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Dr. Ryan Bailey - DVM, DACVAA
Dr. Gianluca Bini - DVM, MRCVS, DACVAA
Dr. Khursheed Mama - DVM, DACVAA
Dr. Joy Tseng - DVM, DACVAA
A selection of some of the discussion topics:
5:00 -- I'm having I'm trying very hard to understand the differences between when you would use dopamine, dobutamine and norepinephrine when you're facing hypotension. How do we come up with these choices?
19:45 -- What is your preferred sedation/anesthetic protocol for a blocked cat assuming they're early in their urinary obstruction, there's no hypokalemia or bradyarrthymia episodes.
30:56 - Nadine asked that she had two patients. Both of them are here for hysterectomies who started shaking their legs during ovarian manipulation. They both have received a local bupivacaine block and both had a premedication of 0.2 mg/kg of methadone and 3 microgram per kilo of dexmedetomidine plus 0.2 mg/kg (??), induced with ketamine and Lidocaine (loading doses of each) and then on to lidocaine and ketamine CRIs plus isoflurane. Both patients had shaking and tremoring with no changes of hemodynamic parameters or change in reflexes. So, her question is: Could this be pain what is happening?
34:30 - Somebody Anonymous asks: This is an interesting case. In the case of a post-spinal surgery at C3-C5 segment. the patients experienced respiratory arrest. They tried to ventilate for more than 12 to 15 hours after the surgery hoping that the patient would regain respiratory drive but so far, no success. The patients involved are extremely hypercapnic with a CO2 between 55- and 70-millimeters mercury despite being aggressively mechanically ventilated at 25 to 30 respiratory rate per minute. We've already had several cases so far with patients that have had badly compressed discs on MRI. Is there something that we could have done differently to improve their outcome and assuming they're specifically speaking about respiratory or ventilatory outcomes.
37:10 - We have all our anesthetic patients on ventilators in our practice currently and we've been seeing low end tidal CO2. What steps could she go about to adjust this?
41:12 - An RVT at a general practice states: We have none of the medications that we just spoke about for treating hypotension. This is very common. The only thing that they have is hetastarch. So, if she's already decreased volatile anesthetic, increased IV fluid rate, and reversed the dexmedetomidine. Is there any support for the use of hetastarch nowadays, or should she be pushing for getting those other pressure support medications for the hospital?