Good Afternoon!

Consider administering gabapentin 10 mg/kg PO 2-3 hrs before surgery for sedation. This will help facilitate catheter placement and reduce the stress response of the patient.

Anesthetic plan:
Cerenia 1 mg/kg IV
Buprenorphine 0.02 mg/kg IV or hydromorphone 0.05 mg/kg IV
Propofol or alfaxalone 4 mg/kg IV
***Pre-oxygenate for 3-5 mins before induction

Even thought the patient has exhibited seizure-like behavior during sleep, I would not include a benzodiazepine like diazepam or midazolam in this protocol. These drugs can promote prolonged sedation or hyperexcitability/agitation in the recovery period. They are reversible with flumazenil IV, however given that this patient has not had multiple grand mal seizures I do not feel it is necessary to administer them.

Maintenance: Isoflurane(1.3%) or sevoflurane (2.3%)

Dental blocks:
Bupivicaine or ropivicaine 2 mg/kg total. Good local anesthesia will help lower the amount of inhalant required for the procedure and maintain normal blood pressure.

Fluid therapy: 2 mls/kg/hr with a balanced crystalloid solution.

Blood Pressure Management: dobutamine or dopamine 3-15 mcg/kg/min can be administered as a constant rate infusion for low blood pressure. I would avoid fluid boluses unless the patient is clinically dehydrated. A lower heart rate (HR <80 bpm) can be treated with atropine 0.01-0.02 mg/kg IV.

Post-operative pain management:
Buprenorphine 0.01 mg/kg IV (if needed)
Carprofen 2.2 mg/kg SC or Meloxicam 0.1 mg/kg SC.
The elevated Alk Phos value (507 IU/L) is not very specific for fulminant liver disease thus I would consider at least one dose of NSAIDs post-operatively and a three day course orally for pain relief.