and I agreed that I would handle the 9 pm walk that night. I went home, fed my own animals, fed myself, and came back in for the 9 pm walk. I put a note on Lily’s dog’s cage to make sure that no one else gave her more food, since she was scheduled for surgery the next day. Home again, I calculated the drug dosages for Lily’s dog for the next day (since I would be handling her anesthesia), and went to bed.

My alarm went off at 4:45 am the next morning. I was at school by 6 am. We walked our dogs, did another physical exam, and wrote up another SOAP, which was very similar to the previous SOAP from twelve hours before. I fed my dog. Then Lily and I premedicated her puppy. This was difficult, as the puppy didn’t want to hold still, and I had to put a very large needle into her back and inject the premedication cocktail into her muscle. But I managed. The puppy started getting drowsy in a few minutes, while we took care of necessaries before surgery, like food, water, and toilet breaks. By 8 am she was ready and so were we, so we carried the sleepy puppy in to the operating room and put her on the table.

To induce anesthesia, we used an injectable solution. First I put in an IV catheter. This is the second time in my life that I have had to thread a catheter into an animal’s vein; the first time, I almost passed out. I did not even get woozy this time. (Thank you, adrenaline.) Then I injected the anesthesia solution, and the puppy got very sleepy. Good puppy.

Next I put an endotracheal tube down the puppy’s throat. I had been nervous about this, but it was easier than it looks. You can actually see the vocal cords and thread the tube right between them. It helps if the puppy is “deep enough” under anesthesia; we gave her a little more juice after my first try.

Next I hooked her up to the anesthesia machine and started the oxygen and anesthesia gas flowing. We had induced anesthesia with an injectable solution, but maintained it with gas. Gas is a lot easier to control; if you want to change anesthetic depth, you can easily turn it up or down. An injectable solution is out of your hands once it’s in the animal.

Next I added several more monitors and started recording information. Every five minutes, I recorded her heart rate (a machine provided that number), her systolic blood pressure (I took it with a cuff, just as the doctor does it to you), her respiration rate (I counted breaths by watching the breathing bag), and her anesthetic depth (I looked at her eye to see the position of her eyeball, and tested her jaw tone; an eyeball rolled down is a good depth, and a loose but not too loose jaw is also a good depth). If I had time left over, I sometimes listened to her esophageal stethoscope (a stethoscope threaded down her esophagus to lie close to her heart), which let me make sure that her heart was actually echoing the sound I heard on one of the monitors.

Every fifteen minutes, I assessed how much fluid had gone in via her IV catheter, recorded her oxygen pressure, and recorded her temperature. How hard could it be to record a temperature? I had to crawl under the surgical drape and try to see the rectal thermometer. This required a flashlight and lots of craning.

Periodically, the anesthesia tech handed me more meds (pain killers or antibiotics) with instructions on how to administer them. At one point I had three medications stacked up, to be administered “four hours after induction” (in an hour), “when your partner closes the linea alba” (watch partner), and “an hour after the first antibiotics dose.” I had to write down the various times so I didn’t forget them, since I was balancing a few other things in my head at the same time.

The surgery went smoothly. When my partner was done, I turned down the gas and let the puppy breathe pure oxygen for five minutes. Then we unhooked her from the machine, unhooked all the monitors, and carried her back to her cage. When she had swallowed twice (after about ten minutes), I pulled out her breathing tube. We covered her with warm blankets and checked on her frequently while doing paperwork. She did exactly what she was supposed to: went back to sleep after the tube was out, and got steadily warmer.

I had a few minutes to have lunch, then went to four hours of lecture. After lecture, at 5 pm, I walked my dog and helped with clinic cleanup. We planned for Lily to cover the 9 pm walk. The next day I would spay my dog. I was tired, but it felt good to be halfway done, and to have not done a bad job so far.

[How to learn how to spay a dog, Part 1: Basic skills]
[How to learn how to spay a dog, Part 3: Surgery]
[How to learn how to spay a dog, addendum: uterus removal]