NAVLE Veterinary Anesthesia and Pain Management 5 — Questions and Answers
Question 1: A 10-year-old diabetic cat is scheduled for dental extraction. Which inhalant anesthetic is preferred due to its lower solubility and faster recovery profile?
- Halothane
- Isoflurane
- Sevoflurane (Correct answer)
- Enflurane
Correct answer: Sevoflurane
Sevoflurane has the lowest blood-gas partition coefficient among commonly used veterinary inhalants, resulting in the fastest induction and recovery.
Question 2: When performing a dental nerve block using the infraorbital approach in a dog, which nerve is primarily desensitized?
- Mental nerve
- Inferior alveolar nerve
- Maxillary nerve branches supplying upper premolars and incisors (Correct answer)
- Lingual nerve
Correct answer: Maxillary nerve branches supplying upper premolars and incisors
The infraorbital nerve block desensitizes the upper incisors, canine, and premolars ipsilaterally by blocking the maxillary nerve at the infraorbital foramen.
Question 3: Which scoring system is validated for assessing acute pain in cats in the postoperative period?
- Glasgow Composite Measure Pain Scale – Short Form (CMPS-SF)
- UNESP-Botucatu Multidimensional Composite Pain Scale
- Numeric Rating Scale (NRS) only
- Colorado State University Feline Acute Pain Scale (Correct answer)
Correct answer: Colorado State University Feline Acute Pain Scale
The Colorado State University Feline Acute Pain Scale is a validated, species-specific tool widely used in clinical settings to assess acute pain in cats.
Question 4: A rabbit undergoing ovariohysterectomy shows bradycardia (HR 120 bpm) under isoflurane. What is the most likely cause and initial treatment?
- Hyperthermia — apply cooling
- Vagal stimulation — administer atropine IV
- Anesthetic overdose — reduce vaporizer setting (Correct answer)
- Hyperkalemia — administer calcium gluconate
Correct answer: Anesthetic overdose — reduce vaporizer setting
Reducing the isoflurane vaporizer setting addresses anesthetic-induced bradycardia by decreasing myocardial depression from excessive anesthetic depth.
Question 5: Which route of buprenorphine administration has been shown to achieve effective plasma concentrations in cats via the oral mucosa?
- Intranasal
- Transdermal patch
- Transmucosally (OTM — oral transmucosal) (Correct answer)
- Subcutaneous injection only
Correct answer: Transmucosally (OTM — oral transmucosal)
Buprenorphine is highly bioavailable when applied to the oral mucosa of cats (OTM) due to the alkaline feline oral pH facilitating absorption.
Question 6: A dog is receiving a fentanyl CRI at 5 mcg/kg/hr intraoperatively. Signs of opioid-induced bradycardia appear. Which drug reverses fentanyl's cardiovascular effects with the least effect on analgesia?
- Naloxone full dose IV
- Glycopyrrolate IV to treat bradycardia without reversing opioid (Correct answer)
- Atipamezole IV
- Flumazenil IV
Correct answer: Glycopyrrolate IV to treat bradycardia without reversing opioid
Glycopyrrolate treats opioid-induced bradycardia by blocking vagal tone without reversing analgesia, unlike naloxone which would eliminate pain control.
Question 7: During a TPLO in a dog, the surgeon requests addition of an NSAID for multimodal analgesia. The dog has received acepromazine and morphine as premedication. Which consideration is most important before administering carprofen?
- Carprofen is contraindicated with morphine due to serotonin syndrome risk
- Confirm the dog has normal renal perfusion before NSAID administration (Correct answer)
- Carprofen must be given at least 2 hours before morphine to avoid drug interaction
- NSAIDs are contraindicated with acepromazine due to additive CNS depression
Correct answer: Confirm the dog has normal renal perfusion before NSAID administration
NSAIDs inhibit prostaglandin-mediated afferent arteriolar dilation in the kidney; adequate renal perfusion must be confirmed before perioperative NSAID use to prevent acute kidney injury.
NAVLE Veterinary Anesthesia and Pain Management 5
A 10-year-old diabetic cat is scheduled for dental extraction.
Which inhalant anesthetic is preferred due to its lower solubility and faster recovery profile?