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398 - What We Get Wrong In Anesthesia
21st May 2026 • The Cone of Shame Veterinary Podcast • Dr. Andy Roark
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Dr. Gianluca Bini, DVM, DACVAA, is here to talk about one of the scariest parts of veterinary medicine: anesthesia, and why so many of us may be overcomplicating the wrong things while underestimating the stuff that actually keeps patients safe. Dr. Andy Roark and Luca dive into veterinary anesthesia safety, monitoring, equipment, technician training, and the myth of the “perfect protocol,” all while making anesthesia feel way more approachable and practical for GP teams. If you’ve ever felt intimidated by anesthesia, worried about complications, or wondered what actually matters most in keeping patients safe, this episode will leave you feeling smarter, calmer, and a whole lot more confident. Gang, let’s get into this episode.

LINKS

American College of Anesthesia and Analgesia: https://acvaa.org/veterinarians/guidelines

Safe Pet Anesthesia: https://www.safepetanesthesia.com/

Safe Pet Anesthesia Instagram: https://www.instagram.com/safepetanesthesia

ABOUT OUR GUEST

Dr. Gianluca Bini graduated from the University of Perugia, Italy. He then moved to the United Kingdom, where he completed two internships, one in anesthesia and one rotating, at Dick White Referrals, one of the largest referral centers in Europe. After completing his residency at North Carolina State University, he worked as an Assistant Professor of Anesthesiology and Pain Management at The Ohio State University.

After realizing how limited the access to a board certified anesthesiologist was, he decided to found Safe Pet Anesthesia.

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Transcripts

Speaker:

dr--andy-roark-_1_03-18-2026_154217:

Welcome everybody to the Cone

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of Shame Veterinary podcast.

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I am your host, Dr.

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End Indoor.

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Guys, I got a really good one today.

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I am here with Dr.

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Jen Luca Beanie.

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he is an anesthesiologist.

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He's the founder of Safe pet anesthesia.

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and he is here talking to me about the

state of anesthesia in general practice.

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you know, I talk, at the

beginning of this episode kind

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of about how he got introduced.

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He's, I am meeting him for the first

time here today on the podcast.

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what a nice guy.

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I really like him.

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He knows his stuff backwards and forwards.

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He's an interesting guy.

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I really love how he

breaks down anesthesia.

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He is kind of tell you, he makes

this sound, it's important.

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It can be.

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He makes it sound quite simple.

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Like, like he, he made me feel

a confidence going, oh yeah,

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this is all very, very doable.

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I could definitely raise my game.

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This is not, this does

not seem overwhelming.

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And so anyway, we're gonna dive into

what are gps doing well with anesthesia?

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What are the opportunities

for improvement in anesthesia?

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We talk a little bit about anesthesia

equipment and, and ask 'em about sort of

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like, Hey, if you're gonna get new stuff.

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How do you know you're getting good stuff?

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How do you know you're not

getting way more than you need?

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Anyway, super practical.

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Pragmatic.

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I really enjoy him.

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let's get into this episode.

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Kelsey Beth Carpenter: This is your show.

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We're glad you're here.

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We want to help you in

your veterinary career.

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Welcome to the Cone of Shame with Dr.

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Andy Roark.

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dr--andy-roark-_1_03-18-2026_154217:

Welcome to the show, Dr.

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Jen Luca Beanie, how are you, my friend?

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I'm so glad that you're here.

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You, this is the first time

I'm getting to talk to you.

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You were so highly recommended from a

mutual friend of ours, Tasha McNerney,

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who I, I just love and respect.

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I liked having her on for, for podcast

episodes, and it's funny, it always means

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something to me when I have someone that

I, I, I really like working with her.

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I really respect, and they send

me a text and they're like, Hey.

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You gotta talk to Luca.

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And I was like, I don't,

I don't know Luca.

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And she was like, look, just,

you gotta talk to this guy.

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He's doing something really cool.

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so I wanna jump on with you, today

for those who don't know you, you

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are ab boarded anesthesiologist.

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You are, a professor, of anesthesiology

and pain management at the Ohio

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State University for a while.

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And now you are the, the founder

of, say Safe Pet Anesthesia.

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gianluca-bini_1_03-18-2026_144217:

anesthesia.

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dr--andy-roark-_1_03-18-2026_154217:

Great.

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and so, yeah, so you've

had this new company.

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I've, I am interested, in talking

with you and what, where Tasha was

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saying, oh, was like, you should go to

talk to, in terms of access to care.

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What Luca's doing is really cool.

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And so like, I just wanna give

you that lead at the beginning.

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I want you to talk to me a little

bit about kind of, as you're doing

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your career, you're, you practice

as an anesthesiologist, there's

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not a lot of anesthesiologists.

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tell me about access to care, I think a

little bit and how you sort of started

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down the path that you're on now.

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gianluca-bini_1_03-18-2026_144217: Yeah.

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first off, thank you so much

for having me here and thank

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you Dasha for connecting us.

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I'm originally from, Italy.

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I graduated over there.

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I got my DVM over there.

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I did two internships in England,

and then I did my residency

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at NC State in North Carolina.

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And after that I became a

professor at Ohio State.

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And, when I was there, I quickly realized

that like, the bills that I was seeing

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were like, 15,000, 20,000 and, know,

and I was like, who are we helping here?

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Right?

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we're helping the.

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Probably the top 0.1%

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on the country.

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Right?

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Not even the 1%.

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and when you look at the total

number of anesthesiologists out

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there, there is about 260 of us.

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there is active anesthesiologists

in the us There's not that many,

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you know, New York has four

anesthesiologist, long Island has zero.

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know, Oklahoma has two.

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Then you have like Ohio State

where they have like five,

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NC State, they have nine uc.

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Davis, depending on the

year, stay around 12.

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Right?

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And so they're all concentrated

in these areas and, but 99.9%

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of pets are not getting anodized

within those walls, right?

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They're out there.

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You know, GPS and smaller

referral centers, but even bigger

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referral centers, they don't have

access to one of us oftentimes.

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So, that was something that, sparked

my interest in trying to figure

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out how to expand access to care.

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and the only way we figured

it out was to do it online.

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we do it on.

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video, we created our own, custom

platform where, people upload their

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medical records, they get their

protocols, and then whenever they're

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ready to induce, they just click

on the video button for that case.

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And it's literally, there is one

of us, one of our teammates there

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the whole time from induction to.

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To recovery and I think it's really cool

and we, 70% of our clients are gps and I

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think for them it's such a game changer.

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that's the most exciting

thing for, them and for us.

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It's like somebody there that

can tell you what to do and how

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to fix it if something happens.

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it's probably one of the

most rewarding thing.

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I get texts all the time of

like people that are like, oh,

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I learned so much from this.

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it's beyond helping the pets.

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I think the reward is, feeling the

gratitude from these people that

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literally had no other option,

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dr--andy-roark-_1_03-18-2026_154217: Yeah.

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gianluca-bini_1_03-18-2026_144217:

out there.

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dr--andy-roark-_1_03-18-2026_154217:

So I wanna come back to this.

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I wanna dive into the types of cases

that you sort of sit in on virtually

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and kind of what that looks like.

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talk to me generally about the

anesthesia landscape in general

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practice when you look at it.

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you're having this experience, you were

working with these really complicated,

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complex cases, and you were like, there's

just, there's not a lot of people who

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get access to this sort of level of care.

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so, I'm a practicing vet.

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I'm I'm a GP doctor.

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I'm an okay doctor.

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I try to be a good doctor.

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I'm not a great, great doctor.

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I'm, but I'm a good doctor.

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talk to me about, about, talk to

me about the sort of the general

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good anesthesia that you see.

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it, how good is it, are there gaps in

general practice anesthesia that you see?

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give us a grade from a plus.

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You're like, there's no use for you,

Luca, there's no reason for you.

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Because there's an a plus all

the way down to we're failing.

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we're really in trouble.

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where do you think most

general practices are?

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I know there's probably a range.

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gianluca-bini_1_03-18-2026_144217: I will

give you, I'll give you some numbers.

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dr--andy-roark-_1_03-18-2026_154217: Okay.

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Okay.

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gianluca-bini_1_03-18-2026_144217:

So when you look at the literature

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out there human medicine, we moved.

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From 1980s where the studies came

out where there was one in:

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people that died under anesthesia,

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dr--andy-roark-_1_03-18-2026_154217: Okay.

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gianluca-bini_1_03-18-2026_144217: the

most recent study was one in 200,000.

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dr--andy-roark-_1_03-18-2026_154217: Okay.

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gianluca-bini_1_03-18-2026_144217:

In veteran medicine, the

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needle hasn't moved at all.

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Right?

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the last couple of studies that came out.

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Dogs specifically on where you read.

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They go from one in 600 to one in

145 dogs die under anesthesia, right?

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And the needle, unfortunately, in the

last 20 or 30 years, hasn't moved.

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And I think that there is some.

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And it's not just gps, like

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dr--andy-roark-_1_03-18-2026_154217: Oh.

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gianluca-bini_1_03-18-2026_144217:

dehi issue is gp.

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the, his issue is a

profession as a whole, right?

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You have the Harvard veterinarian

that get out of vet school, and I

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do teach students, so I, I still

teach the course at Oklahoma State,

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I see that where the students get 10

business days of anesthesia ation.

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They get out there, they go into

practices where sometimes people

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are open to, the new or better quote

unquote, safer way of practicing.

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And then sometimes they go out there

and they encounter a lot of resistance

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and do like, how do we make this

better or safer for these patients?

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And so sometimes as a profession,

I think we hang up a lot on do the,

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that's how I've always done it.

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and so that's one of the issues.

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On the other hand, what I always

try to tell the students, and

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I hope if somebody's listening,

they take this home, as a tip.

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when you go out there and do these

practices, don't pretend that everybody.

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Changes with you, right?

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Like what I tell the student

is, that's your license, right?

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You don't have to force it on them.

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You don't need to force

it on the practice.

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But if you want your patients

to be handled differently,

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anesthesia wise, you can do so.

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You don't need to force it

on somebody that's been doing

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it like this for 20 years.

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dr--andy-roark-_1_03-18-2026_154217:

You don't need to change, you don't need

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to change somebody else's protocols.

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gianluca-bini_1_03-18-2026_144217: right.

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dr--andy-roark-_1_03-18-2026_154217:

you can just say, this is what

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I wanna do with my patients.

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gianluca-bini_1_03-18-2026_144217:

And I think that that's where a lot

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of the resistance comes from, right?

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Like where you're trying to force

that change and undo everybody.

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that's different.

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But if they're familiar with that and

they're comfortable with that and they

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don't want to change, you don't need

to necessarily force it on do that.

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I think that would save a lot

of uncomfortable conversations

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and, would allow you to actually

push that new thing out there.

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the other deal is that, again, I think

that people that have been in practices

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for a while when you're trying to.

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Learn more.

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The first thing you do

is you go to a ce, right?

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You go to a conference.

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dr--andy-roark-_1_03-18-2026_154217: Yeah.

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gianluca-bini_1_03-18-2026_144217:

But what I've seen anesthesia wise

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is that it's really hard bring back

home what you learned into a ce.

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And the reason is that, when you go

and learn about a new preventative,

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the worst that can happen is that

the preventative doesn't work.

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dr--andy-roark-_1_03-18-2026_154217: Yeah.

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gianluca-bini_1_03-18-2026_144217: when

you start trying new things, anesthesia

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wise, you may kill that patient.

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dr--andy-roark-_1_03-18-2026_154217: Yes.

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That's, there's a significant downside to,

to trying things you're unfamiliar with.

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gianluca-bini_1_03-18-2026_144217: Yeah.

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So that's I think where a lot of the.

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of change comes from too, right?

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Like where, they

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dr--andy-roark-_1_03-18-2026_154217: I.

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gianluca-bini_1_03-18-2026_144217: and

they learn, but then they're worried

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about like, can I actually do it?

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I'm by myself now,

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dr--andy-roark-_1_03-18-2026_154217: Yeah.

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gianluca-bini_1_03-18-2026_144217:

nobody's here.

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The speaker at that conference is

not here to help me out if something

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happens, you know, with this

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dr--andy-roark-_1_03-18-2026_154217: Yeah.

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gianluca-bini_1_03-18-2026_144217:

So I think there is a little bit of

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data there that's, shielding change,

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dr--andy-roark-_1_03-18-2026_154217:

yeah, I think so.

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I think a lot of people, myself included,

like I've, I would still want this, I know

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it, I know now it doesn't exist, but I

always wanted to have a, just a routine

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protocol, Luca, you know what I mean?

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Where I was like, this is what we

do, weigh 'em and get it ready.

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you know, and this is what

we're gonna ride with.

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And like, what I've come to understand

is, the one size fits all approach.

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Probably doesn't work as well as we

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gianluca-bini_1_03-18-2026_144217: Yeah.

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dr--andy-roark-_1_03-18-2026_154217:

that it does.

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would you agree with that?

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gianluca-bini_1_03-18-2026_144217: Yeah.

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that's so true.

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and a lot of the times our patients don't

read the textbook either, people try to

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come up with a single protocol or, they

come up to me after the lectures and

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they're like, what's your safest protocol?

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What's your best protocol?

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And what I tell them is oftentimes

is that in 99% of your patients.

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protocol doesn't matter, What matters?

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There is a safe anesthetist.

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dr--andy-roark-_1_03-18-2026_154217: Okay.

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gianluca-bini_1_03-18-2026_144217:

There is no safe protocol, right?

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You need to know what the

drugs do and how to fix it.

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If something happens,

the monitoring is key.

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The protocol is not like when I

receive calls of people that got

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in with anesthesia, Probably I can

count one in 10 years that I've been

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doing this where the protocol was

the issue and it was a math problem.

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It wasn't the protocol that was wrong,

it's just that they miscalculated.

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dr--andy-roark-_1_03-18-2026_154217:

Right.

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gianluca-bini_1_03-18-2026_144217:

it wasn't the protocol issue per se.

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but where people get in trouble

is the lack of monitoring, right?

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We do get a bunch of patients that come

through, even, both when I was at the

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university or now with Safe Pet where.

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We get this PR records where they're like,

oh, the dog arrested during induction or

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in pre-med or And half of the time we su

we use the same exact drugs they used.

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Same exact one.

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And guess what?

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Nothing happens because there

is monitoring throughout.

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The issue is in the drugs.

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The issue is can't pre-med the dog, put

it back in a kennel, wait for an hour.

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nobody's watching it.

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That's how you get Ravo.

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You don't get ravo because you

picked one drug versus another.

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dr--andy-roark-_1_03-18-2026_154217:

I like this a lot.

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honestly, I really appreciate you

sort of saying that and breaking

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it down and go, okay, that tracks.

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'cause I've seen anesthesia done a

million different ways and I've always

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been like, is that the better way?

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Is this the better way?

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How, And it, it.

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It makes sense that it's really

about your overall systems and again,

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you're monitoring, understanding

your interventions, knowing how

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to sort of tweak what's happening.

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All of that makes sense to me.

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Luca, what do you think is the biggest

sort of obstacle for practicing high

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level anesthesia in general practices?

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we talked about difficulty

implementing CE learnings.

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it's changing.

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The patterns that, that

people are used to using?

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like what, what is it, technician

utilization or training?

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is it access to a

limited number of, drugs?

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meaning, most clinics don't carry the

number of anesthetic agents that they

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should, or what do you see as the hurdles

that, that kind of limit the potential

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for your average sort of general practice?

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gianluca-bini_1_03-18-2026_144217:

I'll break those down a little bit.

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dr--andy-roark-_1_03-18-2026_154217: Okay.

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gianluca-bini_1_03-18-2026_144217:

let's start from the last one

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where access to drugs, for example.

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we see it all the time where, for

example, when a clinics sign up with

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us, we tell 'em, Hey, we look at their

drugs and we tell 'em, Hey, this is

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what we need to fix and what we need

to have in order to work with you.

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The issue there is purchasing it.

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The issue, nobody is preventing

you from buying those drugs.

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Like you just need to click

two buttons and purchase them.

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I don't think that there is

an issue with purchasing them.

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I think it's an issue of

knowing how to use them.

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And that circles back to your

first point, which is the training.

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Right?

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I think that where a lot of the issue

come from, I see people that are really

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good and they've sickened their training.

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they've looked for it.

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they trained themselves.

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They went on that path on their own.

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I think that sometimes there is a

little bit of hurdle for technicians to

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actually access that training, right?

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dr--andy-roark-_1_03-18-2026_154217:

Mm-hmm.

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gianluca-bini_1_03-18-2026_144217:

I don't think that there

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is an easy access for them.

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And a lot of it, again, is done in CEEs

where, I go and give a ce, I always

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talk about, I get task to talk about,

the latest and greatest topic, right?

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The latest and greatest is

not always necessarily what

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these people need to need,

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dr--andy-roark-_1_03-18-2026_154217: Yeah.

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gianluca-bini_1_03-18-2026_144217:

to hear, right?

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Like they, a lot of these people,

if you, if I teach you how to.

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implement, concentrate infusions and do

your protocol, but then you don't know

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how UL works, what the side effects are.

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you don't know how DMed works,

what the side effects are.

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I didn't give you, I

didn't do any favor to you.

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dr--andy-roark-_1_03-18-2026_154217: Yeah.

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gianluca-bini_1_03-18-2026_144217:

actually, I had.

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An extra layer of complexity to your

anesthesia, and what you actually

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needed was somebody that told you,

Hey, you know those five minutes

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of hypo at the beginning, after you

push propofol, that's normal, right?

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Or somebody that tells you, Hey,

yes, if your patient is hypo density

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after D Medo, and the heart rate

is low, hundred percent, you can

339

:

give glyco perol, Aine, right?

340

:

You can speed up the heart rate.

341

:

No big deal.

342

:

Right.

343

:

That's what they needed to hear.

344

:

They didn't hear to hear the fancy thing.

345

:

But unfortunately, when we go out

and give we get asked to speak on

346

:

specific topics sometimes, and that's

not always what they need to hear.

347

:

The other issue is that out there, I

love, working with both an, GPS and RVs

348

:

LVTs or, register techs and assistance.

349

:

But, there are some assistants

that are really good, but sometimes

350

:

clinics, they just hire somebody

off the street and they don't have.

351

:

training and then they shove

them in do monitoring anesthesia.

352

:

Right.

353

:

Which is probably one of the most

dangerous thing you could do.

354

:

and so like, I think

they utilize them wisely.

355

:

I love working with all of them,

but, and some of them are amazing.

356

:

once somebody.

357

:

Starts like the first two weeks, you

can draw them on an aesthetic case.

358

:

you need to drain them first and then

you make them monitor anesthesia.

359

:

I think utilizing your resources

appropriately in a practice,

360

:

I think it's really important.

361

:

And recognizing what the limitations

of each one of these people are.

362

:

dr--andy-roark-_1_03-18-2026_154217: Yeah.

363

:

gianluca-bini_1_03-18-2026_144217: I

wouldn't put a new grad a thoracotomy,

364

:

That's, that would be coming.

365

:

it's not something that.

366

:

It's smart to do.

367

:

but somehow that happens.

368

:

and then the last thing, I think that,

369

:

no.

370

:

Standard in Veed when

it comes to equipment.

371

:

And so a lot of the equipment that

we do get sold in Veed is not as

372

:

good as what they got in humans.

373

:

and so like people get frustrated with the

equipment, they believe it doesn't work,

374

:

and then they stop using it and then when

things get dangerous, so I literally got a

375

:

phone call from somebody the other day and

they were like, the monitor keeps beeping.

376

:

So I just turned it off

377

:

dr--andy-roark-_1_03-18-2026_154217: Yeah.

378

:

gianluca-bini_1_03-18-2026_144217:

I'm like, that's.

379

:

Not what, how that's supposed to look

like, but that's not how it works.

380

:

But, that's the problem.

381

:

and that's come back to our fault where

it is totally our fault where we don't,

382

:

anesthesia wise, college-wise, I think

that there is no great guidance in.

383

:

What to get,

384

:

dr--andy-roark-_1_03-18-2026_154217: Yeah.

385

:

gianluca-bini_1_03-18-2026_144217:

all these people out there

386

:

have no clue what to buy.

387

:

Nobody's telling them, Hey,

this is good, this is bad.

388

:

dr--andy-roark-_1_03-18-2026_154217: Yeah.

389

:

gianluca-bini_1_03-18-2026_144217:

out there does that.

390

:

And so, like, out there you find

all sorts of stuff that you know

391

:

may or may not work as it should.

392

:

and the end result is that you're

harming the animals in doing so,

393

:

dr--andy-roark-_1_03-18-2026_154217: let's

say that you were a GP doctor, right?

394

:

And so, you're just out in, general

practice and it's time for you to, let's

395

:

just say you just bought a practice.

396

:

you're a doctor, you just bought a

practice, Luca, and this thing is

397

:

old and you're just gonna update it.

398

:

You're like, let's update this stuff.

399

:

how would you pick your

anesthesia equipment?

400

:

what do you, what would be your process?

401

:

Let's just say that you sort of.

402

:

Say you didn't have the knowledge

yourself intuitively, but you were like,

403

:

I wanna make sure that my practice is

well outfit, I'm not made of money.

404

:

It's not the Taj Mahal,

405

:

gianluca-bini_1_03-18-2026_144217: All

406

:

dr--andy-roark-_1_03-18-2026_154217:

I'm getting this place up and started.

407

:

H how would you go through that process

of sort of equipping your practice in

408

:

a way that you are like, I wanna make

sure I've got something solid that I

409

:

can, that can start on and we'll, we

may upgrade later on, but h how do

410

:

you, how would you do that so that

you felt comfortable with what you

411

:

were putting in your, operating room?

412

:

gianluca-bini_1_03-18-2026_144217:

I think in general you need,

413

:

definitely, you need to have a

monitor, multiparametric monitor with,

414

:

E-C-G-S-P two capnograph temperature.

415

:

Non-invasive blood pressure.

416

:

Those are the minimum monitoring

requirement as a basic anesthesia

417

:

monitor per day 2025 A CVA guidelines.

418

:

Okay, so there is a guideline out there

nowadays that tells you, hey, this is

419

:

basic monitoring, this is advanced.

420

:

and it differentiated that way.

421

:

When it comes down to like specific

equipment, the best advice I have

422

:

for people is call your vet school.

423

:

Where you went to vet school

424

:

dr--andy-roark-_1_03-18-2026_154217: Yeah.

425

:

gianluca-bini_1_03-18-2026_144217:

if you have an anesthesiologist

426

:

that you trust, just call him up and

be like, Hey, what do you suggest?

427

:

Because when I go and buy a car,

Alan has the car salesman, I has the

428

:

dr--andy-roark-_1_03-18-2026_154217: Yeah.

429

:

gianluca-bini_1_03-18-2026_144217: Right.

430

:

And so I asked the mechanic and I'm like,

okay, what, the kind of brand that you

431

:

don't see coming through the door as much?

432

:

Right?

433

:

and so that's how I buy a car.

434

:

dr--andy-roark-_1_03-18-2026_154217: Yeah.

435

:

gianluca-bini_1_03-18-2026_144217:

wanna know which brand doesn't break.

436

:

and so you need to house the people

that use it every day, and they do

437

:

way more anesthesia than you do.

438

:

and figure out what they use.

439

:

terms of machine, I think,

most machines nowadays are.

440

:

Okay.

441

:

I think you need to make sure

that they have some safety Like,

442

:

you know, your pop-off valve,

443

:

dr--andy-roark-_1_03-18-2026_154217: Hmm.

444

:

gianluca-bini_1_03-18-2026_144217:

can't be completely closed.

445

:

Nowadays, there is some with

safety features in them where,

446

:

you know, after a certain pressure

they release no matter what.

447

:

you know,

448

:

dr--andy-roark-_1_03-18-2026_154217:

Do you like that?

449

:

Do you like those features?

450

:

you think like that

would be a plus for you.

451

:

gianluca-bini_1_03-18-2026_144217: I

think it does help a lot, if you have the

452

:

money to buy the new, more, Electronic.

453

:

there is some, a little bit newer

and they have some electronic

454

:

features that are more like safe.

455

:

if you have the money to, to

buy one of those, I would.

456

:

but if you're looking for something basic

where, you don't wanna spend all the

457

:

money, having as many safety features

as possible, that definitely helps.

458

:

And one of the ways, the most

common ways where people kill their

459

:

patient is to leave their pop off

460

:

dr--andy-roark-_1_03-18-2026_154217:

Right.

461

:

gianluca-bini_1_03-18-2026_144217: and

so, I think that probably a big one.

462

:

We try to engrave it into the student's

brain when they come through VE school.

463

:

dr--andy-roark-_1_03-18-2026_154217: Yes.

464

:

gianluca-bini_1_03-18-2026_144217: like,

if that's what you do, you fail, period.

465

:

There is no, even if you did

everything else right, if

466

:

that's what you did, you fail.

467

:

still, unfortunately,

everybody's busy and they're.

468

:

there is always room for mistakes, you

469

:

dr--andy-roark-_1_03-18-2026_154217: Yeah,

470

:

gianluca-bini_1_03-18-2026_144217:

but yeah, so reach out to your

471

:

anesthesiologist around, just ask.

472

:

dr--andy-roark-_1_03-18-2026_154217: okay.

473

:

gianluca-bini_1_03-18-2026_144217: thing.

474

:

dr--andy-roark-_1_03-18-2026_154217:

so I've, I got a question for you here.

475

:

so then just sort of thinking about

this, and let's say for a second that

476

:

you've got a veterinarian, right?

477

:

And, let's say that she's been,

she practiced full-time for like 10

478

:

years, and then she left practice.

479

:

She went, she went to a, a, a, a

nonclinical job, something like that.

480

:

She's gone for about five, six years

and she wants to come back to practice.

481

:

She's getting back in, she's working

part-time and she's moving back.

482

:

Maybe she wants to be.

483

:

Become a practice owner.

484

:

Maybe she just wants to transition

back into sort of full-time

485

:

practice and things like that.

486

:

And so I, I talk to a lot of vets

who have been away and have picked

487

:

practice back up anesthesia.

488

:

I think Luca is a scary part to pick

back up because you're like, this is a

489

:

place where, you know, I'm not, I got it.

490

:

Rabies goes in the right

leg, like I got it.

491

:

You know what I mean?

492

:

but then to the, to your point,

you say, it seems like there's a

493

:

lot here and the consequences for

mistakes are quite high, Luke.

494

:

Build me and just in, in broad

swats, build me a training program

495

:

for the vet that wants to come

back and get comfortable again and

496

:

be like, I know what I'm doing.

497

:

I am the safe anesthetist.

498

:

Where do you start with that?

499

:

Do you start with, do you

start with the equipment?

500

:

Do you start with, drug knowledge?

501

:

Do you start with cce?

502

:

like how, would you, sort of

coach that person if they said,

503

:

look, it's gonna take some time.

504

:

I know.

505

:

help me come up with some sort of

a program for myself to, to get to

506

:

back to where I feel really good

and I feel very safe as an operator.

507

:

gianluca-bini_1_03-18-2026_144217:

Yeah, I think, definitely if I had to

508

:

give you four or five lectures, the

509

:

dr--andy-roark-_1_03-18-2026_154217: Okay.

510

:

gianluca-bini_1_03-18-2026_144217: is,

learn your pre-meds and your induction

511

:

agents learn monitoring, right?

512

:

You need to know.

513

:

How do I fix blood pressure?

514

:

How do I fix bradycardia?

515

:

How do I fix hypoventilation, arrhythmias?

516

:

those are the five most common,

anesthetic complications, right?

517

:

The ones that do happen in probably

almost all of your patients.

518

:

and that's because, we do cause

them with the drug, right?

519

:

So with the drugs we give,

that's what we cause.

520

:

And so as long as you

know how to fix those.

521

:

you're probably good and

you're covered in 99% of cases.

522

:

dr--andy-roark-_1_03-18-2026_154217: Okay.

523

:

gianluca-bini_1_03-18-2026_144217: there

is always gonna be the weird outlier

524

:

out there and, we're looking at broad,

I think that's where I would start.

525

:

Monitoring drugs a equipment.

526

:

I think it's, think it's interesting.

527

:

I think it's, you are better off with

a 15 to 20 minute conversation with

528

:

your, with somebody that you know,

that does way more anesthesia than you.

529

:

Because I think that the

topic is so broad and it's

530

:

dr--andy-roark-_1_03-18-2026_154217: Yeah.

531

:

gianluca-bini_1_03-18-2026_144217: in

detail that people like, get bored.

532

:

when I talk about equipment,

people fall asleep, right?

533

:

that's classic.

534

:

dr--andy-roark-_1_03-18-2026_154217: Yeah.

535

:

gianluca-bini_1_03-18-2026_144217:

only way I have to keep the students

536

:

awake when I have that conversation

is to tell them, Hey, If you killed

537

:

something because you bought the wrong

equipment, you are the one that got sued.

538

:

Not

539

:

dr--andy-roark-_1_03-18-2026_154217: Yeah.

540

:

gianluca-bini_1_03-18-2026_144217:

not the equipment company.

541

:

That's the only thing

that keeps them awake.

542

:

other than that, they're asleep.

543

:

dr--andy-roark-_1_03-18-2026_154217: Is a

544

:

gianluca-bini_1_03-18-2026_144217:

even after three or four coffees,

545

:

they, they're still asleep.

546

:

dr--andy-roark-_1_03-18-2026_154217:

Look, tell me about the type of cases

547

:

that you see in, safe pet anesthesia.

548

:

what do people come to you guys with?

549

:

What are the types of cases where

someone says, I'm in general practice,

550

:

and I would like, an anesthesiologist

to help me walk through this.

551

:

what does that kinda look like?

552

:

And then what does the circumstances

look like most commonly when people

553

:

reach out to you and ask for your help?

554

:

gianluca-bini_1_03-18-2026_144217:

that's a really good question, but

555

:

also was one of the most surprising

thing when we started this, right?

556

:

dr--andy-roark-_1_03-18-2026_154217: Okay.

557

:

gianluca-bini_1_03-18-2026_144217: that

what we were gonna see was patients,

558

:

renal patients, stuff like that.

559

:

And.

560

:

And we do see those, then we start

seeing popping up like Spain noodles.

561

:

we did a nail trim two or three months ago

562

:

dr--andy-roark-_1_03-18-2026_154217:

Really.

563

:

gianluca-bini_1_03-18-2026_144217: right?

564

:

Like I did the nail trim.

565

:

and the reason was that

the owner wants it.

566

:

once they have that option, they

want it, they don't care about, they

567

:

will pay anything for their pet too.

568

:

Be having that extra layer

of safety and recover?

569

:

like we do see a bunch of the

gps out there that they schedule

570

:

us for rather easy procedure.

571

:

It is just a matter of either they are

more comfortable with it because they can

572

:

finally focus on what the procedure is,

573

:

dr--andy-roark-_1_03-18-2026_154217: Yeah.

574

:

gianluca-bini_1_03-18-2026_144217:

they don't need to worry about,

575

:

Hey, how's the dog doing?

576

:

or is the pet owner that they're

like, Hey, I just want it, period.

577

:

Don't care.

578

:

That's what we're seeing and

which is, to me it was crazy.

579

:

but, you know, if that's what

they want, then, of course

580

:

we'll do it, whatever they need.

581

:

dr--andy-roark-_1_03-18-2026_154217:

What does that actually look like?

582

:

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

say I've got a pet on her, and they were

583

:

like, Hey, I don't know how that happens,

but we just say that they're like, Hey,

584

:

there's a, I would like you to have an

anesthesiologist involved in my dog spay.

585

:

I would say, oh, okay.

586

:

Hey, it's an opportunity for me to work

with a specialist and you know, I'm

587

:

gonna, I'm take advantage of this and

lean into it and sharpen my own skills.

588

:

like what, does that look at?

589

:

Look like I said, I, I reach

out to you, I say, Hey, I've

590

:

got this request for this thing.

591

:

here's the procedure,

here's when it's scheduled.

592

:

walk me through kind of what my experience

would be like with you guys doing that.

593

:

gianluca-bini_1_03-18-2026_144217:

Yeah, so the scheduling with us is

594

:

basically scheduling a massage, right?

595

:

I So you

596

:

dr--andy-roark-_1_03-18-2026_154217: Okay.

597

:

gianluca-bini_1_03-18-2026_144217: put

in all the patient info, you upload the

598

:

medical records, you select your day.

599

:

we, they, we do ask you for a time,

but that's indicative is not, we

600

:

are flexible, it doesn't really

601

:

dr--andy-roark-_1_03-18-2026_154217: Sure.

602

:

gianluca-bini_1_03-18-2026_144217:

and that's it.

603

:

Basically, we come up with a

protocol, we ship it to you get it

604

:

by email, you get it on the platform.

605

:

we can have that conversation.

606

:

we can chat about it if you want.

607

:

Like, you know, we can go

over it if you're not familiar

608

:

with some of that stuff.

609

:

and then whenever the procedure

needs to happen, you pre-med, place

610

:

the calendar, then we jump on the

call and literally we're there.

611

:

It's a literally like

this, like a FaceTime.

612

:

it's not a FaceTime, it's through

our system, but it looks like it.

613

:

and then we're there the whole

time where you can chat with us.

614

:

It's literally like having.

615

:

One of us there without the

cost of having one of us there.

616

:

dr--andy-roark-_1_03-18-2026_154217: I'm

imagining like a laptop with a Zoom call

617

:

and you're, is is that kind of what it is?

618

:

Like you just, okay.

619

:

gianluca-bini_1_03-18-2026_144217:

an iPhone, an iPad, a laptop, any

620

:

device with a camera and a wifi.

621

:

we can see everything like, so usually

they point us to the patient first.

622

:

We make sure that the induction is

good, and then we move to the monitor.

623

:

We monitor the whole procedure.

624

:

We tell you, Hey, this

is what we're seeing.

625

:

This is how we fix it.

626

:

This is why we do suggest to do this.

627

:

So there is a learning.

628

:

Opportunity as well there, and then

back to the patient for recovery.

629

:

We make sure that everything is fine.

630

:

The other option you have, you know,

if you didn't want to do it this

631

:

way, was to get somebody in person.

632

:

So like That's great.

633

:

if the owners can afford that's

great, having one of us in

634

:

person is two to $3,000 a day,

635

:

dr--andy-roark-_1_03-18-2026_154217: Yeah.

636

:

gianluca-bini_1_03-18-2026_144217:

plus the travel expenses.

637

:

So there is a huge gap into, know, costs.

638

:

our hours is a 10th of that.

639

:

This is accessible to everybody.

640

:

There is of course, practices that do

get an anesthesiologist in person in,

641

:

every week, every two weeks, every month.

642

:

that's fine.

643

:

And if you can do that's great.

644

:

but it's few and far in between.

645

:

dr--andy-roark-_1_03-18-2026_154217:

Yeah, Luca, where can people learn more?

646

:

I know you guys have a podcast.

647

:

Tell me a little bit about that.

648

:

gianluca-bini_1_03-18-2026_144217: Yeah.

649

:

Our podcast is called The

Random Anesthesia Topic.

650

:

you can find it on our social,

safe pat anesthesia on Instagram

651

:

and threads, all of that.

652

:

we, in our podcast, we have

three anesthesiologists and

653

:

we sit down and we take turns.

654

:

So in whoever picks the topic

and the others two have no clue

655

:

what we're gonna talk about.

656

:

dr--andy-roark-_1_03-18-2026_154217: Yeah.

657

:

gianluca-bini_1_03-18-2026_144217:

it's totally random.

658

:

And one of us picks a topic and we

659

:

dr--andy-roark-_1_03-18-2026_154217:

Oh, that's fun.

660

:

Oh, that's a fun idea.

661

:

gianluca-bini_1_03-18-2026_144217:

it's an interesting way of

662

:

trying to make anesthesia a

little bit more fun, for people.

663

:

I don't wanna become a version of the Calm

I don't want people to go sleep with us,

664

:

dr--andy-roark-_1_03-18-2026_154217: yeah.

665

:

gianluca-bini_1_03-18-2026_144217: So

666

:

dr--andy-roark-_1_03-18-2026_154217: It's

like, yeah, they listen to your voice and

667

:

then they just absolutely fall asleep.

668

:

Yeah.

669

:

I gotcha.

670

:

Okay.

671

:

Got it.

672

:

Very nice.

673

:

And then what's, what's your website?

674

:

for Safe Pet Anesthesia work?

675

:

Where can people, learn

more about the service?

676

:

Outstanding.

677

:

Well, I'll put a link

to it in the show note.

678

:

Luca, thanks for being here guys.

679

:

Thanks for tuning in, everybody.

680

:

Take care of yourselves, gang.

681

:

We'll talk to you later.

682

:

gianluca-bini_1_03-18-2026_144217:

Thank you.

683

:

dr--andy-roark-_1_03-18-2026_154217:

And that's what I got.

684

:

Yeah.

685

:

thanks to Luca for being here.

686

:

Guys.

687

:

Thanks for tuning in everybody.

688

:

If you enjoy the podcast, do all the fun

stuff people ask you to do with podcasts.

689

:

Like share, subscribe, tell your

mom, if she's into podcasts and also

690

:

VE medicine, And, she, I don't know

if she's gonna be doing anesthesia

691

:

and she would wanna know more.

692

:

There's lots of reasons that she might

wanna know about the podcast is all

693

:

I'm saying is just look, just don't.

694

:

you should call her.

695

:

And this is an opportunity.

696

:

And so just maybe, anyway, I'm just

gonna, you know, I'll just enjoy myself.

697

:

Don't worry about it.

698

:

I'll take care of this.

699

:

Anyway, you guys enjoy the rest of

your day and thanks for being here.

700

:

I'll talk to you later on.

701

:

Bye.

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