Tasha McNerney, CVT, VTS (Anesthesia & Analgesia), tackles one of the most common clinical dilemmas, how do you safely sedate dogs and cats for quick procedures without committing them to a full day of anesthesia or risking complications. If you have ever hesitated before radiographs, wound repair, or diagnostics because you wanted fear-free handling but also needed efficiency, this episode delivers practical answers. Tasha walks through reversible sedation protocols, multimodal analgesia, and how to combine opioids, dexmedetomidine, and local blocks to maximize comfort while protecting the airway. She also shares feline sedation strategies, when to add ketamine, and how local anesthesia can do the heavy lifting for painful procedures. You will walk away with confidence, safer sedation choices, and tools to deliver high-quality care even in spectrum-of-care situations. Gang, let’s get into this episode!

Veterinary Anesthesia Nerds: https://www.veterinaryanesthesianerds.com/

Tasha McNerney obtained her CVT in 2005 and has worked clinically in the areas of anesthesia and surgery ever since. Tasha obtained her CVPP (certified veterinary pain practitioner) designation in 2013 and became a veterinary technician specialist in anesthesia in 2015. Tasha has been a featured speaker on various anesthesia and pain management topics at several international veterinary conferences. Tasha is the author of many articles and blogs on anesthesia and pain management related topics. In 2013 Tasha created the Facebook group Veterinary Anesthesia Nerds, which has over 65,000 members taking part in education and exchange of ideas from all over the world!

Mentioned in this episode:

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Welcome everybody to the Cone of Shame Veterinary podcast.

2

I am your host, Dr.

3

Andy R.

4

Guys, I got a, a really good one like

you guys are gonna really love this.

5

I got a really good one today

with my friend Tasha McNerney.

6

She is a veterinary technician,

vet tech specialty in anesthesia.

7

, she was the speaker of the year.

8

Recently for technicians at VMX, the

world's largest veterinary conference.

9

but yeah, she's an incredible lecturer.

10

She's a good friend of mine.

11

, she, as I say at the beginning of

this episode, I did two episodes

12

with her last year, and they

both ended up at the very top.

13

Of the board, , in terms of

popular episodes of Cone of Shame.

14

And so I think I've got something

to rival the episodes from last

15

year that just did so well.

16

This is an episode on brief sedations.

17

I talked to Tasha and I was like,

Hey, look, I find myself more and

18

more in these times, , where either

because of time or because of financial

19

restraints, I'm using sedations

just to kind of get patients down.

20

Get some stuff done in a fear

free, low pain, , or no pain

21

way and, and get them back up.

22

And so can you talk to

me about brief sedation?

23

And she was like, I got you.

24

And let me say, she totally did.

25

she's amazing.

26

This is really good.

27

We talk about brief sedation in

dogs and in cats, and we talk about

28

when there is low pain and all those

healthy pets, , healthy patients.

29

We're, we're talking about, , no

comorbidities here, but

30

. Just in your regular healthy pet.

31

we talked about how to do

it with low pain, no pain.

32

And then we talk how to do it when

it's much more involved and we're gonna

33

be doing, some actual surgical work.

34

So I use the example of a dog fight

that I had recently and I had to kind

35

of stitch a dog back up and clean a

lot of stuff out and things like that.

36

And they just didn't have the

resources to go under anesthesia.

37

So we sedated and got to work

and just did as best we could.

38

And so actually it's a really,

really great episode and she walks

39

through the differences in dogs

and cats had just so, so many just.

40

Pearls of wisdom.

41

It's just like, just watch your

step there because you're gonna step

42

on some pearls of wisdom as you on

your back slip and fall accident.

43

I don't, I'm not insured for that.

44

I just, you're just, I need you to

respectfully handle the pearls that are

45

gonna pour outta this episode and just

put them in a safe place like a drawer.

46

maybe a, a bag of some sort.

47

Something like that.

48

Anyway, , I think I should stop.

49

I think I should be done here and

we should get into this episode.

50

Let's do it.

51

Kelsey Beth Carpenter: This is your show.

52

We're glad you're here.

53

We want to help you in

your veterinary career.

54

Welcome to the Cone of Shame with Dr.

55

Andy Roark.

56

Andy: Welcome to the podcast, Tasha

McNerney, the original anesthesia nerd.

57

How are you my friend?

58

Tasha: I am doing well.

59

Thank you for having me again.

60

Andy: Oh, whatever The honor is all mine.

61

You don't know this, but I'm gonna

tell you, I was looking at the, , cone

62

of Shame podcast statistics behind

the scenes in the dashboard, and.

63

You did not have the number

64

You had the number one and the number two

65

They'd say, I you.

66

If we don't have like an award for Cone

of Shame guests that have incredible

67

podcast, but if we did, it would be

a wrestling belt and you would be the

68

Tasha: Ooh,

69

Andy: So yeah, I thought you would

like that, but yeah, I was, I

70

was looking and I was like, holy

crap, last year you and I did.

71

should you still have tour on your shelf,

72

Tasha: Oh, yeah.

73

Andy: I think that was the number

one episode we did last year.

74

That was a great one.

75

And, , is it time to use Less Opioids

and more Locals was the, was number two.

76

And so both of those with

your episodes, and so anyway,

77

congratulations on doing fantastic

stuff that people loved and shared.

78

Like it's like 30,000 people

listen to those episodes.

79

It's, it's wild.

80

Absolutely wild.

81

So, yeah, absolutely nuts.

82

So anyway, I am thrilled

to have you back on.

83

I have got.

84

It's not, it's not a case.

85

It's a couple of cases, but,

but I, I want your help on it.

86

And so I'm in the practice a good

amount, looking at instances where

87

I need sedation for like a couple

minutes, you know what I mean?

88

And I don't want a pet, I don't

want a dog or a cat that's

89

gonna be out for the whole day.

90

It's just a minor thing, but.

91

In order to sort of keep this as a low

stress, fear, free, you know, exercise

92

in order to minimize pain and just

to be the doctor that I want to be,

93

I a little bit of sedation would be

nice, and I think it makes everything

94

easier and I can leverage my wonderful,

well-trained, super smart technicians

95

to just get it done for me and, and

get everything set up and everything.

96

And I find myself.

97

I'm not exactly sure of how to

approach really, sort of short

98

term sedation in a nice way.

99

And so I've seen some, there's some new

products out there and things like that.

100

but again, I, I would just, I wanted to

give you a couple of different instances

101

and just say to you, what do you, what

do you reach for in this, in this regard?

102

Is that, could I do that with you?

103

Tasha: Yeah, let's do it.

104

Andy: All right, so let's just say

that I've got like, , let's just say

105

that I've got radiographs, right?

106

Like what do, what do you like

for cat and dog radiographs?

107

Let's just say I've I've got some pain.

108

let's do like a limp.

109

I've got, I've got a limping

dog slash limping cat.

110

I wanna be.

111

Good to them, and I wanna get

good radiographs and also not, not

112

hurt my, not hurt them, and not

make them afraid for the future.

113

Tasha, like, let's do dogs

and then we'll do cats.

114

What do you do for like, like radiographs?

115

What do you like?

116

Tasha: Yeah, so unfortunately I'm

gonna give you a typical anesthesia

117

answer, which is, it depends, right?

118

Depends on the patient.

119

So here's the thing.

120

When we're talking about drug protocols,

and we're talking about any, you know,

121

kind of putting together an analgesic

or anesthetic protocol, it really

122

goes by the patient in front of you.

123

Not always the procedure, so we

wouldn't classify something as like,

124

what do I like for radiographs?

125

It would really be more, okay,

what do I want for something and

126

what's the duration that I need?

127

What's the anticipated level of pain and

what's my as SA status of my patient?

128

All of those things are going to

play into the drugs that you choose.

129

Now, let's just say for the sake

of argument, you guys are dealing

130

with a younger, healthier Labrador.

131

You know, comes in with a new limp and

we are taking some stifle, radiographs,

132

Andy: Okay.

133

Tasha: This is not a procedure that

you're going to take to surgery that day.

134

So the anticipated level of pain

should be mild to moderate, not severe.

135

, now if the patient is coming in with

a broken leg, then that it changes the

136

anticipated level of pain, and I might ch

maybe choose something different, however.

137

If we're just going in with, let me

get some radiographs, see what's going

138

on, interpret those radiographs, and

maybe I want something that is going

139

to be fast, then I'm looking at things

that are going to be reversible.

140

So the next thing is that all of our

opioids are reversible with Naloxone.

141

So whatever opioid you have on your

shelf, especially if you have a patient,

142

you're dealing with some mild pain, you

want to choose the appropriate opioid.

143

then you want to pair that opioid

with the appropriate adjunct.

144

Now, what's the appropriate adjunct?

145

Well, again, that depends on the a SA

level of your patient and what other

146

concurrent disease they have going on.

147

Now, for the most part,

cardiovascularly healthy patient,

148

that adjunct is probably going to

be dime toine or an Alpha two drug.

149

Right?

150

And that's probably my go-to is something

like a Butorphanol Dex Meato combination.

151

Both provide good analgesia,

good sedation, again, when

152

the combination is together.

153

Right?

154

And not only that, both of

those drugs are reversible.

155

So you could give that iv, you

could give that combination.

156

Im, you could give that

combination, subq, whatever works.

157

Andy: Do you, you don't have a,

do you don't have a preference?

158

Like, like, um, yeah,

it just, lemme just ask.

159

You just kind of, they tell All right.

160

Good.

161

That's what I wanna hear.

162

So tell me 'cause yeah,

so talk to me about it.

163

Tasha: just not Midazolam.

164

How about that?

165

That's my preference.

166

Andy: Oh, yeah.

167

Okay.

168

Well, we, we can come back to

talk about Medicin, but Okay.

169

But, but like, , so Ded told me,

and you talk a lot about Dex, you,

170

you were like, you were on, you

were on the train at the beginning

171

and you have always been with it.

172

And so, , for stuff like this, I

mean, is is it, is it IV unless

173

there's a reason not to go iv?

174

Is that kind of how you look at it?

175

Tasha: So it really, again, it

depends on the patient, right?

176

Because if I have a patient that

is extremely fearful, then, and I'm

177

gonna give this combination, let's say

Butorphanol and Dinto, I'm still going

178

with the, you know, young, healthy

dog stifle, radiographs example.

179

, if they are really nervous and it

is gonna cause them a lot of stress

180

to be restrained for an IV injection

or an IM injection, then no, I'm

181

probably gonna go with the newer GV 20.

182

, administration of these drugs because

we know that that GV 20 subq drug

183

administration, uh, lends itself

to lower stress handling for these

184

patients, and the onset time is faster.

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Andy: Okay.

186

Tell me more about GV 20.

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Tasha: Great.

188

So GV 20 really has become a big thing.

189

, a lot of the kind of message

boards are talking about it.

190

And Darcy Palmer, who is one of the

other, , anesthesia nerds administrators,

191

she kind of wrote up this whole

blog about it that's on our website.

192

But GV 20 is governing Vessel 20.

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It's an acupuncture site that's

located at the top of the head.

194

So to find the GV 20

location you're gonna.

195

Follow the ridges of the eyes.

196

They're gonna come up to kind of where

it comes to a V and then we are using,

197

we're putting the injection kind of,

you're not trying to hit any point in

198

particular, but you're injecting there.

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Right.

200

And.

201

there have been a decent amount of

studies looking at GV 20 and onset of

202

action and the fact that GV 20 does not

cause a , or does not elicit as much of

203

a pain response as like an IM injection.

204

So for patients who are very

sensitive to being handled, this

205

is sometimes a lower stress.

206

Way of administering a premedication

such as Butorphanol and dinton together

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Andy: In.

208

In your hands, do you, do you buy that?

209

Do you find, do you feel like

there's ara more rapid onset

210

of, , medication using GV 20?

211

Tasha: Yes.

212

So I personally, when Darcy was

telling me about it, I was like, hmm,

213

again, it's a subcutaneous injection.

214

Why would there be more rapid

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Andy: It, it looks cool on social

media and it stops people from

216

scrolling and like that was, I was

wondering how much is that the driving

217

factor, why I'm seeing more of this.

218

Tasha: yes.

219

So it is, however, it's one of those

things, again, like a sge block that

220

you hear about it, but then when you

actually see it and you are like,

221

oh my gosh, this really does change.

222

We had a standard poodle in for,

, reversible sedation radiographs,

223

and we gave butorphanol and d

melatonin at the GV 20 site.

224

I'm sorry it wasn't a standard poodle,

it was a Springer spaniel because I have

225

a video of it on my phone and within

four minutes the patient was lateral.

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Andy: Wow.

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Tasha: timed it four minutes.

228

, so yes, you definitely will see a faster

onset compared to an IM injection.

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Andy: Okay.

230

I like this.

231

Tasha: And, , there have been a

couple of different studies looking at

232

different drugs that are being utilized.

233

, but most commonly is something like

an Alpha two, such as D Meato or

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maybe even, you know, the newer drug

on the block, which is Xen Alpha.

235

, and Xen Alpha is melatonin with oxen.

236

Kind of like in with it.

237

So for those of you guys who haven't

been utilizing something like

238

Xen Alpha, yet, Xen Alpha can be

given in place of din Atomidine.

239

The nice thing about Xen Alpha, especially

for your reversible sedation friends, or

240

for something that is going to be under.

241

You know, , underst sedation for a

quick period of time, bandage changes

242

your nail trims under sedation.

243

Your, you know, these radiographs

that we're talking about, the Xen

244

Alpha, because it has that little bit

of an oxe oxygen in it, you're not

245

gonna see as much of the bradycardia

and a drop in cardiac output as

246

you would with regular Dex Meato.

247

Andy: Got it.

248

So that, that, that totally makes sense.

249

I'll be, I'll be honest with you,

Tasha, I almost never use Naloxone.

250

Like I'm, I can count on one hand

the times I've used Naloxone,

251

like in my, in my career.

252

How often, like, and just in day-to-day

actual practice, are you, are you

253

commonly reversing your opioids?

254

I just kind of let 'em ride.

255

Ride.

256

Tasha: no.

257

For the most part, we're not reversing our

opioids, but again, in anesthesia land,

258

we like to have things that are reversible

on the off chance that a patient has a bad

259

reaction to anesthesia starts to crash.

260

We want to be able to reverse as much

as we possibly can, but in a practical.

261

Point?

262

No, we are not usually reversing our

opioids unless we absolutely need to.

263

And that is because if we feel like

a patient, again, they're limping.

264

If they're painful and they

need that analgesia, we're gonna

265

let that analgesia ride out.

266

Andy: Okay.

267

talk to me a little bit

about, our feline friends.

268

So, I'm not gonna preface with what I,

what, what, what I reach for, because,

269

, there might be something better.

270

, so give me, gimme advice on,

on, on feline radiographs.

271

I have, I have, let's go, let's go with

a healthy young, you know, 3-year-old

272

cat, normal physical examination except

for some limping on the back legs.

273

you know, I, I, I feel like there's,

you know, we, we need to get in there

274

and, and just have a better look.

275

Maybe, maybe I'm sedating for.

276

Good physical examination and then

also plus or minus radiographs.

277

What, what do you, what

do you like in cats?

278

Tasha: Yeah, I mean I'm probably, if

you're giving me this scenario and

279

this cat is cardiovascularly healthy

and liver, kidneys, et cetera are also

280

healthy, I'm probably going the same

where opioid plus D melatonin, um.

281

would say that for most of my patients,

I'm choosing an alpha two, unless they

282

have something like dilated cardiomyopathy

or, you know, heart failure, which would

283

prevent me from utilizing an alpha two.

284

But for the most part, alpha twos are

such nice, , sedatives and analgesics

285

and they place so nicely with other

drugs, , can be mixed in the same

286

syringe with other drugs, et cetera.

287

So I'm almost always utilizing

some combination of opioid.

288

Plus Dex Meato.

289

Now that being said, there's sometimes

with some of our feline friends that they,

290

you know, this young healthy patient,

you, it might be extremely terrified

291

when it comes to the vet practice.

292

So you give it a combination

of opioid and d meato and that

293

might not be enough to sedate it.

294

, and then that's where adding a little

bit of something like a Ketamine

295

is going to work synergistically

with these other drugs Now.

296

Kitty magic as it's commonly referred

to, or a combination of opioid plus

297

Ketamine, plus Dex Melatonin has

been around for a really long time.

298

But what we're finding now is

a lot of people are utilizing

299

these three drugs in combination.

300

However, what we're doing instead

of what we used to do is we're

301

really titrating down the dose.

302

So instead of doing a big dose of ketamine

to get that immobilization that we want.

303

You know, we were getting, you know,

if you've ever worked in, trap, nooner

304

release, you know, these big doses of DTK

for these patients are gonna immobilize

305

them and you almost can intubate

them, you know, without an induction

306

agent because of these high doses.

307

But for this case in particular, we

don't need the patient to be completely

308

immobilized and ready to intubate.

309

, but we wanna add in a little ketamine,

'cause again, it's gonna work

310

synergistically with our opioid that

we have chosen with our Dex melatonin.

311

And it's gonna provide an

additional level of analgesia.

312

Now, the only caveat to adding

in something like ketamine to

313

this combination is that ketamine

is not a reversible drug.

314

So if you're adding in ketamine,

, especially if you're doing it at high

315

doses, you know that five to 10 mgs

per kg, you may be dealing with some

316

of the after effects of ketamine.

317

However, I would tell you guys for

the most part, if we're adding in

318

ketamine or a just a little, what we

call a kiss of ketamine, it's like one

319

to two mgs per kg of ketamine added

into our Dex Meto and Butorphanol

320

combination for these cats, right?

321

That you would need to do again,

sedated radiographs or pulling

322

some blood work or maybe some

diagnostics, ultrasound, et cetera.

323

That's probably our go-to

combination for cats.

324

Now if this cat was compromised,

however, and we did, you know, if you

325

were worried about the cardiovascular

status of this cat, or you know, for

326

instance, you didn't wanna give ketamine

because you had heard a murmur or you

327

didn't wanna give D Meto, et cetera.

328

Then for cats we usually will

go with a combination of maybe

329

Butorphanol for its sedative

properties combined with Alfaxalone.

330

Now giving Alfaxalone I am is off-label.

331

In the US I, I mean, however.

332

Giving opioids to cats is

off-label in the US right?

333

but if you have the ability to give

something like Alfaxalone, if you have

334

a compromised cat that you need to get

radiographs on, then a , opioid plus

335

alfaxalone IM combination is very nice.

336

And you can get the patient usually, you

know, lateral and compliant, within about

337

five to 10 minutes after Im injection.

338

Andy: that definitely makes sense to me.

339

let's walk this back a little bit

and let's talk about higher pain

340

procedures or higher pain situations.

341

So I saw a, we called a

South Carolina yellow dog.

342

Just a sort of a, just a, your,

your standard mixed breed.

343

I saw, I saw one uh, last week and

he, and he had been in a dog fight and

344

so pretty, pretty, like it had some,

some punctures, but mostly he had

345

a one pretty significant laceration

and so it's not gonna take me long.

346

The, then also in this case,

the owners really did not have

347

a lot of financial resources.

348

And so that was kind of also like driving

what I was doing and how I was doing it.

349

Where I thought, you know, I

wanna, I wanna get this dog down.

350

we're gonna flush this thing,

we're gonna clean it out, you know,

351

I'm gonna be invasive in that.

352

We're we, we've got to flush this thing

out really well and, and clean it up.

353

It, it might need a, it might need a

drain, it might not need, need a drain.

354

But it still was not something that I

was planning to, to intubate and take

355

the full surgery for economic reasons.

356

And also I thought I could be pretty

fast about it and kind of get it done.

357

That feels like a, a.

358

A bigger step than a low pain score, you

know, healthy pet just for something like

359

radiographs, how do you look at those in

dogs and cats, like that level of, say,

360

say, laceration, repair, some sort of,

, you know, trauma, something like that.

361

But, but maybe it doesn't rise to the

level that we're gonna intubate either for

362

medical reasons or for economic reasons.

363

Tasha: Yeah, 100%.

364

So let's say you have this dog that

comes in, you come to me and you

365

say, we need to get it down and we're

gonna do this laceration repair.

366

If it's a dog fight, punctures again,

we're gonna base it on the patient in

367

addition to the level of pain anticipated.

368

So.

369

Punctures in anesthesia.

370

Like I have to be thinking

like, just making sure there's

371

no thoracic involvement.

372

You know, if this patient has

a puncture in its chest, this

373

changes things completely.

374

Right?

375

, but if it's, a laceration and maybe

it's, you tell me where it is, but you

376

say, we have some muscle involvement,

we have some skin involvement, I

377

might need to put place a drain.

378

So we definitely are dealing with

a little more pain and inflammation

379

Andy: Yeah, this was in, this was

like in front of the back hip, so,

380

so I wasn't, you know, I didn't

have anything thoracic I was worried

381

about, but it was, it was kind of

that, it was nice, it was vertical.

382

, so it kind of ran with the tension

lines and it was, full, it was

383

sort of full thickness laceration.

384

, the dog seemed totally happy, but

also a horror show at the same time.

385

You know what I mean?

386

Uh, , it, it was, it was that.

387

Tasha: the biggest thing here is what do

you have available on your shelf, right?

388

So yes, the anticipated level

of pain is going to be higher.

389

, but for some clinics, they do not have

schedule two drugs on their shelf.

390

So while I would like to say, Hey, if you

have hydro, let's use the hydro right.

391

Higher, , level of opioid here.

392

We're gonna get a little more bang

for our buck as far as analgesia goes.

393

But a lot of clinics out there don't

have schedule two drugs on the shelf.

394

They don't have access

to fentanyl or hydro.

395

Andy: it's a, it's a pain

to have schedule two drugs.

396

I mean, it is.

397

I said we have, we have one, we have

hydro and like that, but that's it.

398

But like every time people are like,

let's hook up that fentanyl drip.

399

I'm like, what El What else might one do?

400

, you know, and again, I.

401

I'm, I'm, no, not knocking the,

the science of it, but it's also

402

the logistics is, it's tough.

403

So, so yeah.

404

So it, let's, let's,

let's play through it.

405

I I'm gonna ask you to play both ways.

406

so let's go through it.

407

This, let's say I've got, like, I

got hydro, and then I'm actually

408

really curious and, and what you

would do if I, if I did worked at a

409

place that, and they don't have any

schedule twos, how you'd approach it.

410

So, so I'm giving you hydromorphone,

what, what would you do with that?

411

And then I'm gonna take it away from you.

412

Tasha: Okay, great.

413

Well, you might be surprised at

my answer because even if you

414

came to me and said, I have hydro,

415

Andy: I did.

416

That's exactly, I'm show.

417

I'm very proud right

now, just so you know.

418

Tasha: I, I would say

that I, it doesn't matter.

419

Keep your hydro on the shelf.

420

I still wouldn't change my answer.

421

You know why?

422

Because you've told me that we're

not gonna intubate this patient.

423

I know that hydro is gonna

contribute to nausea, vomiting, and

424

Andy: Yes.

425

Tasha: And in a patient that is not

intubated, that's a risk for the airway.

426

So I'm not gonna give a drug

that's gonna increase regurgitation

427

and then potential airway risk.

428

Guess what?

429

We're still gonna stick

with our butorphanol.

430

Yes.

431

And I know it's,

432

Andy: I just wanna go on the record

saying that's exactly what I did.

433

I feel really

434

Tasha: great.

435

And it's a hot take, but here's why

we're gonna stick with our butorphanol,

436

because you've told me we're not

gonna, we're not going to intubate,

437

so we're not gonna have inhalant and

we're not gonna protect this airway.

438

Now, could we still get

vomiting with a combination of

439

Butorphanol and ca and, , dinomi?

440

Of course we could, however.

441

This is what we're gonna go with.

442

If we get in there and we decide, you

know, after the patient's been sedated,

443

we're gonna place an IV catheter, right?

444

If you, this is exactly how I'd play it.

445

Sedate the dog with

Butorphanol plus D melatonin.

446

Let's place an IV catheter.

447

Place an IV catheter.

448

Give some flow by oxygen

with a tight fitting mask.

449

Place our monitoring

clip and clean the area.

450

Then we're gonna place a local block.

451

This is gonna do the heavy lifting

as far as your analgesia goes.

452

So let's say I don't

have that hydro on board.

453

Well, guess what?

454

A really good multimodal plan is

going to cover the basis for you.

455

So a multimodal plan means the little

bit of opioid from the butorphanol

456

combined with the analgesia from the

D meato, combined with the analgesia

457

and complete, stop of transmission of

those painful signals with the local

458

block, you're gonna do that as well.

459

Again, a local block doesn't always

mean something fancy that I need you

460

to do an ultrasound guided nerve block.

461

You know, simply doing a line

block or kind of an L-shaped

462

block, for a laceration is what

I would do with this patient.

463

And then again, cover our bases more.

464

This patient probably has a lot of

inflammatory pain, so can this patient

465

get a non-steroidal anti-inflammatory?

466

If so, great, let's get a

dose of that onboard as well.

467

you don't always have to give a

Schedule two drug in order to provide

468

really excellent multimodal analgesia.

469

Especially if we do not have a

protected airway, I'm gonna be

470

concerned giving things like

hydromorphone or morphine, which could

471

potentially exacerbate regurgitation,

especially in brachycephalic.

472

Patients do not want that.

473

Andy: I love it.

474

Okay.

475

That's super great.

476

That makes me, first of all,

it makes me feel really good.

477

And then also that, that

totally makes sense.

478

How would you, how would

you do this with cats?

479

If it was a, if it was a cat that

came in that had a laceration, , how,

480

how does that differ from what

we sort of talked about early on?

481

I think my thought would probably be

the old, the kitty magic and, and a

482

non-steroidal and sort of, and local

blocks and kind of kinda like that.

483

Is that, is it, is that sort of similar?

484

Is there anything different that

you would do with, with a cat where,

485

same thing, let's say, , I'm not

planning to, to intubate this cat.

486

let's keep this a spectrum of care case

and say, these people are, they came

487

to me, they don't have a lot of money,

but, but we really gotta, not doing

488

something here is not, is not acceptable.

489

How, how would you, how would

you work with that Tasha?

490

Tasha: I would probably play it the same

way, and I think that if you're using

491

Kitty Magic or A DTK, again, as long

as the CAT is cardiovascular stable,

492

we are not dealing with an HCM Cat.

493

You wanted to use a DTK combination

together with a local block and

494

a non-steroidal anti-inflammatory

that is going, that is the way

495

that I would probably play this.

496

And if you were concerned that

the cat needed more, , a higher

497

level of analgesia, right?

498

Maybe it's not just, , skin

and subq involvement.

499

Maybe there's muscle involvement,

which again, deeper, you know,

500

level of pain and inflammation.

501

So maybe instead of, but in my.

502

Combination.

503

I'm going to go with buprenorphine, which

is going to give me a little bit stronger,

504

and I'm gonna send that patient, you know,

I would talk to my clinician about, you

505

know, Hey, how about before this patient

wakes up, we get a dose of buprenorphine

506

on board, or can we send this patient

home with a few doses of buprenorphine

507

to have a stronger level of analgesia?

508

Andy: Do you have any, reservations

about, , nonsteroidal in

509

this, in this case with a cat?

510

I mean, would you do like a Meloxicam

injection or something like that?

511

Tasha: No, I mean we do, , the

anesthesiologists I work with

512

are very comfortable with Onor

and so we, we utilize Onor quite

513

a bit, in our feline patients.

514

, I work with, I.

515

I with, you know, board of dentists and

anesthesiologist and in the practice where

516

we were doing feline dentistry all day,

, we utilized a lot of, because we have to.

517

What type of pain is this

patient experiencing?

518

And if it's a laceration repair,

that's a lot of inflammatory pain.

519

So we need to make sure that we

are treating the type of pain

520

the patient is experiencing.

521

So it would make sense that we

would want to, if we can, and

522

always include an anti-inflammatory.

523

Andy: Yeah.

524

That's awesome.

525

Good.

526

Tasha, thank you so much for being here.

527

Tell me , and the gang about

the veterinary anesthesia nerd

528

symposium that you have coming up.

529

Tasha: Oh yeah.

530

The Veterinary Anesthesia Nerd Symposium

is a three day symposium where we just

531

completely nerd out on everything.

532

Anesthesia and pain management.

533

We start the mornings doing.

534

All kinds of lectures and learning.

535

And then we spend the

afternoons doing hands-on labs.

536

, this year we added a ventilator

lab, a mechanical ventilator lab

537

for all the people who wanted

to learn about ventilation.

538

And then we also have a lab teaching

everybody about local blocks and how

539

to do local blocks because I think

local blocks are really the future

540

of analgesia in veterinary medicine.

541

And I think as we start to.

542

Less on opioids and rely

more on local blocks.

543

It's gonna be imperative that

as many clinics as possible

544

get their staff trained on.

545

Andy: that's fantastic guys.

546

, definitely check out veteran

anesthesia nerds, symposium

547

or, , online if you're not familiar.

548

But Tasha, thank you

so much for being here.

549

Guys, thanks for tuning in.

550

Everybody.

551

Take care of yourselves, gang.

552

Speaker: And that's what I got guys.

553

Thanks for being here.

554

, thank you to Tasha McNerney.

555

Guys.

556

Check out the veterinary anesthesia nurse.

557

Check out their symposium.

558

He, she really, I just, I wouldn't, I,

she doesn't know this, but I just, I'm

559

just gonna tell you guys, I think the

world of Tasha and she moves heaven

560

and earth to put that symposium on.

561

when she says they do hands-on

labs, she's not kidding.

562

And that stuff is hard to do.

563

And as someone who is.

564

Founded a vet conference and has

run over a dozen conferences.

565

I don't know how she makes it all happen.

566

It's really incredible.

567

But she puts together

a phenomenal program.

568

And so if you like anesthesia,

analgesia, things like that, give it a

569

shot Also, because she's a technician

and a lot of the vet anesthesia nerds

570

are, , technicians and technicians,

specialists, such an inclusive group.

571

It's, they're just, they do so many

good things for the profession.

572

So, anyway.

573

, a lot of love to Tasha.

574

Guys, thanks for being here.

575

If this episode helps you out, share

it with your friends, share it with

576

your practice, share it with the

other doctors, this is the type of

577

information that I think is just super

valuable to get into people's hands.

578

So anyway, guys, that's what I got.

579

Take care of yourselves, everybody.

580

Talk to you later on.

581

Bye.