“My dog is geriatric, so I shouldn’t anesthetize him.”
The short answer is fiction, “age itself is not a disease”. With that said, with aging does come some significant changes in organ function, how the body responds to stressors, and therefore risks associated with anesthesia may be increased.
With increasing research and understanding of the body’s physiology and advancements in medical and surgical therapies, patients are living longer, thus increasing the potential need for procedures requiring anesthesia at later stages of life. Additionally, with advancements in research and in drug development also comes great improvements in monitoring techniques and safer drug choices, therefore greatly improving anesthetic safety. Today elderly patients can be safely anesthetized with proper pre-anesthetic workup, pre-anesthetic stabilization of any concurrent disease processes, proper drug choices and diligent anesthetic monitoring.
Typical physiologic changes that can occur with aging included orthopedic, cardiovascular, pulmonary, renal and hepatic, therefore having a thorough physical exam and performing pre-anesthetic blood work and urinalysis cannot be overemphasized. Several veterinary studies have reported that in geriatric patients specifically, routine pre-anesthetic bloodwork diagnosed new or subclinical disease in 30-80% of patients. Patients with new or historical heart murmurs or cardiac arrhythmias that have not been evaluated by a cardiologist recently or at all, should have this done prior to any anesthetic procedure. There are several types of cardiac diseases in cats and dogs. Each of these disease processes can affect the body differently and therefore management under anesthesia is different from disease to disease, making diagnosis of disease and severity paramount. Any preexisting medical conditions (e.g. diabetes, cardiac disease, etc.) should be medically managed and, when possible, controlled prior to anesthesia.
Though orthopedic changes do not directly affect how a patient will do while anesthetized, it can directly impact how they recover, so always be sure to remind your veterinarian or veterinary staff if your pet has preexisting arthritis prior to his/her procedure.
Clearly risks associated with general anesthesia can increase with age, however with proper workup, appropriate monitoring and anesthetic drug choices, many of these elderly patients can be safely anesthetized. If you or your veterinarian are concerned of the risk for you patient, never hesitate to contact your local Veterinary Anesthesiologist for recommendations or direct supervision.
Dr. Amber Hopkins DVM, cVMA, DACVAA
Veterinary Specialty Hospital of San Diego