Anesthesia for cystotomy in a dog with pancreatitis and a portosystemic shunt

A 21-month-old Cocker spaniel with a portosystemic shunt, a moderate thrombocytopenia and a history of pancreatitis, was anesthetized for a cystotomy to remove bladder polyps and stones. The portosystemic shunt had been treated conservatively with lactulose, ampicillin and a special diet. After premedication with methadone 0.2 mg/kg, by intramuscular (IM) injection, anesthesia was induced with propofol 4 mg/kg intravenously (IV) and maintained with isoflurane in oxygen. Additionally, 2 mL lidocaine 2% and 0.1 mg/kg morphine were injected in the lumbosacral epidural space and 0.1 mg/kg meloxicam was administered intravenously. Except for a moderate decrease in arterial pressure after the epidural injection and the need for intermittent positive pressure ventilation during surgery, anesthesia and recovery were uneventful. Postoperative analgesia was provided with methadone (0.2 mg/kg every 4 hours initially, then 0.1 mg/kg every 6 hours IM) and oral meloxicam (0.1 mg/kg the first day, 0.05 mg/kg during 4 days).