For this patient, I would consider a coagulation panel before surgery given that both the ALT and ALKP values are elevated. Although the values are mildly elevated, I would consider this test given her history of IMHA.
Gabapentin: 5-10 mg/kg PO. Given 2-3 hours before the procedure, gabapentin will provide sedation and help facilitate the placement of the catheter.
Cerenia: 1 mg/kg IV. Please dilute 1:3 with 0.9% saline.
Hydromorphone: 0.05 mg/kg IV. This dose may be repeated if the patient is reacting to the surgical stimulus. I prefer to start with a lower dose of hydromorphone with older patients as they can become very sedate with higher doses.
Propofol: 4 mg/kg IV (to effect).
Please provide supplemental oxygen (100 %) via face mask for 5 minutes before induction. It is important that the face mask remains on the patient’s face through the induction period to prevent hypoxemia if the patient becomes apneic.
Isoflurane: 1.3-1.8 %
Sevoflurane: 2.4-3.0 %
Isotonic crystalloid fluids – 3 mL/kg/h
MONITORING: pulse oximetry, ECG, noninvasive blood pressure, end-tidal CO2 and temperature
For intraoperative bradycardia (Heart Rate < 60 bpm), I would consider giving Atropine (0.01-0.02 mg/kg IV) OR Glycopyrrolate (0.005-0.01 mg/kg IV).
Given the size of this dog, intermittent positive pressure breaths will need to be administered to prevent atelectasis from developing during surgery.
Bupivicaine (0.5%): 1 mg/kg.
This local block can be performed during closure of the incision.
As mentioned, the dose of Hydromorphone may be repeated as needed.
Given her elevated liver values, I would not administer or prescribe NSAIDs for this patient.
Please continue to monitor the patient with pulse oximetry in the postoperative period for 30 minutes. If her SPO2 reading falls below 95%, please provide supplemental oxygen via face mask.