Anesthetic considerations in the septic patient
An 11-year-old male intact Dachshund presented to Cornell's Small Animal Emergency Service with caudal abdominal pain, hypothermia, dehydration, and signs of septic shock. A presumptive diagnosis of prostatitis or a ruptured prostatic abscess was made based on history, clinical signs, abdominal ultrasound and cytology, and the patient was placed under general anesthesia for an emergency laparotomy and castration. Pre-and intraoperative anesthetic complications included hypotension, which was treated with fluid therapy and catecholamines, and a mild hypokalemia, which was corrected with a potassium chloride supplementation. This paper reviews the basic pathophysiology of septic shock, discusses strategies for reducing halogenate use through balanced anesthetic protocols, and describes ways to assess fluid responsiveness and treat hypotension in anesthetized patients. The potential causes, consequences and treatment of hypokalemia are also discussed.