Why the line “your cat died under anesthesia” might not always be true

I graduated from veterinary school in June 2000. During the intervening 14 years I have anesthetized animals almost every work day. In fact, I have anesthetized multiple animals on many of those days.

Anesthesia is one of the greatest steps forward in the history of medicine. During the U.S. Civil War, wounded soldiers were given a shot of whiskey and a stick to bite down on during limb amputations. Now it is possible safely and humanely to perform all manners of medical procedures using balanced anesthetic and pain management techniques, and not just in humans. Advances in veterinary anesthesia have largely kept pace with improvements on the human side.

And yet, nothing in life can ever be 100-percent safe. Anesthesia can slow heart and respiratory rates. Body temperature and blood pressure can drop. If the airway is not protected, suffocation or aspiration can occur. It would be a lie to say that significant complications from anesthesia do not occur. Older, sick animals are at greater risk from anesthetic complications than are young, healthy individuals. So just how great is that risk?

Since I became a full-time practicing veterinarian 14 years ago, I have kept a tally of the patients that I have lost due to anesthetic complications. The tally has been very easy to keep track of over the years, because it’s a simple number. Zero. I have never lost a patient — dog or cat — to anesthetic complications. And, working at an emergency hospital for the last several years, I have anesthetized more than my fair share of “high-risk” patients. I can’t count the number of 18-year-old dogs who came to my office with hemorrhaging dental abscesses at three in the morning that required, and survived, emergent anesthesia. The irony is that most of those dogs developed abscesses because their owners thought, years before, that the dogs were “too old” to undergo anesthesia for routine dental work. Instead, the dogs came to my office, sick, a couple of years older, and therefore at much higher risk, and went through anesthesia without complications.

Is my experience an exception? I admit that I’m a stickler: I insist upon the safest possible anesthetic protocol for every patient, not just “high risk” ones. And I have heard stories about other vets who use cheaper, potentially less safe methods in “young, healthy” cats.

But overall, I doubt that my experience is exceptional. Very few of my friends (given my circumstances, I have a lot of friends who are vets) and colleagues have reported significant anesthetic complications to me.

So this brings me to a conundrum. As an emergency vet I do not perform routine anesthetic dental procedures. But I still diagnose a great deal of dental disease. And I recommend dental work to many clients — to be performed with their family vets when their pets have recovered from whatever emergency brought them to my hospital.

And I regularly hear people object to dental work based upon their fears of anesthesia. The line I have heard hundreds and hundreds of times boils down to this: “I don’t want to do dental work because one of my cats died during a dentistry once.”

This makes me wonder: What the hell is going on? How could I and every vet I know have astronomically low anesthetic complication rates, when a quarter of the people out there claim that their pets have died under anesthesia?

Surely there are people out there whose cats truly have expired due to anesthetic complications. It is tragic but I do not doubt it. However, a thread I read a while ago on VIN makes me wonder whether another explanation may also be contributing to the discrepancy.

VIN is short for Veterinary Information Network. It’s an Internet-based forum for veterinarians. Its visionary founders launched it early in the Internet era, and it has achieved sufficient critical mass to ward off websites belonging to giants such as the AVMA and Google. VIN is the place for vets who want to seek advice, commiserate and hobnob with other vets.

In the thread, a veterinarian recounted a harrowing tale. A client brought a cat to the hospital for euthanasia. As the veterinarian was preparing for the procedure, the client asked a favor of the vet. Would he, the vet, be kind enough not to mention the euthanasia to the client’s wife and children? The client intended to tell them that Fluffy had been taken to the vet for a dental procedure and had not survived.

My memory of the thread is that the veterinarian managed, barely, to withhold putting his foot up the client’s rear end as the vet kicked him out of the hospital forever (with the still-alive cat in a carrier).

The story is shocking enough on its own, but what really alarmed me was this: Many other vets involved in the thread had similar stories to tell. Some of them did not find out about the devious owner behavior until after the euthanasia had been performed. Some got dragged into massive family brawls when they later refused to participate in the ruses.

The damage that could be done by such disingenuity is mind-warping. A cat could have been needlessly euthanized. Imagine the emotional scars left on the children by their lying parent. Consider the marital damage that could occur if the spouse found out. And think of the animal suffering that could occur if victims of this type of behavior grow up thinking that anesthesia is not safe, and therefore elect not to perform beneficial procedures (such as dental work) on their cats later in life.

How common is this sort of behavior? I have no idea. Surely it’s rare, but is it more rare than true anesthetic complications? Actual anesthetic complications are vanishingly rare, so where are all of the people who claim to have lost cats during anesthesia coming from?

To my knowledge I’ve never been involved in such a malicious ruse. But, given how rare true anesthetic complications are, it seems plausible to me that a significant proportion of people who think they’ve lost cats to anesthetic complications may in fact not have.

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