Geriatric Anesthesia: Clinical Considerations for Senior Dogs

Although age alone is not a disease, advanced age can and often does increase anesthetic risk in dogs due to concurrent disease and altered drug metabolism. According to a large-scale study on anesthetic mortality in dogs, the risk of dying during or in the 48 hours after surgery was higher in geriatric dogs (1.8%) than in adult dogs (<0.5%). However, veterinary professionals who take appropriate precautions can minimize this risk so that senior pets get the care they need.

Thoughtful planning, careful drug selection, and meticulous monitoring can help teams manage geriatric anesthesia safely and effectively. Here are a few key considerations for anesthesia in senior dogs.

What does geriatric mean?

Geriatric dogs are those who have reached 75% to 80% of their expected lifespan. However, like people, dogs don’t age at the same rate. While a patient’s age in years matters, physiologic age, as reflected in organ function, metabolic health, and overall resilience, often matters more. 

Geriatric and senior dogs often have several chronic conditions, such as osteoarthritis, cardiac disease, renal insufficiency, or cognitive decline, under concurrent management. However, even apparently healthy older dogs may have subclinical changes and metabolic alterations that impact their anesthetic risk profile.

Workup for geriatric anesthesia in dogs

A general physical exam and blood work are the foundations of a pre-anesthetic workup for dogs of any age. For geriatric pets, additional screening targeted to breed or history-specific risks is warranted to ensure safety whenever possible. 

Suggested additional testing may include:

• Blood pressure screening — Patients with kidney disease and endocrine disorders are prone to hypertension, which should be controlled before anesthesia.
• Thoracic radiographs — Screening radiographs ensure normal heart size and lung appearance in older dogs with normal auscultation.
• ECG and/or echocardiogram — Echocardiogram and ECG are the gold standard diagnostics for evaluating heart function in the presence of a murmur or existing disease.
• Urinalysis — Urinalysis complements blood work and blood pressure to evaluate kidney function and check for occult infections or protein loss before an older dog undergoes a procedure.

Pre-anesthetic screening aims not to rule out anesthesia but to classify each dog’s risk status, identify treatable conditions, and help veterinary teams customize the anesthesia plan to avoid exacerbating health issues.

Geriatric anesthesia drug selection

Geriatric dogs often have decreased hepatic and renal clearance, even when blood work appears normal. These changes, combined with potentially reduced cardiac output, mean that many anesthetic drugs have an increased effect on geriatric dogs. Thoughtful drug selection and conservative dosing can moderate this phenomenon.

Each dog’s anesthetic protocol depends on their specific risk profile. However, experts recommend considering the following tips for safer procedures:

• Take a thorough history of current medications before surgery and at intake to assess for possible drug interactions.
• Reduce sedative dosing and use acepromazine and dexmedetomidine sparingly in dogs with cardiac compromise.
• Monitor closely for respiratory depression after opioid administration.
• Titrate propofol or alfaxalone slowly during induction.
• Minimize inhalant anesthetic administration by using a multi-modal drug protocol, constant rate infusions (CRIs), and local nerve blocks.

Monitoring geriatric anesthesia in dogs

The same monitoring principles used for younger dogs also apply to geriatric anesthesia. Arrhythmias, hypotension, and hypothermia frequently occur in older pets and require intervention by an experienced team member. Comprehensive monitoring should include:

• Capnography
• Pulse oximetry
• ECG
• Blood pressure
• Temperature

Senior dog anesthesia requires more intensive monitoring than younger dogs due to age-related changes. Here are a few things to keep in mind:

• Active warming is critical for dogs with diminished body fat and muscle mass. Start warming senior dogs before their body temperature noticeably drops.
• Intravenous (IV) fluid support helps maintain perfusion and prevent injury to critical, aging organs.
• Teams should carefully move and adjust geriatric dogs under anesthesia to avoid worsening pre-existing joint, back, or neck pain.
• Documentation is critical during geriatric anesthesia, as detailed logs help teams understand adverse events and refine protocols for future procedures.

Geriatric anesthesia recovery in dogs

Geriatric dogs may recover more slowly from anesthesia than their younger counterparts, and can benefit from prolonged support from a dedicated team member. The same study that found an increased risk of mortality in older dogs undergoing anesthesia also found that around 80% of anesthetic-related deaths occurred during recovery or in the 24 to 48 hours after a pet goes home, warranting close observation.

Older dogs may suffer from dysphoria, prolonged sedation, and difficulty maintaining a normal body temperature during recovery. Some tips for helping older dogs recover from anesthesia include:

• Sit with dysphoric patients or administer sedative micro-doses to avoid injury.
• Create a quiet recovery area with adequate cushioning for sore joints.
• Provide good traction on the floor or cage surface.
• Continue active warming and temperature monitoring.
• Continue IV fluid therapy for patients with reduced renal function.

Communicating with pet owners about geriatric anesthesia in dogs

Many clients mistakenly believe that pets cannot safely undergo anesthesia past a certain age. Discuss with pet owners that anesthetic risks in senior pets are often minimal compared to the risks of not performing the necessary surgery or procedure. Inform the pet owner of your pre-anesthetic screening recommendations, monitoring protocols, expected recovery timelines, and possible outcomes so they can make an informed decision based on fact rather than fear.

Geriatric anesthesia is about managing risks, not avoiding medical care that often drastically improves a pet’s quality of life. Using safe medications, such as PropofolVet Multidose, and adjusting doses can help veterinarians treat senior dogs safely and confidently. Contact us or visit our website to learn more about our Pet Care products and how they can help you provide safe anesthesia and sedation to pets of all ages.