References

AAHA. Tips and Tricks for Anesthetizing Diabetic Dogs and Cats. 2018. https://www.aaha.org/guidelines/diabetes_guide-lines/anesthetizing_diabetic_dogs_and_cats.aspx (accessed 2018-12-08)

Assam JH, Bernhisel A, Lin A. Intraoperative and postoperative pain in cataract surgery. Surv Ophthalmol.. 2018; 63:(1)75-85 https://doi.org/10.1016/j.survophthal.2017.07.002

AVTAA. American Society of Anesthesiologists (ASA) Physical Status Scale. 2018. http://www.avtaa-vts.org/asa-ratings.pml (accessed 9th December, 2018)

[Package insert].Netherlands: Intervet International BV; 2015

Culross B. Sensory function: Nursing Management of Cataracts, 6th ed. In: Meiner SE, Yeager JJ (eds). Missouri: Elsevier; 2019

Crompton S, Hill P. Post-operative recovery of the surgical patient. The Veterinary Nurse.. 2011; 2:(4)190-8

Diabetes mellitus and anaesthesia: dealing with its potential problems. 2011. https://www.vettimes.co.uk/article/diabetes-mellitus-and-anaesthesia-dealing-with-its-potential-problems/ (access date: 2018-12-02)

Arterial Blood Pressure Measurment. 2005. http://www.vetfolio.com/monitoring-and-nursing/arterial-blood-pressure-measurement (accessed 2018-12-09)

Farry TA, Norkus CL. Monitoring the Critical Patient, 2nd ed. In: Norkus CL (ed). Pennsylvania: Wiley Blackwell; 2019

Gross ME, Pablo LS. Opthalmic patients, 5th ed. In: Grimm KA, Lamont LA, Tranquilli WJ, Greene SA, Robertson SA (eds). Iowa: Wiley; 2015

Haberman CE, Kang CK, Morgan JD, Brown SA. Evaluation of oscillometric and Doppler ultrasonic methods of indirect blood pressure estimation in conscious dogs. Can J Vet Res.. 2006; 70:(3)211-17

Hughes L. Breathing systems and ancillary equipment, 2nd ed. In: Seymour C, Duke-Novakovski T (eds). Gloucester: BSAVA; 2007

Kelwala DN, Patil D. Electroretinography (ERG) for Clinical Evaluation of Vision Abnormalities – A Clinical Study of 9 Dogs. Intas Polivet.. 2016; 429-31

Anaesthesia for the diabetic patient. 2014. http://www.vetfolio.com/veterinary-technician/anesthesia-for-the-diabetic-patient (2018-12-08)

Lumbis R. A practical approach to caring for patients with appetite reduction. The Veterinary Nurse.. 2012; 3:(2)90-100

Martin-Flores M, Gleed RD, Basher KL, Scarlett JM, Campoy L, Kopman AF. TOF-Watch(R) monitor: failure to calculate the train-of-four ratio in the absence of baseline calibration in anaesthetized dogs. Br J Anaesth.. 2012; 108:(2)240-4 https://doi.org/10.1093/bja/aer378

Monticelli P, Dawson C, Adami C. Life-threatening hyperkalaemia in a diabetic dog undergoing anaesthesia for elective phacoemulsification. Vet Anaesth Analg.. 2018; 45:(6)881-2 https://doi.org/10.1016/j.vaa.2018.06.007

Oliver JA, Clark L, Corletto F, Gould DJ. A comparison of anaesthetic complications between diabetic and nondiabetic dogs undergoing phacoemulsification cataract surgery: a retrospective study. Vet Ophthalmol.. 2010; 13:(4)244-50 https://doi.org/10.1111/j.1463-5224.2010.00793.x

Ramsay I. Small Animal Formulary, 7th ed. Gloucester: BSAVA; 2011

Robertshaw HJ, Hall GM. Diabetes mellitus: anaesthetic management. Anaesthesia. 2006; 61:(12)1187-90

Today's Technician: Blood Pressure Monitoring From a Nursing Perspective – Part 2: Blood Pressure Monitoring Techniques. 2015. https://todaysveterinarypractice.com/wp-content/uploads/sites/4/2016/06/T1503C12.pdf

Thompson S. Opthalmic surgery, 2nd ed. In: Seymour C, Duke-Novakovski T. Gloucester: BSAVA; 2007

TOF-Watch®. Objective neuromuscular transmission monitors, because patients should not be extubated until TOF ≥0.91. 2007. http://www.fennomedical.fi/files/fennomedical/Potilasvalvonta/TOF-Watch-esite.pdf (accessed 2019-02-23)

VOM. VOM og hundemat. 2018. https://vomoghundemat.se (accessed 3rd December, 2018)

Patient care report

Anaesthetic management of a patient undergoing unilateral phacoemulsification with concurrent diabetes mellitus

02 June 2019

Clinical

11 mins read

02 June 2019

Volume 10 · Issue 5

ISSN (print): 2044-0065

ISSN (online): 2052-2959

Abstract

This report discusses the anaesthetic approach of a canine undergoing a phacoemulsification surgery with concurrent diabetes mellitus. It is the anaesthetic nurse's role and responsibility to deliver updated and high quality nursing care, therefore it is vital to know basic physiology of the patient and pharmacodynamics of anaesthetic drugs as it affects the outcome of the procedure and the recovery. This article looks at the important anaesthetic aspects of both the speciality procedure and the disease in the pre, peri and post anaesthetic period.

The patient was referred to the hospital for bilateral cataracts 6 months after being diagnosed with diabetes mellitus (DM). The patient was fed a raw food diet (VOM, 2018) three times daily (TID) at home, a diet that consisted of equal or more fat than protein content. This patient was fairly controlled with insulin (Caninsulin^® Vet 40IU/ml) 5 IU twice daily (BID) at home where the owners monitored his blood glucose several times a day. His blood glucose normally stayed within 7–15 mmol/litre (ideal blood glucose 4.4–6.6). It was decided to do a phacoemulsification on the left eye to recover partial vision and increase patient welfare.

Species: Canine

Breed: Miniature Schnauzer

Age: 8 years 8 months

Sex: Male entire

Weight: 7.3 kg

American Society of Anesthesiologists (ASA) Physical Status Scale: Class III (Severe systemic disease present).

It is recommended to perform an electroretinogram (ERG) prior to phacoemulsification surgery to rule out general retinal disease (Kelawala and Patil, 2016) as a patient with retinal disease would not regain eyesight through phacoemulsification. The patient had a successful ERG, which meant that this type of surgery would benefit him.

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