injectable versus isofluorene anaesthetic

My rabbit Olly is diue to go for a dental at a new vets practice tomorrow morning - we just moved house. I am a bit worried about it because they use a combination of injectable drugs to anaethetise rabbits - Medetomidine, Butorphanol and Ketamine, rather than isofluorene gas (sp?) which is what was used at my old vets practice. I wondered if anyone had any experience of the injectable drugs in their own rabbit - good or bad. I did google the drugs and it seems that they are commonly used with rabbits, I just dont have any expereince of them myself. I need to decide whether to go ahead with the dental at this practice or find another one which uses gas. This is especially important because Olly has lost a lot of weight recently and had a slightly elevated measure of renal function in his blood test - this adds to my concerns about the dental! Thanks.

I would say the safest anaesthetic is the one the vet is experienced and competent with.

Using isoflurane alone to anaesthetise is actually quite stressful for a rabbit, as it has an unpleasant smell. Sevoflurane is said to be better in this respect but is probably not as widely available.

Many vets use a combination of injectable and gaseous anaesthetics. Injectable anaesthetics are particularly useful for dentals because gas anaesthetic need to be delivered via a tube or mask which may get in the way of the vet doing the dental (although it is a good idea to tube a rabbit to deliver oxygen anyway)

To minimise anaesthetic risks I would ask your vet to pre-oxygenate your bunny and would also ask for iv fluids to help support his kidneys. I would also make sure he is as healthy as possible before the surgery. Good pain relief is also essential after a dental to get him eating again as soon as possible.

Also to add that its really hard to do a thorough Dental just using Isoflurane as the Bun keeps waking up as the gas is taken away to access the mouth to do the Dental. So the Bun's major organ systems are put under alot more stress going under/waking up/going under again etc.
Some Buns actually scream on smelling the Isoflurane This does not happen if Isoflurane is combined with injectable GA drugs

Personally I would not feel at all comfortable about a Bun having a Dental with only Isoflurane as the GA.

It would appear I have been under a mis-conception previously then - I had always read that the isoflurane gas was the best and most reliable anaesthetic for buns. My last vets used a combination of injectable anaesthetic and gas for all the procedures they did on my buns - from neuterings to abcess removal - the injectable to sedate / lightly anaesthetise and then the gas to maintain the anaesthetic. I am not absolutely sure what they used for the one dental they did for me - I had just assumed it would be the same protocol, but i will check the form after this. It is possible i did not get the high level of care I thought I was previously - but at least that info has set my mind at rest about my present vets (though i will still be v worried when I actually have to hand Olly over tomorrow!) Thanks for all the info both of you.
Edit - having re-read you posts I see that the combination of injectable + gas is the norm - apologies for not stating fully what my previous vets used. The main difference is that the new vets use ONLY injectable anaesthetics and not isoflurane gas at all. But I remain reassured on that point from your posts. Thanks

I have heard it is the best possible gas but combined with other injectable meds is the best for your bun . If you weigh it up with a dental bun he will die if you dont do it or he could die if you do .

I think the methods used by your previous vet sound fine. With your new vets, I would want to know that they had an aesthethetic circuit available to deliver oxygen and/or isoflurane/sevoflurane if the bunny required it.

My vet anaethetises my dental bun with sevoflurane, but also administers a light sedative first.

My vet used to use Ketamine etc, but the combination of drugs was no where near as safe as the sevoflurane that is now used. I found my dental bun took much longer to come round from the anaesthetic when she was given the ketamine etc.

Now I don't think I would be happy with a bunny being anaethetised using anything other than sevoflurane and a light sedative.

Cerys

I have a chronic snuffly bun who has regular dentals using the above combo and always recovers brilliantly even with her health problems. A reversal agent can be given which helps too. I am very happy with this protocol and have never had a problem.

The protocol chosen should always be a decision based on the individual rabbit e.g.

What age?
What Breed?
What Procedure?
Estimated length of procedure?
Health Status of rabbit (e.g. routine healthy spey or old rabbit with thymoma for thoracotomy?)

to name but a few

Whatever protocol is chosen it should always include pain relief and fluid therapy. for older rabbits and those on long term medication or having frequent anaesthetics, periodic blood sampling is recommended to assess organ function

At my clinic, all protocols are recorded and any individual issues noted for future anaesthetics. Each rabbit recieves an anaesthetic plan drawn up with that individual rabbits requirements in mind

Hope this helps