Health Tips

<body topmargin=0 leftmargin=0 marginheight=0 marginwidth=0> <table cellpadding=0 cellspacing=0 border=0><tr> <td valign="top" height=110 BGCOLOR="#666699" TEXT="#080000" bgproperties="fixed" background="04b00840erlcjm.png"> <div> <FONT SIZE="5" COLOR="#FFFFFF" FACE="Arial" ><B>Namtrah Tibetan Spaniels</B></FONT><B>     |     </B><A HREF="index.htm" TARGET="_top" TITLE="Namtrah Tibetan Spaniels"><U><B>home</B></U></A></div> <div> <A HREF="id19.htm" TARGET="_top" TITLE="Philosophy"><U>Philosophy</U></A>   |   <A HREF="id35.htm" TARGET="_top" TITLE="The Namtrah Tibbies"><U>The Namtrah Tibbies</U></A>   |   <A HREF="id78.htm" TARGET="_top" TITLE="Show News"><U>Show News</U></A>   |   <A HREF="id36.htm" TARGET="_top" TITLE="To Contact Us"><U>To Contact Us</U></A>   |   <A HREF="id47.htm" TARGET="_top" TITLE="Recent Ads"><U>Recent Ads</U></A>   |   <A HREF="id22.htm" TARGET="_top" TITLE="Application for adoption"><U>Application for adoption</U></A>   |   <A HREF="id72.htm" TARGET="_top" TITLE="Litter Announcements Available Tibbies"><U>Litter Announcements & Available Tibbies</U></A>   |   <A HREF="id25.htm" TARGET="_top" TITLE="Where are they now"><U>Where are they now</U></A>   |   <A HREF="id61.htm" TARGET="_top" TITLE="Kindred Spirits Tibbies"><U>Kindred Spirits Tibbies</U></A>   |   <A HREF="id108.htm" TARGET="_top" TITLE="A Special Black Tan Litter"><U>A Special Black & Tan Litter</U></A>   |   <A HREF="id28.htm" TARGET="_top" TITLE="Sept 2000 Puppy Pics"><U>Sept 2000 Puppy Pics</U></A>   |   <A HREF="id60.htm" TARGET="_top" TITLE="Jewels 2002 pups"><U>Jewel's 2002 pups</U></A>   |   <B>Health Tips</B>   |   <A HREF="id26.htm" TARGET="_top" TITLE="More Tibbie Info"><U>More Tibbie Info</U></A>   |   <A HREF="id52.htm" TARGET="_top" TITLE="Heidi 2002 pups"><U>Heidi 2002 pups</U></A>   |   <A HREF="id27.htm" TARGET="_top" TITLE="Class of 2001"><U>Class of 2001</U></A>   |   <A HREF="id57.htm" TARGET="_top" TITLE="Litter Basket"><U>Litter Basket</U></A>   |   <A HREF="id109.htm" TARGET="_top" TITLE="Guest Book"><U>Guest Book</U></A></div> <div> </div> </td> </tr><tr> <td valign="top" height=370 BGCOLOR="#FFFFFF" TEXT="#080000"> <div>                                                                     Health Tips</div> <div> The fist HEALTH TIP 1 article was published in a recent Tibetan Spaniel Club of America Newsletter:</div> <bR> <div> Since the first health tip was published Dr. Hartman has switched to a new gas anesthetic called </div> <div> Sevoflurane and has used it on Tibbies with great success. Although this new gas is more costly </div> <div> it is safe and has the fastest recovery time yet. I witnessed my own Tibbies up on their feet and </div> <div> running around just 20 minutes after a procedure with no side affects.</div> <bR> <bR> <bR> <div> <B><U>HEALTH TIP 2</U></B></div> <bR> <div> <B><U>Sevoflurane Anesthetic Protocol for Tibetan Spaniels</U></B></div> <div> By Dr. Lewis R. Hartman</div> <bR> <div> Mask with 6% to 6.5% Sevoflurane concentration with 2 Liter OXYGEN flow until deep enough </div> <div> anesthetic plane to intubate.</div> <bR> <div> After intubation maintain at 3.0 to 3.5% Sevo (Sevoflurane) concentration at 1.5 to 2 liter oxygen flow.</div> <bR> <div> Recovery starts within a few minutes after Sevo is discontinued.</div> <bR> <div> I have used Sevoflurane with out the need for pre-anesthetics since it is not irritating and well</div> <div> tolerated.  However using a pre-anesthetic can shorten the masking time. Torbugesic at .2 to</div> <div> .3 mg/kg combined with glycopyrrolate at 0.015mg/kg is a suitable and safe pre-anesthetic </div> <div> protocol with the additional advantage of having an analgesic benefit.   </div> <bR> <div> However if your veterinarian does not have this new anesthetic available here is a safe protocol for Tibetan Spaniels. As you may or may not know Tibbies are very sensitive to anesthetic and can have difficulties if precautions are not taken.</div> <bR> <bR> <div> <B><U>HEALTH TIP 1</U></B></div> <bR> <div> <B><U>Anesthetic Protocol for Tibetan Spaniels</U></B></div> <div> By Dr. Lewis R. Hartman </div> <bR> <div> This protocol will be most helpful for first time Tibbie owners and their Veterinarians who have limited experience with the Breed.</div> <bR> <div> Many of you have “Tibbie experienced” Veterinarians, who have developed their own anesthetic protocols. I welcome their inputs and participation. They can send their favorite protocols to me at LRHMDH@aol.com. </div> <bR> <div> Tibetan Spaniel Anesthetic Protocol</div> <bR> <div> <B>Pre-Anesthetic:</B></div> <div> .015 mg/kg glycopyrrolate (Robinul) IM</div> <div> .01 mg/kg  medetomidine ( Domitor ) IM 15 to 20 minutes later (option of giving at same time) </div> <div> Wait 40 minutes after Domitor injection to start Induction                                         </div> <bR> <div> <B>Induction:</B></div> <bR> <div> IV Diazepam/Ketamine (1:2 ratio) given slowly to effect until able to intubate  (.75 to 1.0 ml/10 lbs. )</div> <div> Option of Isoflurane/ O<FONT SIZE="1" COLOR="#000000" FACE="Arial" >2</FONT> mask (3% Isoflurane with 2 liter O<FONT SIZE="1" COLOR="#000000" FACE="Arial" >2</FONT> flow)</div> <bR> <div> Maintenance Anesthesia:</div> <div>      </div> <div> Initial 1% Isoflurane with 1 liter O<FONT SIZE="1" COLOR="#000000" FACE="Arial" >2</FONT> flow rate gradually reduce to 0.5% to 0.25% Isoflurane</div> <div>      Use a Non-Rebreathing system</div> <bR> <div> Anesthetic Monitoring:</div> <div>      <FONT SIZE="3" COLOR="#000000" FACE="Arial" >Pulse Oximeter mandatory with ECG monitoring preferred</FONT></div> <bR> <div> Comments:</div> <div> Domitor as a pre-anesthetic enables the use of much lower Isoflurane concentrations during maintenance anesthesia</div> <div> The reversibility of Domitor with atipamizole ( Anisedan ) enables quick recovery if needed</div> <div> Domitor as an analgesic is also an advantage</div> <div> This protocol is most suited for the young to middle-age Tibbie</div> <bR> <div> HIGHER RISK PATIENTS (Geriatric)</div> <bR> <div>      Butorphanol (Torbutrol) 0.2 mg/kg IM as a pre-anesthetic</div> <div>      Isoflurane/O<FONT SIZE="1" COLOR="#000000" FACE="Arial" >2</FONT> mask Induction</div> <div>      Isoflurane maintenance anesthesia</div> <bR> <div> CAUTION:</div> <bR> <div> With extended anesthesia time a DECREASED PULMONARY TIDAL VOLUME is often seen. This occurs even when the Respiratory Rate is normal. This is why Pulse Oximeter monitoring is absolutely necessary. Assisted Ventilation by bagging two to three times per minute will prevent this from happening. Also maintain O<FONT SIZE="1" COLOR="#000000" FACE="Arial" >2</FONT> blood levels above 92% with Ventilation.</div> <bR> </td> </tr></table></body>