How to Actually Use Small Animal Anesthesia by Diane Mckelvey in a Clinical Setting
The textbook itself is dense. It's organized as a reference work rather than a quick read, which is fine if you know where to look but annoying if you need something immediately. Mckelvey's approach covers the standard premedication protocols, induction techniques, and maintenance phases for dogs and cats, but it assumes you already have baseline knowledge. It doesn't hold your hand through the fundamentals. That said, it remains one of the more practical references available for small animal practice because it stays grounded in what actually happens on the table rather than theoretical ideal scenarios. The book really shines in its pharmacology sections. The drug interactions chapters are where most other texts cut corners, and Mckelvey does not. She lists the specific dosages, the routes, and the expected timeframes. For example, the section on combining ketamine with medetomidine gives you the exact concentration ranges and notes when hypotension becomes a real risk versus when it's just a paper finding. I spent about two weeks working through the pharmacology chapters cover to cover when I started building my own clinic's protocol binders. It took me roughly 40 hours total, but having those pages pulled together changed how we handled geriatric patients with unknown cardiac status. One thing people miss about this book is the chapter on monitoring. Most practitioners treat monitoring as a checkbox exercise, but Mckelvey walks through what each parameter actually tells you and, more importantly, what it doesn't tell you. EtCO2 readings can look normal while a patient is quietly becoming hypothermic. Pulse oximetry is unreliable with poor perfusion, which happens more often than you'd think in cats under propofol induction. The book points this out directly. I stopped relying solely on pulse ox after a case where the SpO2 read 98% right up until the patient went into cardiac arrest from undetected hypovolemia. The monitor was working fine. The reading was just misleading.
Another section worth sitting with is the anesthesia record format. Mckelvey provides a structured template that tracks vitals at specific intervals. When I implemented this at my clinic, I found that the act of writing numbers down every five minutes during the first hour caught three separate patients who were developing hypotension before they became clinically obvious. That might sound trivial, but it's the difference between catching a problem early and discovering it when the patient is already bradycardic. We switched from informal note-taking to her template format and saw a noticeable reduction in emergency interventions during the intraoperative period within the first six months. Here's a specific edge case from my own experience that the book doesn't fully address. We had a 14-year-old Maine Coon cat that needed a dental procedure. The standard medetomidine-ketamine-xylazine combination caused severe hypertension and tachycardia, which was unexpected for a geriatric cat that should have been sensitive. We reversed with atipamezole but the hypertensive crisis didn't resolve quickly enough. I ended up using IV acepromazine at a very low dose to counteract the alpha-stimulant effects, which isn't something Mckelvey covers directly. It worked, but I wouldn't have known to consider that combination without understanding the receptor-level pharmacology that the textbook explains thoroughly. The workaround required reading between the lines of her drug interaction tables and applying basic veterinary pharmacology principles to get the physiology right. The book has limitations. The sections on exotic species are thin, which makes sense given the title but still frustrates practitioners who see rabbits and ferrets regularly. There are also no images of actual monitoring equipment setups, which would help beginners visualize what a proper anesthesia circuit looks like. The drug dosages are given in mg/kg ranges rather than fixed doses, which means you still need to do calculations or reference additional material for specific case planning.
Another gap is the lack of discussion around emergency drug protocols and crash cart setup. Mckelvey mentions resuscitation briefly but doesn't walk through the decision tree for what to administer first in different arrest scenarios. For that, you'll want to supplement with a resuscitation guide or your clinic's emergency protocol. The textbook is strongest as a pharmacology and physiology reference, not as an emergency handbook. If you're looking for a copy, the book is widely available through veterinary textbook retailers and used book sites. Mckelvey has released updated editions over the years, so check the publication date if you're buying used. The core content doesn't change drastically between editions, but newer ones include more recent drug formulations and safety data. A current edition will have information on drugs that weren't available when the earlier printings came out, like certain newer sedative combinations that have become standard in the last decade. For anyone running a small animal practice, this reference earns its place on the shelf. It's not glamorous reading. It's not easy reading either. But when you need to understand why a particular drug combination might cause hypotension in a dehydrated patient, or what to adjust in an opioid protocol for a cat with hepatic insufficiency, the answers are in there. The practical value comes from understanding the physiology behind the recommendations, not just memorizing dosages.
Get the Full Details
