Rabbiting On About The Remarkable Rabbit Anaesthesia Alfaxan Roadshow
Jurox’s ‘Remarkable rabbit anaesthesia’ Alfaxan roadshow, which took place during November and December, was a big hit having attracted over 400 veterinary professionals to the eight different locations across the UK.
Aiming to educate veterinary surgeons and nurses on the full anaesthetic procedure in pet rabbits from pre-med through to recovery, the roadshows foused on factors that make rabbits different to cats and dogs and provided delegates with practical tips to help reduce the risk of complications.
Featuring leading experts in rabbit anaesthesia including Ian Self, European Specialist and Clinical Associate Professor in Veterinary Anaesthesia and Analgesia at Nottingham Vet School and Pride Veterinary Centre; Joanna Hedley, Lecturer in Exotic Species and Small Mammal Medicine and Surgery at the Royal Veterinary College in Camden; Jenna Richardson HFSA Veterinary Lecturer and Clinician, Rabbit, Exotic Animal and Wildlife Practice at the Royal (Dick) School of Veterinary Studies and Richard Saunders, RCVS Registered Specialist in Zoo and Wild Animal Medicine (Mammals) at Bristol Zoo, several key points were discussed during the meetings:
- The importance of reducing stress factors as much as possible - Rabbits are prey species and can easily be stressed. Stress affects several body systems (cardiovascular, metabolic, neurohormonal, immune) and therefore the anaesthetic procedure. It is also important to remember the causes of stress, especially sound (why do rabbits have big ears), light levels and unsympathetic handling.
- It is advisable to remind owners of pre and post anaesthesia considerations (consider creating a checklist to hand out) – Do not starve, give hay up to the point of premedication. Get owners to bring own food (and usual drinker), bring a companion and bedding, advise practice staff as soon as the rabbit arrives in practice and minimise time in the waiting area. Post-procedure considerations consist of watching for any abnormal behaviours or to be more precise, lack of normal behaviours in rabbits (for example eating).
- Place IV catheters in all patients - Placing IV catheters as standard in all patients has great benefits. IV fluids can be administered, induction agents can be dosed to effect and there is quick access if emergency drugs are needed. These three things increase the vet’s and/or nurse’s control, improving success of the procedure. Use the marginal ear vein. Consider cephalic or intraosseous routes in small patients to increase flow. If alfaxalone (Alfaxan) is administered as an induction agent administer slowly to effect over 60 seconds, checking reflexes. Alfaxalone (Alfaxan) is used by experts because of its reliable effect, less apnoea, shorter recovery and its wide safety margin.
- Pre-oxygenate – Rabbits have very small lungs (5-6ml/kg tidal volume). Pre-oxygenating for at least three minutes can dramatically delay blood oxygen desaturation. Raising the head and chest (eg on a towel) can help angle the abdominal contents away from the diaphragm and ease respiration.
- Intubate all patients - Different intubation techniques are used by experts but they all agree that intubating all animals gives better outcomes. Some use an otoscope to find the larynx aided by also by a stylet, while others listen for breathing as they intubate blind. If using a supraglottic airway device (V-gel) a capnograph is always recommended.
- Access and treat pain in all patients - Include analgesia in premedication and consider further treatment after the procedure. Evaluate the effectiveness of pain treatment (eg using the Grimace scale). Preventing and treating pain has been found to improve and speed the recovery.
- Rabbits need to be monitored at all times - Heart rate is not reliable to monitor rabbits. Respiratory pattern is a better indicator. The recovery stage is where there is higher risk of fatalities in rabbits (CEPSAF study), therefore monitoring the recovery is especially important in this species. The three factors that significantly improve recovery are: administering fluids IV, pain management and managing hypothermia. Experts emphasise that room temperature is the best way to keep rabbits warm.
Jurox invests in a wide range of educational and best practice initiatives that help veterinary practices deliver the most up-to-date and comprehensive anaesthesia for their patients. In addition to its CPD meeting series, these include: in-clinic discussions on practice protocols relating to pre-meds and analgesia and lunch and learn meetings.
For further information on Alfaxan or Jurox’s educational and best practice initiatives visit alfaxan.co.uk, contact Jurox customer service on [email protected] or telephone 0800 500 3871.
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