Episode 205 - High-Risk Veterinary Anesthesia with Liver Disease and Heart Failure Cases

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Host: Dr. Brett Beckman, DVM, FAVD, DAVDC, DAAPM

In this episode of The Vet Dental Show, Dr. Victoria Lukasik, DVM, DACVAA, tackles the complexities of managing high-risk dental cases. Through detailed case studies, they discuss anesthetic protocols for patients with hepatic portal shunts and chronic heart failure. Learn how to navigate potential complications like hypoglycemia, hemorrhage, and ventricular tachycardia, while ensuring patient safety and optimizing recovery.

What You’ll Learn: 
✅ Understand anesthetic considerations for patients with hepatic portal shunts. 
✅ Discover strategies for managing hypoglycemia and electrolyte imbalances. 
✅ Simplify anesthetic protocols for patients with chronic heart failure. 
✅ Apply techniques for recognizing and treating ventricular tachycardia. 
✅ Master the use of short-acting and reversible drugs in high-risk patients. 
✅ Recognize and address delayed recovery in the post-anesthetic period.

Key Takeaways: 
✅ Patients with hepatic portal shunts require short-acting, reversible drugs to minimize liver burden. 
✅ Intermittent hemorrhage in patients with hepatic dysfunction may lead to platelet consumption and anemia. 
✅ Bounding femoral pulses can indicate dehydration; adjust fluid therapy accordingly in cardiac patients. 
✅ Lidocaine has centrally depressing effects; anticipate mental dullness or sedation post-administration. 
✅ Early intervention with lidocaine is crucial for managing ventricular tachycardia and preventing further complications.

Questions This Episode Answers:
❓ How should anesthetic protocols be adjusted for patients with hepatic portal shunts?
❓ Which anesthetic and analgesic drugs are safest for patients with true hepatic dysfunction?
❓ When should dextrose supplementation be considered in dental patients with liver disease?
❓ How do you manage intermittent hemorrhage, anemia, and low platelets during dental procedures?
❓ What causes delayed anesthetic recovery—and how do you systematically troubleshoot it?
❓ How should cardiac medications be handled on the morning of anesthesia for heart failure patients?
❓ What do bounding femoral pulses indicate, and how should fluid therapy be adjusted?
❓ Why can lidocaine cause deep sedation and delayed recovery after anesthesia?
❓ How do you recognize ventricular tachycardia intraoperatively—and when should you intervene?
❓ What recovery expectations should you have after treating ventricular tachycardia with lidocaine?

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Questions? Leave a comment below with your thoughts, experiences, or cases related to veterinary dentistry!

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KEYWORDS: Veterinary Dentistry, IVDI, Brett Beckman, Dog Dental Care, Cat Dental Care, VetTech Tips, Animal Health, Veterinary Education, Veterinary Dental Practitioner Program, Vet Dental Show, Anesthesia, High-Risk Patients, Hepatic Portal Shunt, Chronic Heart Failure, Ventricular Tachycardia, Lidocaine, Hypoglycemia, Electrolyte Imbalance, Delayed Recovery