Anesthesia in feline patients can be challenging. Anesthetic techniques such as premedication, doses, monitoring, and pain management are often unique. Therefore, understanding these challenges and preparing for difficulties and complications are prudent practices. Below is a list of some challenges that can be encountered by anesthetists.

Size: It is important to get an accurate weight for drug calculation when possible to prevent over- or underdoses leading to complications; e.g., prolonged recovery or excitement during induction. Size can make IV access difficult. If the patient's weight is less than 7 kg, a nonrebreathing anesthetic circuit is recommended with a higher oxygen flow (~ 200 ml/kg/min). This may exacerbate hypothermia (one of common complications during anesthesia).

Temperament: Because of different temperaments in cats, sometimes higher doses of premedication may be used which can lead to prolonged recovery. If cats are very difficult to handle, the use of induction chamber for anesthetic induction may be needed.

Laryngospasm: Cats have a tendency to laryngospasm which can make endotracheal intubation difficult. Prior to attempting to intubate feline patients, sufficient anesthetic plane should be achieved and laryngeal blockade with lidocaine solution or gel should be done.

Epidural administration: Pain control can be provided via epidural route. Because the spinal cord in cats ends ~ L7-S3, epidural administration of drugs may have higher risks of penetrating the subarachnoid space leading to spinal block instead of epidural block.

Existing diseases: Feline patients may be presented with existing diseases such as hyperthyroidism, etc. Thorough physical examination, patient signalment and full history are highly recommended when possible. This will assist anesthetists in choosing appropriate anesthetic medications and techniques, thus preventing further anesthetic complications or worsening conditions.

Anesthetic monitoring: Monitoring feline patients can be difficult if there is a lack of appropriate equipment (i.e., blood pressure cuff size, nonrebreathing circuit) in hospitals. Because of cats' sizes, the use of oscillometric method for blood pressure parameter and accuracy can be challenging due to the smaller cuff size needed. Doppler blood pressure monitoring method is recommended, and the number may be closer to mean blood pressure than systolic blood pressure. Amount of fluid administration (10 ml/kg/h) should be monitored closely to prevent overload of fluid.

Hypothermia: Because of their sizes, cats may lose body temperature quickly if the surgical area is large. Therefore, monitoring body temperature is highly recommended. Actions must be taken when appropriate.

Postoperative care: If heavy premedication is used, expect to have prolonged recovery during which animals should be monitored at all times.

References

1.  Greene SA. Veterinary Anesthesia and Pain Management Secrets: Patient Management. Philadelphia, PA: Hanley & Belfus, Inc.; 2002:1–43.

2.  Seymour C, Duke-Novakovski T. BSAVA Manual of Canine and Feline Anaesthesia and Analgesia. 2nd ed. Gloucester, UK: British Small Animal Veterinary Association; 2007.