Читать книгу Surgery of Exotic Animals - Группа авторов - Страница 19

Small patients have a small total blood volume and what may appear to be minimal hemorrhage can be life‐threatening. If the patient is anemic and surgery can be postponed, it should be postponed until the hematocrit is into the normal range. It would be a rare event that surgery made a hematocrit increase, typically the opposite is the norm. Consider a blood transfusion from a conspecific, if more than minimal hemorrhage is anticipated or if the patient is anemic preoperatively. Strict attention to intraoperative hemostasis is essential when performing surgery on any small patient.

In patients experiencing serious blood loss during surgery, crystalloid or colloid fluid therapy should be administered as quickly as possible for cardiovascular support. More ideal, blood from a conspecific should be used, but often this is not available. Preplanning by having a conspecific blood donor available can be life‐saving. In ferrets, there are no blood types and no reports of transfusion reactions. It is safe to use any ferret as a blood donor. In many species, blood typing may not be known. If it is unknown whether a species has blood types, a crossmatch should be performed prior to administering a blood transfusion.

Anesthesia results in loss of fluids because of dry gases making parenteral fluid administration vital for most surgical procedures. It can be difficult to achieve vascular access in small patients. Vascular access provides a route for the administration of fluids during anesthesia at the standard rate of 10 ml/kg/hr and, maybe more importantly, provides a route for administration of emergency drugs in the event of a crisis. An IOs catheter can be placed relatively easily in most species even in small patients. SC administration of fluids is much less effective than IV or IOs and is an ineffective route for administration of emergency drugs. A single dose of 10 ml/kg SC of 4% dextrose has been recommended for short procedures in healthy small exotic mammals (Redrobe 2002). Fluids administered subcutaneously or intraperitoneally are slowly absorbed and not appropriate for treatment of severely ill, dehydrated, or shocky patients.

Maintain vascular access in the postoperative period if at all possible. Continue to administer fluid at least at a maintenance rate until the patient has completely recovered and is eating and drinking well.