Day 5
Sometimes when you're learning anesthesia, you happen upon the most beautiful protocol, and it just makes your heart happy to see it work its magic. This was the case for
@Coopah, who had a complex case to work up, but impressed her anesthesiologist with the work she put in to tailoring her drug selections for her patient. She put her telazol away for this one - she wouldn't need it if she played her cards right. He was a grumpy kitty with terrible peripheral veins, so they were going for alfaxalone and dexmedetomidine pre-med to facilitate placing a jugular catheter. Doses were kept low because he had hypertrophic cardiomyopathy, systolic anterior motion of the mitral valve, and stage 2 chronic kidney disease. She was nervous about dexmed being part of her pre-med and maintenance protocol, but cats are special, and she had done her research. She knew this might be the best thing for his beefy little heart.
@mizchiefmanaged assisted with placing his catheter, after which she gave a fentanyl loading dose and midazolam, and then titrated etomidate to effect. Intubation was smooth, kitty was hooked up to his fentanyl and dexmedetomidine CRIs, and kept on a very low percentage of isoflurane gas.
@WonderingStudent was on standby with a dose of ephedrine in case he needed it, though she was a little disappointed that she wasn't going to need the butorphanol she had drawn up. In fact, it would probably be counterproductive in his case. He needed the pain management and MAC reduction benefits of a full mu agonist, which was where the fentanyl CRI came in! He had been through multiple anesthetic procedures and his heartrate and blood pressure had always been inconsistent, requiring multiple administrations of anticholinergics. The dexmedetomidine CRI would hopefully keep him vasoconstricted, bumping up his blood pressure and causing a reflex bradycardia to help maintain his diastolic filling and keep his heart well-perfused.
Everyone was invested in this case, so
@cubsrule4e was lurking nearby as well, and @Strroganoff was keeping an eye on the fluid rate - they didn't want to go over 3ml/kg/hr total for this kitty, between his multiple CRIs and Norm-R. While everyone watched the monitors, willing kitty's heart rate and blood pressure to stay consistent, cubs tiptoed over to the vaporizer. He turned the isoflurane to 3%, and watched as kitty's blood pressure started to drop over the next few minutes...Coop was on it though! She caught him with his hand still hovering over the dial, and shooed him out of the OR. Wondering escorted him out and reported his actions to the anesthesiologist. Miz shot him a threatening glance, and wished she had another dose of carfentanil on hand...
Dead is @cubsrule4e, who was hypotension, a vanilla wolf
VILLAGERS WIN!!!
1.
@Stroganoff - Norm-R
5.
@Coopah - Norm-R -->
Telazol - seer whether someone could do anything at night (including wolf kills) or not (granted d2)
7.
@Stagg737 --->
@WonderingStudent - Norm-R -->
Butorphanol - jailer (granted d3)
14.
@mizchiefmanaged - Norm-R --->
Carfentanil - 1 shot day vig (granted d4)
Dead:
8.
@BigCats - Norm -R
10.
@SARdoghandler - Norm-R
3.
@Doggo Labs - Norm-R
6.
@PippyPony - Norm-R
15.
@Navilly - Norm-R
13.
@Barkley13 - Norm-R
12.
@mmmdreamerz --->
@johnnaboo - Norm-R
9.
@genny -
Hypothermia
2.
@Animal Midwife - Norm-R
4.
@dolphin106258 -
Hypoventilation
11.
@cubsrule4e -
Hypotension