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Step 2: Equipment Preparation

Prior to the start of any general anesthesia or sedation-only procedure, it is critical to ensure that all equipment and monitors are turned on, are functioning, and have undergone appropriate safety checks.

Caudal Mandibular Regional Blocks

For additional information on other dental nerve block techniques, see the 2019 AAHA Dental Care Guidelines for Dogs and Cats . Caudal mandibular (inferior alveolar) regional blocks  INDICATIONS: Dental and orofacial surgery on the mandible (i.e., dental extractions, mass removals, fracture repair, etc.) This desensitizes all tissues to midline on the ipsilateral side.  INSTRUCTIONS:  1.  Select and calculate the full dose of a local anesthetic, i.e., lidocaine (cats = 2–4 mg/kg, dogs = 4–6 mg/kg), bupivacaine (cats = 1 mg/kg, dogs = 2 mg/kg), or ropivacaine (cats = 1 mg/kg, dogs = 2 mg/kg).*  2.  Prior to the procedure or extraction is performed, choose intraoral vs. extraoral approach, based on clinical indication, and personal preference. 3. The mandibular foramen or nerve can often be palpated on the lingual side of the mandible, just rostral to the angle of the mandible and just caudal to the last molar in approximately the middle 1/3 rd of the mandible (as measured from dorsal to ventral). NOTE:  The foramen is often difficult to palpate in very small patients like cats and small dogs.

The individualized approach

Encourage clients to acclimate dogs to safe travel prior to the veterinary visit. Plan appointments to minimize wait and create a quiet, calm environment. Train the veterinary team in low-stress handling techniques. 

Phase 1: Preanesthesia

An individualized anesthetic plan with specific and sequential steps ensures the continuum of care throughout the entire anesthetic process. A complete anesthetic plan must address all phases of anesthesia, with inclusion of perioperative analgesia throughout each phase. Although each patient should be treated as an individual, having a set of anesthesia plans that are used repeatedly is appropriate.

Resource Center

Resources  from the 2019 AAHA Canine Life Stage Guidelines   for both pet owners and veterinary teams.

Step 1: Preanesthetic Evaluation and Plan Considerations

The preanesthetic patient evaluation is critical for patient safety as it promotes identification of individual risk factors and underlying physiologic changes or pathologic compromise that will impact the anesthetic plan.

Update on Feline Injection-Site Sarcomas

The Task Force believes that there is currently insufficient research to justify recommending a single vaccine type. Since injection site sarcomas are a risk, the Task Force recommends vaccination in the lower distal limbs to facilitate clean margins if surgical amputation is required.

2020 AAHA/AAFP Feline Vaccination Guidelines

A task force convened by the American Animal Hospital Association (AAHA) and the American Association of Feline Practitioners (AAFP) examined the most current feline vaccination research and concluded that vaccine protocols should be tailored for individual cats’ unique lifestyles and infectious-disease exposure risks. These new guidelines encourage communication with the pet owner about how your team assesses disease risk and makes vaccine recommendations.

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