Diabetic Dog Brain Milliosmoles Anesthesia : Understanding the Complexities

Anesthetic Protocols for Diabetic Dogs

Drug Selection

Selecting appropriate anesthetic agents is critical to minimizing risks.

Induction Agents

• Propofol: A short-acting agent with minimal impact on glucose levels.
• Etomidate: Another safe option for diabetic dogs.

Maintenance Agents

• Isoflurane or Sevoflurane: Inhalant anesthetics with predictable effects and easy reversibility.

Adjuncts

• Opioids: Provide effective pain relief without causing significant glucose fluctuations. Examples include morphine, hydromorphone, or fentanyl.
• Anti-Nausea Medications: Drugs like maropitant (Cerenia) help reduce nausea and promote faster recovery.

Drugs to Avoid

• Ketamine: May increase blood glucose levels and exacerbate hyperglycemia.
• Alpha-2 Agonists (e.g., Dexmedetomidine): Cause transient hyperglycemia and complicate glucose management.

Monitoring During Anesthesia

Continuous monitoring is critical for ensuring the safety of diabetic dogs under anesthesia. Key parameters include:

Blood Glucose

• Check glucose levels every 30–60 minutes.
• Aim to maintain levels between 150–250 mg/dL to avoid hypo- or hyperglycemia.
• Use IV dextrose supplementation (2.5%–5%) if blood glucose drops below 100 mg/dL.

Electrolytes

• Monitor sodium, potassium, and magnesium levels closely. Correct any imbalances as needed.

Cerebral Osmolality

• Avoid rapid glucose corrections to prevent fluid shifts that could lead to cerebral edema.