Why Don’t Pets Have Anesthesiologists Attending Them?
Q. I know in human medicine, one doctor handles the anesthesia while another doctor does the surgery. Why isn't it the same way in veterinary medicine?
A. I can’t tell you how happy your question makes me! You are an advocate for your pet and are clearly interested in working in partnership with your veterinarian. I love when people ask questions that show them to be pushing me to expand their veterinary knowledge — and my own as well, on occasion.
Anesthesiologists vs. Veterinary Technicians
In most routine cases, an anesthesiologist isn’t monitoring a human patient. While that specialist is on the premises, the actual monitoring is being handled by a nurse anesthetist or other specially trained health care professional.
The same is true in veterinary medicine. A trained health care professional is monitoring anesthesia, but the decisions are being made by the doctor. The veterinarian doing the surgery also performs the role of the overseeing anesthesiologist, making adjustments as necessary during the course of the anesthetic event. Although the technicians are highly skilled and have attended training programs accredited by the American Veterinary Medical Association, they are not ever “playing doctor.” The veterinarian is always handling that task.
How Does the Surgical Team Work?
I checked in with my colleague and longtime friend Dr. Robin Downing of the Downing Center for Animal Pain Management in Windsor, Colo., for more information about the role of veterinary technicians in surgery. Dr. Downing is an internationally recognized expert in anesthesia and pain management.
“There are certain high-risk patients who really need a veterinarian handling all aspects of their anesthesia,” she says, noting that in certain cases, an additional veterinarian is brought in for a surgery. “That’s true in human medicine as well: There are human high-risk patients who need a board-certified anesthesiologist running their case."
But the majority of surgeries and dentistries conducted in general veterinary practice don’t require an additional veterinarian, says Dr. Downing, who notes that she relies on her highly trained technicians to assist her during surgery.
“My veterinary technicians conduct, manage and monitor very complex anesthesia cases,” she says. “For instance, I may have a surgery patient who needs three or four intravenous medications in addition to the regular IV fluids flowing during anesthesia. My technician attends to the medications, the fluids, the patient's temperature (they are keeping the patient warm), their blood pressure, oxygenation, EKG, pulse rate, breathing rate, and they are inflating the lungs with a full breath every five to 10 minutes. All this while they are recording their findings in the very detailed anesthesia log attached to that patient as part of the permanent medical record.”
This type of team approach, with staff members you know well and work with often, really does offer the best care, says Dr. Downing. “Not only are my technicians adequately trained to perform these professional duties, I could not practice without them,” she says.
I feel the same way about the technicians I am fortunate enough to work with as well.