PDA

View Full Version : Effects of anesthetics


July 1st 06, 05:26 PM
My cat was put to sleep yesterday. It all happened so fast. At the same
time I'm not confident about certain decisions that were made by the
veterinarian. I realise my investigations will not bring my cat back to
life, but I'd like to clear some things up, and I need an independant
objective medical evaluation or opinion, something I feel I'm not
getting from my vet for whatever reason.

I recently moved with my cat (april 30). He was approximately 13 years
old. He used to have several enclosed gardens to roam around, but his
new home was an appartment with no outside area.

Initially things went as expected. I realised my cat would have to go
through several changes, all at once (new environment without outdoor
area). Still he seemed to be handling the change quite well. However,
about 3 weeks ago he started to wine and complain, yet his complaints
were very pyschological, he always first made eye contact and then
wined. He never wines while looking in another direction (i.e. without
eyecontact with me). I initially thought that he was still getting used
to the place and was starting to realise that he wasn't going back to
his garden. Or that he was trying to see how far he could stretch his
wining in this new place. I remember discussing this situation with
several people.

Last weekend he started to vomit yellowish liquid. On Tuesday I noticed
that he hadn't eaten in two days. I also noticed that he wasn't
responding to my normal eye contact salutation (making eye contact and
then slowly closing and opening eyelids). I visited a new vet on
Wednesday because my old vet was in a different area. The vet gave him
an examination and noticed an area on the back of his tongue that
seemed infected. It could also have been a tumor, but because my cat
would resist, the vet wasn't able to take a sample of the infection or
tumor. The vet somewhat immediately suggested anesthetics to be able to
take a sample of what's on his tongue. I hesitated but agreed. We made
an appointment for the next day (Thursday). We then force-fed the cat
with disolved cat food by applying the solution in his mouth with a
syringe (without needle) and I took him home afterwards.

When I came back home I noticed that my cat was somewhat more
responsive. He still didn't eat, and was still clearly sick of
something, but he started making our eye-contact-salutation again. I
also noticed that his fur was feeling somewhat better than the previous
days. He didn't seem to be vomitting, but I noticed some vomit on the
carpet the next day.

The next morning I noticed that he would do his regular after-shower
drinking which he hadn't been doing for several days. That is, after I
take a shower he walks straight into the shower completely disregarding
the fact that I'm there, and starts to drink the leftover water.

Now comes the hard part. I still had the appointment with the vet for
the further investigation of his tongue condition. I brought him to the
vet at 9 a.m.. The vet was going to conduct the procedure at around 1
p.m.. The moment I left the vet, I felt something wasn't right. I
returned at 1 p.m., but the vet still hadn't treated/investigated him.
I started to get irritated by this situation. Call it emotional, but
according to my reasoning, the cat is sick and being in a strange place
doesn't help him, he just gets more stressed. Then he's in an
environment with a lot of other sick animals which could easily make
him more sick than he was. The vet('s assistant) told me they would
call me when he was ready. Still I returned at 3 p.m. to find out he
still hadn't been treated. I returned again at 5 p.m. and learned that
he had been treated with anesthetics and was just waking up. I went
with the doctor to visit him, the doctor started off by saying that he
was already very old and that I shouldn't hope too much.

The first thing I noticed when I saw him was an abnormal breathing
condition. He seemed to be breathing through his mouth. I asked the doc
if this was due to the anesthetics and he said it was. He then went on
to say that my cat turned blue during the application of the
anesthetics. The doctor had responded by feeding him oxygen. The doctor
stated that he had taken a sample of the affected tongue tissue and
that would be sent to a pathologist for further examination.

I took him home afterwards. I noticed that he continued breathing
through his mouth. The breathing (contraction) was coming from his
abdominal area. Later he would breath using muscles located in his
upper torso. I eventually noticed that he was hardly using his body to
breath, only his neck was moving and he seemed to be having trouble
getting air in his lungs. I also noticed that he would position his
head above his water saucer. Not that he was drinking, but just keeping
his head above the water level. When I moved the saucer, he responded
by moving to the saucer and positioning his head directly above the
water level. He started to develop moisture below his eyes and his nose
was completely dry and pale. The eye moisture, pale nose and irregular
breathing through his mouth are symptoms that only manifested
themselves after he went through anesthetics. The next morning he
seemed to be in worse condition. It seemed as if his muscles were
paralysed. He could hardly walk. He tried to find the most isolated
place in the appartment. He started to cry during each breath of air.
His fur was clearly in bad condition since the day before. I initially
though it was because he wasn't cleaning himself. In retrospect I
believe that he was sweating.

I rushed him to the vet. The vet immediately examined him and took an X
ray of his body. They discovered that most of his lung capacity was
gone, only the part of the lung just under his neck was black on the
x-ray, the rest of his lungs were a foggy white. According to the vet,
that indicates that there's either moisture or tissue that has accrued
in the lungs. The vet attempted to drain the (possible) moisture
through a needle, but no moisture came out. The vet concluded that the
foggy white in his lungs must be tissue, possibly a tumor. The cat was
getting more and more unresponsive. When I purred close to him, he used
to respond with purring, but now he didn't respond at all. The vet
stated that he was getting worse and worse and that it's hardly
feasible for him to recover. The conclusion was to put him to sleep. I
had to quickly go through possibilities of recovery but there didn't
seem to be any viable options left. He was breathing more and more
heavily and was apparently losing conciousness. I agreed to put him to
sleep (what the hell did I do?!?!) and remained with him till after the
apparently normal muscle spasms start.

He died on Friday afternoon. I still haven't received results from the
tissue sample taken off his tongue.

There's two things that don't seem to fit. First, the vet's proposal to
use anesthetics came across as an attempt to sell something. Judging by
the speed with which the proposal was made and the $ 200 bill for the
anesthetics procedure (which I have no trouble paying), I don't find
that unlikely. But more importantly, after the anesthetics procedure,
my big buddy exhibited symptoms he didn't exhibit prior to the
anesthetics procedure.

This prompted me to find out more and here's where my understanding
becomes shallow. Based on the symptoms after the anesthetics procedure,
I've discovered that there's a frequently occuring condition that takes
place when using volatile anesthetics, namely malignant hyperthermia
(MH) or malignant hyperpyrexia. Apparently this occurs using halothane
based anesthetics, but other anesthetics may cause the same condition
and symptoms thereof. And the symptoms correspond largely to the
symptoms that manifested themselves immediately after the anesthetics
procedure. I have yet to find out which anesthetics were used.

My cat's heavy breathing corresponds with the lack of oxygen occuring
with MH as well as to the subsequent respiratory acidosis that takes
place due to MH. His loss of muscle power (he was a rag doll when I
took him to vet on Friday) also corresponds with symptoms subsequent to
MH manifestation (rhabdomyolysis). His fur was almost moist which leads
me to believe that he was sweating to the extent that cats are able to
sweat. I somehow believe that his (lessened) fur condition on Thursday
and Friday were caused by overheating. The heavy breathing came across
as someone that's too hot (like my dog used to normally do). I actually
visited the doctor on Thursday because of his breathing and apparent
overheating. I even suggested taking my cat to a cool basement, but the
doctor didn't think it would help. The doctor gave me a medicine called
Prednoral which according to him would ease any pain. I'm now wondering
to what extent Prednoral relates to aspirin which is a possible cause
of the closely related malignant hyperpyrexia.

I'm not a doctor and have no medical training whatsoever. Still, I
believe that the anesthetics caused my cat's bodily functions to go
into a negative feedback cycle. I realise he was sick prior to the
anesthetics, but the additional symptoms after the anesthetics are just
too independant of the initial symptoms to disregard. The only symptom
related to MH not observed is a hypermetabolic state, my cat wouldn't
eat. However, he was clearly suffering from eating disorder prior to
the use of anesthetics.

I also realise the x-ray showed that his lung capacity was severly
diminshed, however I wonder how fast three quarters of the lungs can be
affected by MH? The muscular disorder involves excessive release of
calcium (due to a failing ryanodine receptor?). I'm wondering to what
extent the foggy white appearing on the lungs of my cat's x-ray
correspond either with calcium or the effects of the muscle breakdown?
In fact, the affected part of his lungs corresponds with the lower part
of the lungs up to and including the lower half of his chest. Based on
my observation that after anesthetics my cat was breathing from his
lower part of the lungs (abdominal level), then from the upper part
(chest level), then only from his neck I have a suspicion that his
lungs were filling up.

On Monday I'll be visiting the vet to a) find out what the tissue
results were, b) find out what type of anesthetics he used and c) to
find out if he's aware of malignant hyperthermia and keeps the treating
drug (dantrolene).

If anybody can comment on this, I'd be most appreciative. I realise
that what's done is done, but as a computer troubleshooter I also
realise there's a lot of people that either diagnose (troubleshoot)
whatever makes them the most money or diagnose (troubleshoot) for the
(egotistical) sake of being able to make a diagnosis, whether it's
wrong or right. Furthermore, I dont' expect my vet to admit that the
application of anesthetics worsened my cat's condition. If my cat had
been killed by a car or a prolonged period of sickness, then the cause
of his death would be more clear. I feel that in this case somebody
made a stupid decision, and apparently was unable to recitify the
consequences. I speculate that the vet pitched a money making procedure
(anesthetics) that was inappropriate and subsequently tried to cover
that up. I can't understand why my observations of my cat's 'heated'
state were answered by prescribing Prednoral, which is apparently a
pain killer. In retrospect I feel the vet should at least have
considered hyperthermia and acted accordingly, however if the vet is
covering up, then the Prednoral prescription fits nicely.

Ultimately, I'd like to be proven wrong about this. But I have a strong
feeling that given my cat's initial condition, given the application of
anesthetics and given my cat's additional symptoms after applying
anesthetics that there's something very fishy going on here.

Thanks,

Martin

Spot
July 2nd 06, 02:30 AM
I'm so sorry for your loss...

More often than not when a lump is found in the mouth it is cancerous. When
the vet aspirated the lung and didn't get fluid it seems to me a good
indication that what was showing on the xray was indeed cancer. Cancer is
awful and cats don't often show signs of pain or distress till it's very
late. He most likely had it for quite a while before it caused any
discomfort.

Putting any animal at any age under anesthesia is risky but there would have
been no other way that I know of to get a biospy of the tongue. I went
through this with my one cats and it's scary. My vet told me not to hold
out much hope for him because this is almost always cancerous. In Squeekers
case it was a rare birth defect caused from migrating thyroid tissue that
caused the lump and it was safely removed.

I too would have been upset by the vets lack of responsiveness in finding
what was going on. But in this case it seems to me the only difference
would have been that he would have been put to rest much sooner. I know
this doesn't help how you feel.

Celeste


> wrote in message
oups.com...
> My cat was put to sleep yesterday. It all happened so fast. At the same
> time I'm not confident about certain decisions that were made by the
> veterinarian. I realise my investigations will not bring my cat back to
> life, but I'd like to clear some things up, and I need an independant
> objective medical evaluation or opinion, something I feel I'm not
> getting from my vet for whatever reason.
>
> I recently moved with my cat (april 30). He was approximately 13 years
> old. He used to have several enclosed gardens to roam around, but his
> new home was an appartment with no outside area.
>
> Initially things went as expected. I realised my cat would have to go
> through several changes, all at once (new environment without outdoor
> area). Still he seemed to be handling the change quite well. However,
> about 3 weeks ago he started to wine and complain, yet his complaints
> were very pyschological, he always first made eye contact and then
> wined. He never wines while looking in another direction (i.e. without
> eyecontact with me). I initially thought that he was still getting used
> to the place and was starting to realise that he wasn't going back to
> his garden. Or that he was trying to see how far he could stretch his
> wining in this new place. I remember discussing this situation with
> several people.
>
> Last weekend he started to vomit yellowish liquid. On Tuesday I noticed
> that he hadn't eaten in two days. I also noticed that he wasn't
> responding to my normal eye contact salutation (making eye contact and
> then slowly closing and opening eyelids). I visited a new vet on
> Wednesday because my old vet was in a different area. The vet gave him
> an examination and noticed an area on the back of his tongue that
> seemed infected. It could also have been a tumor, but because my cat
> would resist, the vet wasn't able to take a sample of the infection or
> tumor. The vet somewhat immediately suggested anesthetics to be able to
> take a sample of what's on his tongue. I hesitated but agreed. We made
> an appointment for the next day (Thursday). We then force-fed the cat
> with disolved cat food by applying the solution in his mouth with a
> syringe (without needle) and I took him home afterwards.
>
> When I came back home I noticed that my cat was somewhat more
> responsive. He still didn't eat, and was still clearly sick of
> something, but he started making our eye-contact-salutation again. I
> also noticed that his fur was feeling somewhat better than the previous
> days. He didn't seem to be vomitting, but I noticed some vomit on the
> carpet the next day.
>
> The next morning I noticed that he would do his regular after-shower
> drinking which he hadn't been doing for several days. That is, after I
> take a shower he walks straight into the shower completely disregarding
> the fact that I'm there, and starts to drink the leftover water.
>
> Now comes the hard part. I still had the appointment with the vet for
> the further investigation of his tongue condition. I brought him to the
> vet at 9 a.m.. The vet was going to conduct the procedure at around 1
> p.m.. The moment I left the vet, I felt something wasn't right. I
> returned at 1 p.m., but the vet still hadn't treated/investigated him.
> I started to get irritated by this situation. Call it emotional, but
> according to my reasoning, the cat is sick and being in a strange place
> doesn't help him, he just gets more stressed. Then he's in an
> environment with a lot of other sick animals which could easily make
> him more sick than he was. The vet('s assistant) told me they would
> call me when he was ready. Still I returned at 3 p.m. to find out he
> still hadn't been treated. I returned again at 5 p.m. and learned that
> he had been treated with anesthetics and was just waking up. I went
> with the doctor to visit him, the doctor started off by saying that he
> was already very old and that I shouldn't hope too much.
>
> The first thing I noticed when I saw him was an abnormal breathing
> condition. He seemed to be breathing through his mouth. I asked the doc
> if this was due to the anesthetics and he said it was. He then went on
> to say that my cat turned blue during the application of the
> anesthetics. The doctor had responded by feeding him oxygen. The doctor
> stated that he had taken a sample of the affected tongue tissue and
> that would be sent to a pathologist for further examination.
>
> I took him home afterwards. I noticed that he continued breathing
> through his mouth. The breathing (contraction) was coming from his
> abdominal area. Later he would breath using muscles located in his
> upper torso. I eventually noticed that he was hardly using his body to
> breath, only his neck was moving and he seemed to be having trouble
> getting air in his lungs. I also noticed that he would position his
> head above his water saucer. Not that he was drinking, but just keeping
> his head above the water level. When I moved the saucer, he responded
> by moving to the saucer and positioning his head directly above the
> water level. He started to develop moisture below his eyes and his nose
> was completely dry and pale. The eye moisture, pale nose and irregular
> breathing through his mouth are symptoms that only manifested
> themselves after he went through anesthetics. The next morning he
> seemed to be in worse condition. It seemed as if his muscles were
> paralysed. He could hardly walk. He tried to find the most isolated
> place in the appartment. He started to cry during each breath of air.
> His fur was clearly in bad condition since the day before. I initially
> though it was because he wasn't cleaning himself. In retrospect I
> believe that he was sweating.
>
> I rushed him to the vet. The vet immediately examined him and took an X
> ray of his body. They discovered that most of his lung capacity was
> gone, only the part of the lung just under his neck was black on the
> x-ray, the rest of his lungs were a foggy white. According to the vet,
> that indicates that there's either moisture or tissue that has accrued
> in the lungs. The vet attempted to drain the (possible) moisture
> through a needle, but no moisture came out. The vet concluded that the
> foggy white in his lungs must be tissue, possibly a tumor. The cat was
> getting more and more unresponsive. When I purred close to him, he used
> to respond with purring, but now he didn't respond at all. The vet
> stated that he was getting worse and worse and that it's hardly
> feasible for him to recover. The conclusion was to put him to sleep. I
> had to quickly go through possibilities of recovery but there didn't
> seem to be any viable options left. He was breathing more and more
> heavily and was apparently losing conciousness. I agreed to put him to
> sleep (what the hell did I do?!?!) and remained with him till after the
> apparently normal muscle spasms start.
>
> He died on Friday afternoon. I still haven't received results from the
> tissue sample taken off his tongue.
>
> There's two things that don't seem to fit. First, the vet's proposal to
> use anesthetics came across as an attempt to sell something. Judging by
> the speed with which the proposal was made and the $ 200 bill for the
> anesthetics procedure (which I have no trouble paying), I don't find
> that unlikely. But more importantly, after the anesthetics procedure,
> my big buddy exhibited symptoms he didn't exhibit prior to the
> anesthetics procedure.
>
> This prompted me to find out more and here's where my understanding
> becomes shallow. Based on the symptoms after the anesthetics procedure,
> I've discovered that there's a frequently occuring condition that takes
> place when using volatile anesthetics, namely malignant hyperthermia
> (MH) or malignant hyperpyrexia. Apparently this occurs using halothane
> based anesthetics, but other anesthetics may cause the same condition
> and symptoms thereof. And the symptoms correspond largely to the
> symptoms that manifested themselves immediately after the anesthetics
> procedure. I have yet to find out which anesthetics were used.
>
> My cat's heavy breathing corresponds with the lack of oxygen occuring
> with MH as well as to the subsequent respiratory acidosis that takes
> place due to MH. His loss of muscle power (he was a rag doll when I
> took him to vet on Friday) also corresponds with symptoms subsequent to
> MH manifestation (rhabdomyolysis). His fur was almost moist which leads
> me to believe that he was sweating to the extent that cats are able to
> sweat. I somehow believe that his (lessened) fur condition on Thursday
> and Friday were caused by overheating. The heavy breathing came across
> as someone that's too hot (like my dog used to normally do). I actually
> visited the doctor on Thursday because of his breathing and apparent
> overheating. I even suggested taking my cat to a cool basement, but the
> doctor didn't think it would help. The doctor gave me a medicine called
> Prednoral which according to him would ease any pain. I'm now wondering
> to what extent Prednoral relates to aspirin which is a possible cause
> of the closely related malignant hyperpyrexia.
>
> I'm not a doctor and have no medical training whatsoever. Still, I
> believe that the anesthetics caused my cat's bodily functions to go
> into a negative feedback cycle. I realise he was sick prior to the
> anesthetics, but the additional symptoms after the anesthetics are just
> too independant of the initial symptoms to disregard. The only symptom
> related to MH not observed is a hypermetabolic state, my cat wouldn't
> eat. However, he was clearly suffering from eating disorder prior to
> the use of anesthetics.
>
> I also realise the x-ray showed that his lung capacity was severly
> diminshed, however I wonder how fast three quarters of the lungs can be
> affected by MH? The muscular disorder involves excessive release of
> calcium (due to a failing ryanodine receptor?). I'm wondering to what
> extent the foggy white appearing on the lungs of my cat's x-ray
> correspond either with calcium or the effects of the muscle breakdown?
> In fact, the affected part of his lungs corresponds with the lower part
> of the lungs up to and including the lower half of his chest. Based on
> my observation that after anesthetics my cat was breathing from his
> lower part of the lungs (abdominal level), then from the upper part
> (chest level), then only from his neck I have a suspicion that his
> lungs were filling up.
>
> On Monday I'll be visiting the vet to a) find out what the tissue
> results were, b) find out what type of anesthetics he used and c) to
> find out if he's aware of malignant hyperthermia and keeps the treating
> drug (dantrolene).
>
> If anybody can comment on this, I'd be most appreciative. I realise
> that what's done is done, but as a computer troubleshooter I also
> realise there's a lot of people that either diagnose (troubleshoot)
> whatever makes them the most money or diagnose (troubleshoot) for the
> (egotistical) sake of being able to make a diagnosis, whether it's
> wrong or right. Furthermore, I dont' expect my vet to admit that the
> application of anesthetics worsened my cat's condition. If my cat had
> been killed by a car or a prolonged period of sickness, then the cause
> of his death would be more clear. I feel that in this case somebody
> made a stupid decision, and apparently was unable to recitify the
> consequences. I speculate that the vet pitched a money making procedure
> (anesthetics) that was inappropriate and subsequently tried to cover
> that up. I can't understand why my observations of my cat's 'heated'
> state were answered by prescribing Prednoral, which is apparently a
> pain killer. In retrospect I feel the vet should at least have
> considered hyperthermia and acted accordingly, however if the vet is
> covering up, then the Prednoral prescription fits nicely.
>
> Ultimately, I'd like to be proven wrong about this. But I have a strong
> feeling that given my cat's initial condition, given the application of
> anesthetics and given my cat's additional symptoms after applying
> anesthetics that there's something very fishy going on here.
>
> Thanks,
>
> Martin
>

July 2nd 06, 05:54 PM
wrote:

> Isofluorane is volatile and is apparently an improvement over
> the dreaded halothane.

I'm finding out more about the isofluorane anesthetic:

http://www.mhaus.org/NonFB/Slideshow_eng/SlideShow_ENG_files/frame.htm

I see that isofluorane is associated with 6 out of 9 Malignant
Hyperthermia related surgical deaths. This report however doesn't show
how often isofluorane is used in comparison with the 3 other deaths
using different anesthetics.

Apparently, various muscle disorders (Central Core Disease, Evans
Myopathy, Hypokalemic Periodic Paralysis) all indicate a susceptibility
to MH. One of the symptoms I indicated prior to his first treatment was
a stiffening/pulling of his right back leg which is often a sign of one
of these muscle disorders. This occurred two weeks prior to the visit
to the vet and had not been observed since, although my cat previously
showed a stiffening of one of his back legs which never lasted more
than a day and occurred once or twice a year.

Additionally, tachypnea occurred prior to at least one patient's death
due to MH (in aforementioned study). Tachypnea is apparently a form of
rapid breathing not to be confused with hyperventilation. My cat had
been breathing heavily through his mouth after his anesthetics
treatment. For my cat, it was rapid breathing (and heavy).

My cat had been administered Domitor upon which he turned blue. The
subsequent oxygen treatment is appropriate (for MH), but inhalation
agents should not be administered. Afterwards, the vet applied the
isofluorane (inhalation agent). I'm not sure he should have done that
after the initial complications from the Domitor. The precautions for
Domitor (which exclusively speaks of use with dogs, but doesn't
explicitly rule out use with other animals such as cats), states that
caution should be excercised when used with other sedatives, for fear
of overdose. If the Domitor is giving complications then I find it
strange that the isofluorane was still administered ("ah, he's an old
cat anyway" could have been the thought which continued the isofluorane
administration).

Finally I realise that testing for MH susceptibility (the so-called
caffeine contraction test) with human patients is apparently an
expensive procedure. I realise that with animals, the threshold to do a
susceptilibity test is higher (not necessariliy for me), and I also
bear in mind that there may be hundreds of other effects for which a
susceptilibity test should be performed causing a complete skip of any
susceptilibity testing. Still the following quote is something I wish I
had read/known prior to his anesthetics procedure:

"It has been said that there is no such thing as the perfect
anesthetic, and there is always potential for risk with any of them. It
therefore behooves us to do our homework prior to allowing any
procedure requiring anesthesia, and to insist on a pre-anesthetic blood
screening."

>From http://cats.about.com/cs/anesthesia/a/understanding_2.htm

There was no screening whatsoever prior to the anesthetics procedure
(other than visual observation). I wonder if a blood screening would
have indicated one of the signs of susceptibility to MH.

It's good there's internet; I wouldn't know where to start
understanding what just happened.

It's bad there's internet; without it, I would have let be what just
happened.

It's good there's internet; isolated incidences which may occur on a
large scale are exposed, hopefully for the better.

Martin

Wayne Boatwright
July 3rd 06, 06:21 AM
I'm really very sorry for your loss. The circumstances and suddenness must
have been very traumatic.

I'm not sure what I would have done under the same circumstances. I don't
think I would have delved into the details of all of it, but I can't say for
sure. More likely, I would concentrate on my memories.

We all react differently.

--
Wayne Boatwright @@
_____________________

July 3rd 06, 08:50 AM
Wayne Boatwright wrote:
> I'm really very sorry for your loss. The circumstances and suddenness must
> have been very traumatic.

Thanks. The traumtic part is the difference before and after
anesthetics. Before the anesthetics my cat was suffering from flu-like
symptoms. After the anesthetics it was like my cat was burning up with
rapid breathing and acute muscle breakdown. When I reported these
symptoms and even suggested moving my cat to a cold basement the vet
didn't recognize what I consider to be hyperthermia.

If the vet is using isofluorane then he should be aware of the
possibility of hyperthermia caused by isofluorane. The symptoms I
described (after anesthetics) to my vet are exactly those of
hyperthermia. And my vet initially used Domitor which caused the cat to
turn blue. After feeding my cat oxygen, the vet went on to apply
isofluorane, which I consider dubious at that stage. Domitor warns not
be combined with other sedatives. And the MH society in the US warns
not to continue/proceed with inhalation agents when complications
arise. And apparently for humans, people getting general anesthetics
are to be tested for susceptibility, which suggests that if anesthetics
are applied to a subject that hasn't undergone testing, then one should
be even more careful and diligent towards the anesthetics complications
and additional symptoms.

Here's a vet that apparently uses isofluorane and even warns (i.e.
demonstrates awareness) of the possiblity of hyperthermia when using
isofluorane:

http://groups.google.com/group/alt.med.veterinary/browse_frm/thread/6d85242b232f1242/4200c88e806f7410?lnk=st&q=isoflourane+hyperthermia&rnum=1#4200c88e806f7410

This is from 1999, my vet should have been aware of the onset of
hyperthermia. I bring my cat to the vet to determine what his condition
is. I don't bring him in to accelerate his death by burning him up from
inside so my vet can get accustomed to his particular anesthetics.

>
> I'm not sure what I would have done under the same circumstances. I don't
> think I would have delved into the details of all of it, but I can't say for
> sure. More likely, I would concentrate on my memories.

Given different circumstances, I would haven't have delved into the
details. But there's too much of a difference before and after
anesthetics and too little recognition of the symptoms after the
anesthetics.

A vet who makes a mistake resulting in the death of my cat, can easily
rub this off his conscience as the death of a test subject. And the
after-anesthetics symptoms are effectively blamed on his
pre-anesthetics condition, which I don't buy.

I've heard "he's an old cat" too many times from this vet, even before
any results came in. I don't consider 13 to be that old. And any
professional who makes generalised statements is effectively not saying
anything at all. From a general statement we may allow pigs to fly, or
vets to experiment.

>
> We all react differently.

Agreed, just as we all face slightly different circumstances.

In case nobody noticed, I too have fond memories of my beloved cat.
I've exhausted the positive superlatives in the English language when
describing him. I've called upon linguists to introduce the concept of
hyperlatives to be able to describe the grandness of my cat, which
wouldn't even approach what he means to me anyway.

Friends that had come over frequently and had gotten to know my cat,
would lateron subconciously greet their girlfriend using his name.

It's Monday, Vet day, we'll see what he has to say.

Thanks,

Martin

July 3rd 06, 10:30 PM
I spoke to the vet. He doesn't believe cats are susceptible to
malignant hyperthermia. It's a human or pig (known as porcine stress
syndrome) condition according to him. He called the veterinary faculty
at the university (in my presence) and spoke with the chief academic on
anesthetics who has never seen a case of malignant hyperthermia in
cats. They subject approx 250 cats to isofluorane per year and have
never encountered MH in cats.

Sounds like a done deal then?

I wonder why the pharmaceutical company Merck specifies in their vet
manual that pigs, dogs, *cats* and horses may undergo malignant
hyperthermia:

http://www.merckvetmanual.com/mvm/index.jsp?cfile=htm/bc/81000.htm

(1st paragraph, last sentance).

Then why wouldn't the veterinary faculty have noticed MH if they
subject 250 cats to isofluorane per year? Maybe because molecular
genetics estimates susceptibility for MH in 1 in 2000 to 3000 (human)
individuals according to the American association for MH. If the same
proportion exists for cats, then the faculty would thus require 10 to
15 years of 250 cats subjected to isofluorane per year to have a
reasonable chance of detecting an MH susceptible cat. And then the
symptoms may be blamed on something else or even completely discarded.

Martin

Wayne Boatwright
July 4th 06, 07:00 AM
Oh pshaw, on Mon 03 Jul 2006 02:30:17p, meant to say...

> I spoke to the vet. He doesn't believe cats are susceptible to
> malignant hyperthermia. It's a human or pig (known as porcine stress
> syndrome) condition according to him. He called the veterinary faculty
> at the university (in my presence) and spoke with the chief academic on
> anesthetics who has never seen a case of malignant hyperthermia in
> cats. They subject approx 250 cats to isofluorane per year and have
> never encountered MH in cats.
>
> Sounds like a done deal then?
>
> I wonder why the pharmaceutical company Merck specifies in their vet
> manual that pigs, dogs, *cats* and horses may undergo malignant
> hyperthermia:
>
> http://www.merckvetmanual.com/mvm/index.jsp?cfile=htm/bc/81000.htm
>
> (1st paragraph, last sentance).
>
> Then why wouldn't the veterinary faculty have noticed MH if they
> subject 250 cats to isofluorane per year? Maybe because molecular
> genetics estimates susceptibility for MH in 1 in 2000 to 3000 (human)
> individuals according to the American association for MH. If the same
> proportion exists for cats, then the faculty would thus require 10 to
> 15 years of 250 cats subjected to isofluorane per year to have a
> reasonable chance of detecting an MH susceptible cat. And then the
> symptoms may be blamed on something else or even completely discarded.

Martin, I'm glad you posted this after seeing the vet once again. You
certainly are well researched and well versed on the specifics, far more
than I would have been.

All that said, medications, including anesthetics, can and will have
different effects at an individual level, regardless of species. It can
sometimes be unpredictable regardless of history or testing.

I am reminded of my mother's death in the hospital a few days following
surgery, and I'm convinced that surgical procedure and possibly medications
hastened if not caused her death. Of course, it was not something I had
any chance of proving, and the result remains the same. My mother is gone.

I'm quite sure your cat was remarkable. I currently have five cats and one
of them, Bailey, is the most remarkable cat I've never known and loved. I
love all our cats, but Bailey is extraordinary.

I understand. It's all very difficult, and it's all very sad.

I wish you only the best...

--
Wayne Boatwright @@
_____________________

July 4th 06, 11:36 AM
Wayne Boatwright wrote:
> Oh pshaw, on Mon 03 Jul 2006 02:30:17p, meant to say...
>
> > I spoke to the vet. He doesn't believe cats are susceptible to
> > malignant hyperthermia. It's a human or pig (known as porcine stress
> > syndrome) condition according to him. He called the veterinary faculty
> > at the university (in my presence) and spoke with the chief academic on
> > anesthetics who has never seen a case of malignant hyperthermia in
> > cats. They subject approx 250 cats to isofluorane per year and have
> > never encountered MH in cats.
> >
> > Sounds like a done deal then?
> >
> > I wonder why the pharmaceutical company Merck specifies in their vet
> > manual that pigs, dogs, *cats* and horses may undergo malignant
> > hyperthermia:
> >
> > http://www.merckvetmanual.com/mvm/index.jsp?cfile=htm/bc/81000.htm
> >
> > (1st paragraph, last sentance).
> >
> > Then why wouldn't the veterinary faculty have noticed MH if they
> > subject 250 cats to isofluorane per year? Maybe because molecular
> > genetics estimates susceptibility for MH in 1 in 2000 to 3000 (human)
> > individuals according to the American association for MH. If the same
> > proportion exists for cats, then the faculty would thus require 10 to
> > 15 years of 250 cats subjected to isofluorane per year to have a
> > reasonable chance of detecting an MH susceptible cat. And then the
> > symptoms may be blamed on something else or even completely discarded.
>
> Martin, I'm glad you posted this after seeing the vet once again. You
> certainly are well researched and well versed on the specifics, far more
> than I would have been.

Thanks Wayne, I obviously regret not having such knowledge prior to the
anesthetics.

>
> All that said, medications, including anesthetics, can and will have
> different effects at an individual level, regardless of species. It can
> sometimes be unpredictable regardless of history or testing.

I can't disagree with this. I do have a problem if there is a malignant
condition taking place which is not *recognized*. If the vet is under
the impression that such a malignant condition can't take place, then
the results will seem unpredictable. If however there are vets who do
recognize such conditions, and have documented these, then such results
can't be qualified as unpredictable.

I have to note that if a vet exclaims "He's an old cat...", then even
though he may be saying that to prepare the owner for the worst, he's
also letting go of his own focus somewhat. And with such a general
conclusion in the back of his head, the situation taking place can
easily be erroneously related to his condition prior to the
anesthetics.

Some people throw away stuff easily, others hang on to stuff.

Going through this Merck Vet Manual is startling when I relate what the
manual states with the observed symptoms (described previously).

"In unanesthetized animals, open-mouthed breathing, tachypnea, and
hyperventilation may progress to apnea."

Although my cat was an anesthetized animal, he was open-mouthed
breathing after anesthetics and showing signs of tachypnea (rapid
breathing).

"Because hypothermia is an expected consequence during general
anesthesia, detection of hyperthermia is a key sign, along with the
presence of tachycardia and tachypnea. "

This seems to be a typo in the manual. Hyp*o*thermia is the opposite
condition of hyp*er*thermia. If the vet doesn't believe cats may suffer
from hyperthermia, then he's not going to backtrack tachypnea (rapid
breathing) to hyperthermia.

"Affected muscles from an animal that dies acutely are pale and soft
and appear exudative or wet."

Prior to his death, he had lost most of his muscle tone. It was like he
was paralysed. His skin and fur felt wet, like he was sweating.

I strongly feel that my cat was fighting for his life. He didn't
consider it to be "his time" and he fought the onslaught of the
overheating condition for 48 hours.

I spoke to another vet prior to my own vet yesterday. These are
difficult talks since it's always a hindsight discussion. He didn't
deny hyperthermia presence in cats. He even queried on one of the
signs, namely cola-colored urine which has to do with release of
certain chemicals.

I have an appointment with another vet this afternoon. I may even want
to speak with the chief academic anesthetics who denied hyperthermia in
cats yesterday.

>
> I am reminded of my mother's death in the hospital a few days following
> surgery, and I'm convinced that surgical procedure and possibly medications
> hastened if not caused her death. Of course, it was not something I had
> any chance of proving, and the result remains the same. My mother is gone.

I am very, very sorry to hear this. In my experience, and I hate to say
this, but lack of knowledge on the 'consumer' side often results in
sloppiness, misjudgment or downright lying on the 'producer' side. The
producer can mask his actions with whatever explanation serves him
best, for the consumer has no way of demonstrating otherwise. We have a
saying in this country: "In the land of the blind, one eye is king". I
may be blind, but I can still smell something fishy.

It's paradoxical. Although we may suspect malpractice or negligence or
in this case maybe even lack of academic knowledge, it doesn't help us
to bring our loved ones back. But at the same time, we expect none
other than competence and professionalism which may be difficult for us
to judge. So how do we achieve the desired level of competence without
being able to judge or measure competence in a particular field?

In many ways obviously, but as laymen we may at least demand a good
*specified* explanation of the situation. A doctor must be able to give
a justified rundown of the situation. There will always be certain
details that are difficult for us to comprehend. But given the
difference before and after the anesthetics, I'm not going to allow
this to be discarded with the *general* statement "he's an old cat".
This is masking the situation to me. It may not be intentionally, but
it certainly doesn't justify what occurred.

If I bring in my cat for stomach related problems and he suffers from
hyperthermia after anesthetics, the vet must explain to me what those
stomach problems were and how they resulted in hyperthermia. We still
have no results from the anesthetics procedure, no knowledge of what
the stomach problems were. The transition from stomach problems to
hyperthermia has not been explained. These things just happen, I think
not.

A vet who is accustomed to having to justify situations no matter how
difficult it seems to be to explain something will improve on his/her
capabilities of handling situations. On the other hand, a vet who is
accustomed to generalise cases out of the realm of medicine into
philosophical or social statements as "these things happen" or "he's an
old cat", will proceed to a lower level of competence. I can visit a
priest for generalised statements. Let the Lord giveth and let the Lord
take, but the rest of us better get with their respective programs.

>
> I'm quite sure your cat was remarkable. I currently have five cats and one
> of them, Bailey, is the most remarkable cat I've never known and loved. I
> love all our cats, but Bailey is extraordinary.

Is he male? Then give him that "alpha-male" like feeling. Lead by
example!

Go Bailey GO!

>
> I understand. It's all very difficult, and it's all very sad.
>
> I wish you only the best...

Thank you. I wish Bailey and the gang good health and good times.

Martin

July 4th 06, 12:49 PM
wrote:

>
> "Because hypothermia is an expected consequence during general
> anesthesia, detection of hyperthermia is a key sign, along with the
> presence of tachycardia and tachypnea. "
>
> This seems to be a typo in the manual. Hyp*o*thermia is the opposite
> condition of hyp*er*thermia. If the vet doesn't believe cats may suffer
> from hyperthermia, then he's not going to backtrack tachypnea (rapid
> breathing) to hyperthermia.

On second thought, this is probably not an error in the manual. This
suggests that hypothermia (under cooling) is to be expected with
anesthetics and any sign of hyperthermia (over heating) is a clear sign
that something's going wrong.

Martin