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wishes to thank Dr. Lisa Carpenter for permission to post this article on
Anesthesia for Papillons and Phalenes

written by Dr. Lisa Carpenter DVM  

I am a veterinarian and would like to help others understand the facts behind some of the medical issues that are of concern to Papillon and Phalene owners.  I feel I should offer some additional and more up to date information to clarify the various issues about anesthesia for Papillons and Phalenes.  I will try to keep it brief
 First of all, Isoflurane is now widely used as the best anesthetic for all dogs, not just Papillons and Phalenes  You should expect it. It is no more expensive than the other older gas anesthesias. 
Second, a fairly safe induction drug (to allow the pet to become unconscious so a tube can be put in the windpipe to aid in oxygen and gas delivery) combination is ketamine and valium.  I have used these almost exclusively for over 13 years with almost no problems.   This combination is even safe for many heart problem patients. Of course, dosing is done only to effect.  We wait to see if we need to give all of a precalculated dose.  Some patients will be more quiet and won't need all of the dose.  For very old patients or those with kidney disease, I may just anesthetize with masked Isoflurane avoiding injectable drugs.  There are also numerous new drugs available for complicated cases.  You should, of course, follow the advice of your own veterinarian regarding your Papillon's or Phalene's special needs.  There is never only one good way to perform anesthesia. 
Third, narcotics, such an Numorphan (oxymorphone), morphine and butorphanol are all pain medications.  They are not meant to be the only anesthetic used.  If your Papillon or Phalene will need dental extractions, pain meds will be needed but other drugs must be used in addition. 
Fourth, I do not believe you will find any veterinary dentists (board certified) who would ever recommend cleaning of the teeth under only light sedation. This is a very discomforting procedure when done correctly and you cannot do a good job if the dog is awake.  I understand some Papillons or Phalenes may be more tolerant but I would personally never recommend cleaning without full gas anesthesia. 
Fifth, what has been lacking in this discussion is information about monitoring the anesthesia.  Use of doppler blood pressure monitors, EKGs and pulse oximeters and fully trained technicians to check heart rate, respiratory rate and depth of anesthesia is essential to assure prevention of complications.  More dogs will die due to rapidly lowered blood pressure (hypotension) than due to many other factors. Most anesthesia drugs will lower the blood pressure.  Only by monitoring, will the technicians and doctors know to lower anesthesia or start fluids to control blood pressure better.  Also, all dogs, but especially the toy breeds need to be on circulating hot water blankets to maintain body temperature-another reason for difficulties with anesthesia recovery. 
Finally, all of these precautions and procedures do not come cheap.  I understand that for those of you with many Papillons and Phalenes, the costs for a proper dental prophylaxis and cleaning will be high.  However, I am guessing that everyone who has lost a dog to anesthesia would have gladly paid the going rate to have their dog back. I do not intend any disrespect to any veterinarian or breeder who chooses their own personal procedures and standards, I just thought I would offer my opinion to those who are not aware of many of the latest in anesthesia protocols. For what it is worth, I have never had to anesthetize a Papillon (not many in my area), however, never have I read or heard that they should have any more or any less anesthetic deaths when proper, modern anesthesia protocols are used.
Anesthesia has always and will always carry some risk.  Even the best protocols, doctors and monitoring may still lead to the loss of a patient. This is tragic and sad.  For those of you who have lost a pet this way, I send my heartfelt sympathies and understanding.  This is the phone call no vet ever wants to make and I assure you, we never forget those we lose.  We take every one of them to heart.  I offer this information as a way to know what questions to ask to better avoid problems so no one loses these precious pets.
 

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