The Cutting Edge Veterinary Podcast

STUDENT: Caroline Beninger

FACULTY MENTOR: Dr. Nigel Caulkett

The purpose of this CE is to elucidate existing evidence-based recommendations on routine pre-anesthetic screening bloodwork (SBW) in both human and veterinary medicine. SBW refers to testing that is not indicated by clinical suspicion prior to anesthesia. SBW is challenging to interpret as the pre-test probability (PTP) is low, and statistically 84% of healthy patients will have at least one abnormal value due to chance. Human and veterinary studies have shown SBW rarely identifies unsuspected abnormalities and rarely influences patient management. In both, SBW is not predictive of complications and does not influence patient outcome. Therefore, pre-operative SBW is no longer recommended in human medicine; our recommendations similarly favour targeted testing indicated by history and physical exam. A pre-anesthetic PCV/TS on all patients is recommended as this is the only parameter associated with an increased risk of mortality. SBW may be beneficial in sicker patients (ASA 4-5/E), and older patients provided disease prevalence increases PTP. Value in medicine is critical, and current evidence suggests benefits of SBW do not justify costs in young, healthy patients (ASA 1-2). Client communication and understanding mutual risk tolerance is imperative when SBW is desired for healthy patients in which targeted testing is not indicated.