Anesthesia Guidelines from the American Animal Hospital Association

Photo Credit: The Pet Doctor Inc.

I have great respect for the American Animal Hospital Association (AAHA). One of the many wonderful things this organization does is the gathering of experts within the profession to create practice guidelines for veterinarians. In the past, for example, I’ve exposed you to AAHA guidelines for vaccination protocols. Not only are such guidelines helpful for veterinarians, they are also available to you, the consumers of veterinary medicine. With such information in hand, I’ve no doubt that you will be better able to make informed decisions for your pets. And there’s nothing I like better than helping people become better medical advocates!

AAHA’s latest endeavor has been the creation of guidelines for anesthesia for dogs and cats. They cover multiple aspects of anesthesia including preanesthesia patient evaluation (detailed medical history, thorough physical examination, assessment of risk based on breed, age, and overall health), diagnostic evaluation, preanesthetic medications, recommendations for induction and maintenance of anesthesia, monitoring parameters and equipment, pain management, staffing recommendations, and monitoring of the patient following anesthesia. Did you know that 47 percent of canine deaths and 60 percent of feline deaths associated with anesthesia occur during the anesthetic recovery period rather than during the actual anesthesia? I had a hunch about this, but was unaware of these statistics until I read the Anesthesia Guidelines.

As a small animal internist, it’s a given that I only see patients who are sick. (I truly miss all of those well puppy and kitten exams!) So, I truly appreciate the section written about managing anesthesia for patients with preexisting medical issues including kidney disease, diabetes, heart disease, and liver disease.

Although the AAHA guidelines are written for veterinarians, I encourage you to take a look. Let me know if you need any help interpreting what you read. Keep in mind that these guidelines are simply that- guidelines. Veterinarians are not required to follow them. This is why it is up to you to ask the right questions to learn how your veterinary staff members anesthetize and monitor their patients. In addition to reading these guidelines when formulating your list of questions, I encourage you to also read the chapter called “Important Questions to Ask Your Vet…And How to Ask Them” in Speaking for Spot.  There, you will find a thorough list of questions to ask your vet when anesthesia is recommended. Perhaps the very first question should be, “Have you read the new AAHA Anesthesia Guidelines?”

What have your experiences been with pets undergoing anesthesia?

Best wishes for a happy new year,

Nancy Kay, DVM

Diplomate, American College of Veterinary Internal Medicine
Author of Speaking for Spot: Be the Advocate Your Dog Needs to Live a Happy, Healthy, Longer Life
Author of Your Dog’s Best Health: A Dozen Reasonable Things to Expect From Your Vet
Recipient, Leo K. Bustad Companion Animal Veterinarian of the Year Award
Recipient, American Animal Hospital Association Animal Welfare and Humane Ethics Award
Recipient, Dog Writers Association of America Award for Best Blog
Recipient, Eukanuba Canine Health Award
Recipient, AKC Club Publication Excellence Award
Become a Fan of Speaking for Spot on Facebook

Please visit to read excerpts from Speaking for Spot and Your Dog’s Best Health.   There you will also find “Advocacy Aids”- helpful health forms you can download and use for your own dog, and a collection of published articles on advocating for your pet’s health. Speaking for Spot and Your Dog’s Best Health are available at,, local bookstores, and your favorite online book seller.




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8 Comments on “Anesthesia Guidelines from the American Animal Hospital Association

  1. thank you Dr. Kay, I really appreciate you bringing these guidelines to your reader’s attention. I had not previously heard of this. I printed it out and will use this as a reference. I just scheduled one of my dogs for a dental procedure next month, so I will read this very soon, even though I really trust my vet, he has done procedures on several of my pets in the last decade including senior dogs, and they have all done very well with whatever he does.

  2. Judi is right on the money about MDR-1.

    My dogs are all normal/normal but I still ask my vet to consider that in their care plan (our breed is an MDR-1 breed). My last vet wanted to put them on ivermectin BEFORE we knew their MDR-1 status. I think, in general, vets have a low awareness of the MDR-1 issue.

  3. I am surprised that IV fluids are not [art of routine anaesthesia… they ARE for human beings who undergo anaesthesia. When my bitch became an unbitch (spay job), I asked that she be started on IV fluids to help her recovery. It went very well, aside from her deciding at one point that she did not want the IV any more and doing a DIY removal.

    I do think the fluids helped her recovery. It was an extra $75 (gasp) to have that done but she was a far less out-of-it girl and quickly recovered at home. Her recovery from the anaesthesia was much faster than any of my other animals who were not IV’d

  4. I guess I would have to see the old guidelines to see if these are an improvement. I was a bit disappointed to see that they didn’t include long term effects of the anesthesia, so owners are left to research that on their own.

    Ketamine is one example. It can cause learning disabilities and nightmares in children for up to 7 years after being administered. It’s not used all that much anymore for children or adults (by those who do keep up).

    Also no mention that despite what type of anesthesia used it takes a while to leave the bloodstream. In humans, it takes 12 to 14 days and can cause mood swings.

    I use Cats Claw and Thuja to help flush it out of the system. To be fair though most surgeons for humans don’t mention that either.

    It is kind of exciting to see aniaml medicine progress though isn’t it?

  5. I’m glad you are emphasizing anesthesia. I’ve had my dogs take a long time to recover and need an extra round of fluids from being over-anesthetized for a simple dental extraction. I like isoflurane especially for small dogs, always had good luck with it, but it’s expensive and sometimes you have to ask for it. Not sure if there’s something better. I do find that the combination of drugs can be a problem. I would suggest that everyone keep track of what their animals are given during a procedure, monitor their recovery time, and make sure that goes into the animal’s record, for future possible surgeries. Thanks for all the great information.

  6. Thank you, Dr. Kay, for helping us. Like Amy, I ask my vet his opinion on topics like vaccination frequency. He knows I take a holistic approach to my life and does not seem to think less of me for it. He laughs and says, :”What I am going to recommend is not holistic, it is antibiotics, are you ok with that?” He cracks me up. And his tech, a dear friend, recently explained there is a new vaccine for rabies that does not affect the nerve covering (!). They are sooo excited in her office,

    Unfortunately, in our city there is a practicing vet who, I have heard from knowledgeable sources, does not administer oxygen after surgery and I have seen some very sick dogs come out of there, still unable to stand! One was brought to my boarding kennel after her spay. I had to carry her in and she was not really well for two days! I was livid. The owners did not seem overly concerned, even after I explained she should not be out of the hospital yet. I figured she was probably better off with me watching her than her owners. In retrospect I should have called my vet and asked if he could help. Stupid me. Wish that guy would retire! People pay him money and animals suffer.

  7. Although they mentioned brachycephalic breeds as a risk factor, I was kind of surprised they didn’t mention genetic conditions like the MDR-1 mutation as a risk factor for anesthesia.

  8. I read one of these review articles when I had a sick dog and I was very encouraged by the readable guidelines they publish for the everyday practitioner. Before I found that article I had tried to puzzle through some studies, and they were really hard to understand and sometimes didn’t even have useful conclusions. I have run into a couple of vets who don’t keep up. I gave them a pass for their other good qualities, but in the end my pets suffered. Now I have one who keeps up, is a member of the AAHA & AVMA, and will explain to me why this or that study wasn’t conclusive and what the current state of knowledge is. I have no idea whether he’s a good surgeon but at least I can truly trust that he knows what he’s supposed to know, yet doesn’t think he knows it all. We had a long conversation about vaccine studies yesterday when I updated my girlie’s shots. The opener was when I mentioned an article I’d recently read (maybe the one you linked). I recommend this method as a quick way to see what kind of person you’re trusting your pet’s health to!