There’s a reason they tell you it’s important not to let your cat eat the night before a surgery or other procedure where kitty is being put under anesthesia. I found out the hard way with Ashton last month during her tooth extraction due to tooth resorption, and it has taken me a while to be ready to talk about it.
The anesthesia guidelines from the American Animal Hospital Association (AAHA) are clear. Cats over 16 weeks of age should not eat or drink overnight if they have morning procedures. This is to reduce risks of vomiting up stomach contents and potentially breathing some of it in while under anesthetic.
Mistake #1
My vet, like nearly every other vet on the planet, has withholding food the night before part of their preoperative instructions.
I like to think of myself as a pretty good vet client. Ashton’s Sleepypod was ready 24 hours beforehand. Her dental was the last thought on my mind as I drifted off to sleep the night before, curled up with her in bed. But I forgot to pick up the water bowls, and I didn’t think to tell my husband that she should not eat the next morning.
I didn’t remember until it was nearly time to leave for the vet. So instead of leaving, I waited anxiously for the vet’s office to start answering their phone so I could confess and reschedule the dental procedure.
Mistake #2
The tech on the phone from the vet’s office asked how much she had eaten. “1.25 ounces.” That’s the regular amount for her raw food breakfast. The tech said that they would do her dental last instead of first to give extra time for her stomach to empty, and it would be fine.
Mistake #3
I could have insisted on rescheduling, but I didn’t. Instead, I took Ashton to the vet for her dental.
Ashton’s Anesthesia
Time drags when you’re waiting, and I spent the morning waiting for a status update on Ashton. When Newton had his dental, a tech at my vet’s office phoned to tell me he was under anesthesia, and she phoned again when he was awake. Not hearing anything made me anxious, so at nearly noon, I called to check on her.
The dental before hers had run long, the tech told me, but they had actually just put her under. I didn’t realize until looking back that there had probably already been problems.
Much more time passed before I got the second call that she was awake again than I expected. I told myself that when Newton has his dental, he only had a tiny tooth removed, and Ashton was having a premolar out and maybe more. That could account for the delay.
When the phone finally rang, I jumped to answer it. The tech told me that Ashton was awake, then gave the phone to the vet, something that didn’t happen after Newton’s dental.
“So we had a little bit of trouble…” Ashton’s vet began.
Trouble Under Anesthesia
If a cat has any stomach contents, they usually lose it when they are premedicated for anaesthesia. Ashton didn’t, so they felt confident to insert the tube into her airway for ventilation. But when they did, fluid unexpectedly came up from her stomach and was visible around the tube.
“She didn’t want to stay breathing when she was under,” Ashton’s veterinarian told me. After they woke her, it appeared that the lower right lobe of her lung had not gotten a lot of oxygen during the procedure. “You’ll want to watch her for coughing for a few days in case she aspirated.”
Coughing after an incident like this could be a sign of pneumonia. Cats, like humans, have an airway to the lungs (trachea) and a tube that carries food to the stomach (esophagus). Those two tubes intersect in the cat’s throat (pharynx) in a way similar how they do in yours.
When a cat is awake, her swallowing reflex causes her to cover the opening of the trachea with her larynx when he eats or drinks, preventing breathing in food or water. But when a cat is under anesthesia, that reflex doesn’t kick in, leaving them vulnerable if they regurgitate stomach contents or have reflux of stomach acids.
One of the things that helps prevent this during anesthesia is your vet’s staff using an endotracheal tube. The tube goes down into the trachea and the cuff near the end inflates like a balloon. The inflated cuff creates a seal to prevent your cat from inhaling anything she shouldn’t, like stomach contents.
Stomach contents making their way down the trachea ends up as a foreign substance in the lungs, and it causes an inflammatory reaction. That reaction is called aspiration pneumonia, and it was my vet warned me I would need to watch Ashton for.
Ashton’s Outcome
Having to wait over four hours to pick up Ashton gave me lots of time to worry. I probably had the world record in worrying by the time I was able to get there and see her again.
When I went to pick her up, the veterinarian walked me through what happened during Ashton’s anesthesia. “We looked, and her trachea was closed up tight.” She assured me they did extra radiographs of her lungs just in case to be sure there weren’t signs of Ashton having aspirated any of that reflux into her airway. The x-rays showed her lungs looking clear.
Finally, the vet tech brought Ashton out. She looked glassy-eyed and was awkwardly affectionate to everything familiar.
While I got her discharge instructions, she kneaded the inside of her Sleepypod. I was so relieved to see her breathing well and feeling all right.
Ashton was on antibiotics for her dental surgery anyhow, but they did double-duty as preventatives for pneumonia. Still, I was on pins and needles for a week, watching Ashton for the slightest cough. I felt fortunate that she was fine.
Lessons Learned
This was a big lesson to me. I don’t care what my vet’s office suggests, if I forget to fast a cat in the future, they aren’t going under anesthesia. I’m going to err on the side of caution and reschedule. It’s the safe thing to do.
Update: Before there are any misunderstandings, I should add that I don’t blame my vet’s office for my decision to bring Ashton in for her dental after she ate. That decision was mine, and it’s why I feel so strongly that people who love cats need to understand the risks so they are sure to do the right thing if they make the mistake of feeding their cat before scheduled anesthesia.
Research and Further Reading
Journal of the American Animal Hospital Association, AAHA Anesthesia Guidelines for Dogs and Cats
Veterinary Anesthesia Specialists, Options for Anesthesia Airway Control in Cats
Cornell University College of Veterinary Medicine, Pneumonia
Summer says
I’m so glad everything turned out all right for Ashton – but I don’t blame you for being so worried!
The Island Cats says
Thank cod Ashton is okay. The mom would have been worried too.
The Florida Furkids says
That had to be super scary. We’re glad Ashton is okay!
The Florida Furkids
Madi and Mom says
Oh my goodness we are so thankful everything turned out ok for Ashton. …
I guess cats can be just like humans. Some humans have a very very slow digestive system.
Thank you for sharing this very important PSA
Extra hugs madi and mom
Random Felines says
“trouble” – the word no one wants to hear from their vet. Glad Ashton is doing well.
Three Chatty Cats says
I’m sorry that happened to Ashton, but I’m glad she’s doing well. And thank you for the warning about fasting and anesthesia!
Buckwheat says
Wow, that’s quite the situation that you all experienced. Glad it turned out ok in the end. I think I’ve been told that water was ok, but always hold food. Ill keep this in mind next time.
da tabbies o trout towne says
ashton, many thanx for sharing this post; we understand why your mom was worried; we would have worried as well, and have in another circumstance, so we know how she felt. we are glad you are doing well and 984 paws up you continue to do so. it was nice that your vet took that extra step to double check your lungs ~~ ♥♥
Katie Isabella says
Thank goodness it turned out well and thank you or this article. I wondered of they were being just too cautious. I am a firm believer in fasting now. Water included!!
Annabelle says
Oh my paw…we are so sorry for what happened to Miss Ashton and Mr Jinx is already purring his hardest for his sweet beauty.
Roberta Diamond says
Thank goodness Ashton is OK! And thank you for telling us about your experience. I’ve certainly learned from it. Like Buckwheat, I’ve been told that it’s OK to let the cat have water before surgery. But now I’m having second thoughts, and the next time my cats ned surgery, I think we’ll avoid water as well as the food.
Brian Frum says
We know you had to be so worried and scared. We are so happy that all is okay with your sweetie Girl.
The Daily Pip says
I am so glad Ashton is OK. I agree always best to follow your instincts.
Mary McNeil says
So glad Ashton is doing ok ! Purrs and POTP for all of you to get things back to normal 1
Mickey's Musings says
What a scary time for you 😮
We are glad Ashton did well and is better now.
Thanks for this important information too!
Purrs Georgia,Julie and JJ
Melissa & Mudpie says
This is one of the most important blog posts I’ve ever read because it’s something I’ve always wondered about yet never asked. “So we had a little bit of trouble…” my heart just about stopped reading those words, so I can just imagine how you felt when you heard it. So, so happy everything is ok for your sweet girl.
Ellen Pilch says
Thank you for this warning. I am glad Ashton is OK, that is scary.
William's Kith & Kin says
OMC, what a scare for both of you! We’re relieved Ashton’s experience ended well, but now it’s time for you to stop blaming yourself. We all learn along the way.
Katie Kat says
So thankful Ashton made it through. I get different instructions from vets all the time before procedure. Some say water ok or nothing after midnight or start fasting at ten. From now on I will start fasting early and no water either. Thanks so much for sharing what happened.
Cathy Keisha says
I”m sorry Ashton had to go through that. I’m glad she’s none the worse for it.
The Menagerie Mom says
This is such a fantastic post. And I am so, so happy that Asthon is doing well after her dental. I used to work at a cat clinic and assisted during procedures, including dentals. I won’t lie, that was one of my least favorite parts of the job. Anesthesia is nothing to bat an eye at, and I’m so glad that you wrote this wonderfully honest post addressing that.
Maxwell, Faraday & Allie says
Excellent post – and SO important.
Marty says it’s probably much more like 6 hours than 12 but they double it to be absolutely certain (cats and people share the same issues).
And depending on the surgery there are different levels of anesthesia. The surgery Marty’s team did had to have the patient VERY FAR under (“just one step away from death” the anesthesiologist working with the team called it) because the patient had to be VERY still. And we move while under anesthesia very much like when we’re asleep!
The deeper it is, the greater the risk of aspiration too.
Connie says
My heart stopped when you said it took you a while to talk about it. I am so sorry that happened. It is the proverbial nine times out of ten delaying surgery to the afternoon is more than enough to compensate for eating breakfast, but it is that one time that reminds you not to take it for granted.
I am so glad Ashton is okay.
Judy Cessna says
I just left my cat at the vet for a teeth cleaning and a possible tooth removal. She knocked over the trash this morning and I am scared that she may have eaten something. Oh my, my heart is racing and I can’t wait until it is time to get her home. Many prayers, please! Thank you!!! <3
Christine says
I’m so happy (for me) that I came across this post. I’m so sorry that you had to worry (to say the least)! I’m bringing my sweet Charlotte in tomorrow morning for a dental cleaning. She’s 14 and very sweet. She’s also very thin (8lbs) and delicate. She’s my life (along with her sister Scarlet). Charlotte had her teeth cleaned several years ago and the vet never suggested she refrain from food or water.
Since then, I’ve been studying every corner of cat’s care. I know now the importance of this! Believe it or not, the vet never said a thing about holding food and water back again! I figured that they had forgotten last time (but what a tragic thing to forget)! I’m very close to cancelling her apt. for tomorrow. I hope that every cat (pet) owner reads your post and treats this error as a life or death deal! Thank you so much! I’m so happy that you have your Ashton! 😻
Elissa says
Thanks for this. I recently had the same thing happen and I insisted on rescheduling, even though I had to pay a cancellation fee and the vet’s office clearly thought I was being silly when the vet had ok’d everything. It was almost the same response from them – that they would do him last. I am so glad Ashton is ok but glad my fear was not unfounded – especially as my kitty is almost 17.
Christina says
Hello,
Thank you for this post. I am terrified about my cat going through a cleaning and extraction in a couple of weeks.
She free-feeds wet food, and I know she will be extremely hungry between 7pm and 8am–the time I need to drop her off. No water would compound the feeling of hunger, I imagine, especially since she has no idea why we are not feeding her.
I should have made her let me brush her teeth.