The Importance of Pre-Op Labs; A Cautionary Tale.
January 2, 2018
Meet Archie. What a happy looking guy, eh?
Archie is a 9 year old puggle, whose teeth were looking pretty icky, so his family decided it was time for his teeth to be cleaned. Archie came in for a pre-anesthesia physical and from all outward appearances, seemed healthy.
The day came for Archie’s teeth to be cleaned. This procedure in dogs and cats requires general anesthesia; they don’t say “ahhh” on command like people. Archie’s family agreed to a pre-op blood screening panel. This is recommended for all anesthetic procedures at our office, but is often declined by pet owners due to concerns about costs. Standard pre-op blood screening runs $52 at our office, and gives us the chance to evaluate your pet’s blood count (red and white blood cell counts), liver function, kidney function, hydration status, and protein levels before they have anesthesia.
Boy, are we glad that Archie’s family decided to say “yes” to the pre-op screening. Archie was DANGEROUSLY ANEMIC. In fact, Archie’s red blood cell count was so low we thought he might need a blood transfusion. Luckily, we were able to catch this potentially fatal blood loss before we anesthetized Archie. Anesthesia drugs cause changes to heart rate, rhythm, and contraction even in patients with normal blood counts and normal blood pressures. Archie’s very low red blood count meant that his heart was pumping many times harder than normal to supply his body tissues with the oxygen they need to function. Changes to his blood pressure or heart function caused by anesthesia drugs would have lead to cardiac arrest and death while under anesthesia for his teeth cleaning!
Archie’s teeth cleaning was canceled immediately. Next, we had to determine why Archie had become so anemic so quickly – after all, he had been in shortly before and passed his physical with flying colors! Based on the type of anemia Archie had, we knew he was bleeding internally – but from where?
We took x-rays of Archie and found a mass in his abdomen that was so large, it was pushing his internal organs to the side. This looked to be the source of Archie’s internal bleeding and anemia. Things were looking very scary for Archie at this point since abdominal masses that cause internal bleeding in dogs are usually cancerous and fast spreading. Archie’s family took him to the Dayton Care Center for an abdominal ultrasound where a specialist confirmed that he had massive internal bleeding from a tumor on his spleen. Within 2 days, Archie’s red blood count had dropped even lower.
Archie's very enlarged spleen inside red circle compared to a normal sized spleen in green circle
Based on the severity of the anemia and the size of the mass, we knew we had to act quickly, or Archie would bleed to death. Archie had an emergency surgery at our office to remove his spleen (luckily you can live without a spleen!). The surgery was long, complicated, and very risky. A blood donor dog was on stand-by during the procedure in case Archie suddenly needed a blood transfusion during surgery. Archie’s spleen was riddled with tumors and weighed almost 5 lbs! It took up almost his entire abdomen – all his internal organs were squished.
Fortunately, the surgery was a success! Archie pulled through without needing a transfusion, and within days, his red blood count started to improve.
Archie's rather large incision after surgery
Archie made a full recovery and at this time has no evidence of spread of the tumor. His red blood count has stabilized and his family is happy to report he is doing really well. He might even get to have his teeth cleaned soon!
We are thrilled that Archie’s story has a happy ending, but it might not have, if his family had opted out of the pre-op blood screening. Archie had NO SYMPTOMS of blood loss until the days after his diagnosis. None. Zero. We know for a fact that if Archie had been put under anesthesia for his teeth cleaning that day, he would not be here today.
Underlying blood count issues, inflammatory conditions, cancers, liver, and kidney diseases can be silent killers without pre-op screening. We diagnose conditions such as these in symptom free pets every single day.
We know that you are budget conscious, but pre-op blood screening gives us a look at vital information that can tell us if it is not safe for your pet to have anesthesia. That extra $52 could save your pet’s life. It saved Archie’s.