The dilemma of whether to operate on any patient can be a difficult one. The decision whether to subject an elderly patient to a general anaesthetic can be difficult. Debating the advantages and disadvantages of a surgical procedure in an elderly patient with kidney problems is a tricky one.

Trying to convince Erain, our head nurse at Fairfield, that her aged cat with kidney disease requires a surgical procedure and general anaesthetic was an onerous task.

Erain's cat, Smokey Joe, had a swollen ear flap (aural haematoma) but also has a known kidney problem for which he receives regular checks including blood and urine tests and blood pressure measurements.

Fortunately, with the advances made in anaesthetic techniques and the fact that our own practice was awarded a gold standard in anaesthetic protocol by a European anaesthetic specialist the arguments against surgery are considerably diminished.

That doesn't mean to say that there are no risks involved, only that we have taken steps to ensure that those risks are significantly reduced. When the owner concerned is your head nurse you want to be sure that those risks are minimal.

After considerable debate and pre-anaesthetic blood tests we were able to anaesthetise Smokey-Joe and perform the drainage technique that his ear required. Considering that Smokey-Joe was hand reared by Erain from only a few weeks of age and has been cherished by her ever since, the requirement to keep him healthy year upon year requires a commitment from his owner that has never faltered and health care from his veterinary practice in which she has considerable influence!

If Smokey-Joe could have chosen his home this Christmas he couldn't have chosen better!

Terry Dunne BVMS, Cert SAO, MRCVS

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