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Topic Dog Boards / Health / local anaesthetic?
- By lilyowen Date 14.06.12 07:22 UTC
Last night I had a very traumatic experience with on of my dogs. She managed to break a toe nail and it was sticking out at right angles from its normal position and obviously very painful. I know from previous experience that my vet will first advise leaving for a couple of days to see if it will come off on its own. Unfortunately it soon became obvious this was not going to happen so off I went to the vets expecting sedation or GA to remove the nail. However the vet looked at it, disappeared and came back with forceps and a bottle of styptic fluid and a muzzle told me to hang on to my poor girl and pulled the nail out. It took quite a lot of fiddling and pulling. at least 5 minutes although it felt like a year. My poor little girl was screaming while this was happening. He did eventually get the nail off and managed to stop the considerable bleeding. We are both traumatised by this.

Why do vets not use local anaesthetic for something like this? if it had been a human I am sure they would have done. As it is my dog obviously associates me with the pain. She won't come near me. If I walk into a room where she is then she gives me a haunted look at leaves and won't come if I call her. I am hoping she will get over it. She was always very nervous of vets before this when she had only had vaccinations and been spayed. I can't imagine I will be able to get her into the vets again after this without major anxiety.

I understand the nail needed to be removed and she is already walking more soundly. I know a GA carried risks and is expensive but I would have been happy to pay for it to prevent my girl going through such an obviously painful and traumatic experience, Surely a local would have been preferable to this? Obviously if it happens again I will insist on a GA but is there anything I can do to help her recover from the trauma now?
- By Stooge Date 14.06.12 07:32 UTC
Local anaesthetic stings like Billyoh so I think the vet make a judgement that pulling it off would be quicker and less traumatic.  As it turned out that judgement proved not to be such a good call as it took a lot more to pull off than I think they generally do but of course the vet did not have benefit of hindsight.
I think you may be surprised at what is done in A&E without local anaesthetic :)
As to helping her get over it perhaps calling in to the surgery at non busy times and asking them to give her a treat would help.
- By Jeangenie [gb] Date 14.06.12 07:33 UTC
Poor you (and her!); that sounds very scary. :-( I've had vets pull off loose nails without pain relief when they've just been hanging by a thread, and one quick split-second pull has removed it; one squeal and it was all over. If it was going to take any longer then I'd certainly want some kind of pain-killer. However local anaesthetics can take ages to have any effect especially on a nervous animal (the adrenalin can over-ride the drug) and is painful in itself, and of course sedatives and GA require several hours fasting beforehand.

It might be a good idea every couple of days to take your girl into the vet reception, praise her (if she's not making too much fuss) then leave straight away so that she stops thinking something horrid's going to happen. Hopefully she'll come right before too long.
- By JeanSW Date 14.06.12 08:23 UTC
I have a bitch who frequently damages her dew claws (they are  big, flappy, useless ones.)  Twice vets have removed in a couple of seconds, and she has screamed.  Now, when I take her to the vet, even for a booster, she poos in the surgery with fright.

Over the years she has damaged claws at least 18 times (I have never counted exactly, and that is a very conservative estimate.)
If I go anywhere near her nails she is desperate to get to a safe place away from me.  I now insist on sedation at the very least, although she has had GA's loads of times.

Yes, it is expensive, but I owe her that.  She is a large Bearded Collie, and I have had the nails removed with sedation, even when she has eaten.
- By lilyowen Date 14.06.12 11:11 UTC
My poor girl does seem to be prone o damaging her nails as this is the third time. The first  a large outside rear toe nail came off without a problem in a day or two. the second was a dew claw which broke in half. I managed to cut that myself to prevent a trip to the vets. this one was the same toe as the first time but obviously much more firmly attached than last time. :(

I wish I had instsited the vet sedate her.She will take a long time to get over this. It will not be a case of feeding her in reception. She used to start wailing as soon as we got into the car park before this happened. To be honest I think the amount of work involved in desensitising her to the vets now will  be prohibitive.

Useful to know that your dog has been sedated even after having eaten. I thought it must be possible as I am sure dogs don't always wait until a several hours after a meal to have a medical emergency.

I am interested that another poster said that administering a local stings. I have had several for dental work and although not the most pleasant experience I don't remember them stinging. I still think it would be preferable to putting a dog through such obvious pain though.
- By PennyGC [gb] Date 14.06.12 11:24 UTC
when a dog of mine did this to her nail we were at a show so went to the vet 'on call' and she cut it off, without anaesthetic, but my dog didn't notice... she then bandaged it up and in a couple of days she was right as rain.  I would NOT have allowed her to pull the nail out .... that would be too painful.... with humans we have a choice and know what's happening.  I don't think any doctor would yank a nail out without some form on anaesthetic, although an injection would hurt, not as much as this - don't forget pulling nails out is a form of torture (anyone watch Laurence of Arabia???)
- By Stooge Date 14.06.12 11:30 UTC

> I have had several for dental work and although not the most pleasant experience I don't remember them stinging.


A lot will depend on whether it is being giving sub cutaneously or as a nerve block, which is what I suspect you had at the dentist.  You do say, though, that even that was not a pleasant experience.  Leaving aside that you clearly need a lot of cooperation from the patient to give an injection to the mouth and just looking at more accessable areas of the body, how practical do you think it would be to give this to an already anxious animal preferably without risk of applying it to the handler :)?
I really think the only practical option is a general anaesthetic following a period of starvation or sedation but this is not without risk and does take time during which the animal is continuing to experience pain from the injury. 
- By lilyowen Date 14.06.12 16:05 UTC

> Leaving aside that you clearly need a lot of cooperation from the patient to give an injection to the mouth and just looking at more accessable areas of the body, how practical do you think it would be to give this to an already anxious animal preferably without risk of applying it to the handler :-)?


I would imagine that it would be a hell of a lot easier to administer a small injection than it was for me to hang on to my dog while her toenail was pulled out so painfully. And a lot less distressing for both of us.

> I really think the only practical option is a general anaesthetic following a period of starvation or sedation but this is not without risk and does take time during which the animal is continuing to experience pain from the injury. 


I totally agree and that was what I was expecting the vet to do. However when he decided to pull the nail out I trusted that he would be able to do it quickly and without causing my girl undue discomfort. After all he is supposed to be the expert and I trusted his decision. I was never even asked if I wanted her to have a GA or sedation and had I been asked I would have gone for this option as I know how sensitive my girl is and how badly she handles pain.
- By Stooge Date 14.06.12 16:57 UTC

> However when he decided to pull the nail out I trusted that he would be able to do it quickly and without causing my girl undue discomfort.


I suspect he thought the same :)
- By Jeangenie [gb] Date 14.06.12 17:38 UTC
I'm sure your vet expected to be able to do it in an instant, but sometimes things don't always go according to plan. :-(
- By G.Rets [gb] Date 15.06.12 17:38 UTC
This may be a case for changing vets now. Going into a new surgery would not give your girl bad memories. I do hope she recovers from her ordeal soon.
- By Pedlee Date 16.06.12 06:56 UTC
When Hattie did the same, my vet cut the nail off as short as she could. If it had needed to be removed completely she would have had a GA.

I've had a number of emergency situations over the years, where dogs have eaten beforehand (or certainly less than the "overnight starvation" usually required) and had no problems whatsoever.
- By Jeangenie [gb] Date 16.06.12 07:00 UTC

>and had no problems whatsoever.


Have you been there during the surgery, though? It can be dodgy when they vomit when they're unconscious, even when intubated.
- By Pedlee Date 16.06.12 07:08 UTC
No I haven't. But in an emergency situation, what's the alternative? Wait 10 hours for the dog to bleed to death or suffer considerable pain......

I appreciate that under normal circumstances it would be better to give GA/sedation with an empty stomach, but sometimes situations don't allow for that.
- By Stooge Date 16.06.12 07:10 UTC

> It can be dodgy when they vomit when they're unconscious, even when intubated.


Exactly.  An emergency situation, where to delay could be equally risky, is different but you would not wish to chance it in anything less than an emergency.
Cross posted with Pedlee :)
- By Jeangenie [gb] Date 16.06.12 07:18 UTC

>But in an emergency situation, what's the alternative?


Don't get me wrong, I agree totally - in an emergency. :-) I was just pointing out that a) a torn nail, although painful, isn't an emergency, and b) you can't say that it's done 'with no problems' if you weren't there.
- By Pedlee Date 16.06.12 07:20 UTC
Perhaps I should rephrase it to no problems "reported" to me then....
- By Jeangenie [gb] Date 16.06.12 07:23 UTC
Perfect. :-)
- By dogs a babe Date 22.06.12 15:10 UTC
I had this thread in the back of my mind when I noticed, this morning, a nail completely separated from the quick but quite firmly attached still...

A trip to the vet today, who judged him very brave (and handsome!) and gave him a local anaesthetic then pulled the remaining nail away.  He was stoic throughout and charmed the remaining nurses with his "ooh I think I might be terribly poorly" look, and a request for a biscuit :)  They've also given him antibiotics as there is some infection

I'm sorry yours was such a traumatic experience - it certainly didn't need to be - but thanks for posting.  In the end I needn't have worried but at least I was prepared.  Thanks again and I hope your girl is ok now
- By lilyowen Date 22.06.12 17:30 UTC
I am glad your lad came through his experience relatively unscathed and thanks for asking about my girl. Physically she is healing well and managed some nice walks while I was away last week. Mentally however is another matter.  She does let me look at the nail to check the wound. She is such a good girl it would never occur to her to protest, but she completely goes in on herself and starts shaking and then runs away and hides from me. I think it will be a long time before she trusts me with her feet again
- By Butler 1 [gb] Date 22.06.12 18:08 UTC
OMG mine has has his removed again tonight! but infection this time and has a bandage this time and AB have to keep the bandage dry (in this weather) Vet tried to do it under local, but could not and he is not very good with antisetic?So had to put him under fully but not so much this time!! He had the same toe done in FEB!!
- By lilyowen Date 22.06.12 19:03 UTC
I feel for you. I have just got back from a walk to discover her daughter has now broken a dew claw!! It is not broken as close to the toe as Sadie's was and is a lot wobblier so at the moment I am trying to decide  whether to take her to the vets, cut it off myself or leave it for a couple of days to see if it comes off on its own. It doesn't seem to be bleeding and is obviously not as painful as Sadies was so I think I will hang on for a day or two and see how it progresses. Lets hope this is something that doesn't come in threes.
Topic Dog Boards / Health / local anaesthetic?

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