July 30, 2025 • 19 mins
Hypothermia during anesthesia represents one of veterinary medicine's most common yet preventable complications. While warming methods abound, which ones actually work? Dr. Rachel Kreisler and veterinary students Mahtab Khanezarrian and John Boules join us to challenge conventional wisdom and share evidence-based solutions.
Their groundbreaking research reveals something surprising: those cotton toddler socks commonly used in clinics provide absolutely no benefit for maintaining feline body temperature during procedures. Instead, their carefully designed "kitten mittens" made from down blanket material demonstrated remarkable effectiveness, keeping cats up to 1.2°F warmer with passive insulation alone. When low-voltage heating elements were added, temperature preservation improved even further.
The science behind this breakthrough centers on redistribution hypothermia - the averaging of warmer core blood with cooler peripheral blood during the critical first 45 minutes after induction. By focusing protection efforts on the extremities rather than just the trunk, veterinarians can make a meaningful difference in patient outcomes. The research team shares practical insights about preparation timing, environmental temperature management, and pre-warming considerations that can be implemented immediately in practice.
Looking ahead, Dr. Kreisler discusses promising new materials that may offer superior insulation while addressing the practical challenges of sanitation and reusability in clinical settings. Whether you're working in a standard veterinary practice or a specialized setting like MRI where warming options are limited, this episode delivers immediately applicable knowledge to enhance patient care. Listen now to transform your approach to feline temperature management during anesthesia, and discover why evidence-based medicine matters for even the most routine procedures.
JAVMA article: https://doi.org/10.2460/javma.25.02.0095
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Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Speaker 1 (00:00):
From the makers of vet-recommended Greenies dental
treats comes an easy way tosupport your dog's wellness.
Greenies Smart Essentials dryfood delivers complete, balanced
nutrition with science-backedrecipes.
Greenies Supplements, developedby a team of PhD animal
nutritionists, offers options tohelp support healthy joints,
(00:22):
digestion and more, Whether it'smealtime or mobility support
Greenies helps you care for yourdog from the inside out.
Learn more at Greeniescom.
Speaker 2 (00:35):
You're listening to Veterinary Vertex, a podcast of
the AVMA Journals episode.
We chat about how insulatingthe extremities of cats with
highly insulating materialsduring anesthesia reduces core
temperature decline, withadditional benefit from active
warming, with our guests RachelKreisler, matab Kanazarin and
John Boulis.
Speaker 3 (00:57):
Welcome listeners.
I'm Editor-in-Chief LisaFortier, and I'm joined by
Associate Editor Sarah Wright.
Today we have Rachel, john andMatav joining us.
Hey you guys, thanks so muchfor being here with us today.
We know a couple of you are vetstudents and very busy time of
the year, so really appreciateyour time today.
Speaker 2 (01:15):
Thank you for having us.
Speaker 4 (01:16):
Yeah, thank you for having us, it's not a problem.
Speaker 2 (01:19):
All right, let's dive right in.
So, rachel, you're a repeatguest on the podcast and we're
so excited to be chatting withyou today about cats.
So your Jabna article discusseshow covering the extremities of
cats undergoing anesthesia withhighly insulating materials
slows the core temperature.
Can you share with ourlisteners the background on this
article?
Speaker 5 (01:37):
Sure Thanks.
So I was.
This goes back actually acouple of years.
I was curious about theinsulation of extremities
because I'd noticed that a lotof clinics use cotton toddler
socks during anesthesia tosupport the maintenance of the
core body temperature.
And this really surprised me,because during the first 45
minutes or so followinginduction of anesthesia, the
(01:59):
greatest contributor to the dropwe observe in core body
temperature is actually just theaveraging of the warmer blood
from the core with the coolerblood from the extremities.
So the fancy term for this isthe redistribution hypothermia,
and for the most part heat's notbeing lost to the environment.
It's just again this sort ofaveraging of cooler and warmer
blood as the arteriovenousshunts go offline because of the
(02:21):
anesthesia.
And so it seemed true,especially for our cats.
They're furry, so they'reprobably not losing as much to
the environment as compared topeople.
They've got fur, so there'sless radiant loss and things
like that.
So a couple of years ago we rana study to see if cotton toddler
(02:41):
socks helped maintain core bodytemperature, and it turned out
they didn't help at all, noteven a little bit, not even a
fraction of a degree.
And in that same study we alsolooked to see if low voltage
heating elements inside thecotton toddler socks would help,
and they did, but it was onlyabout half a degree Fahrenheit
sort of at the end of the day,so not very impressive.
(03:03):
So I guess for all that work wewere like definitely there's no
reason to use cotton toddlersocks.
But when we were writing up ourmanuscript we were of course
making sure we looked at otherstudies and there was one that
used bubble wrap on theextremities of cats and also
covered their thorax, and theydid seem to find a difference.
(03:24):
But their cats didn't look likeour cats in terms of you know,
our patients are prepped at anaverage of 11 minutes and these
guys took about an hour and theyactually were hitting the
surgical table between 94 and 97degrees Fahrenheit, and that's
just not similar to us at all.
So we decided to run this studyand see if using better
(03:46):
insulating materials might makea difference.
So our first step was to run anin vitro study to determine the
best insulating materials, andI'll let Matab tell us a little
bit more about that.
Speaker 6 (03:58):
Yeah, so we warmed up four 500 milliliter lactated
ringer fluid bags in the foodwarmer and we actually used
these like barbecue probes tomeasure the temperature on the
inside to just for our whole,because it was very nice, it had
a online like portal or sentall of the data so we're able to
(04:22):
measure every minute to see howeverything was insulating.
And we used differentinsulating materials like bubble
wrap, wool, socks, and we usedown blankets and we did these
trials with nine differentvariations of materials and
thicknesses three times and wefound that the two layers of the
(04:44):
down blanket uh performed thebest and that's what we used to
make the kitten mittens and weuh the mittens were used to like
passively insulate theextremities of cats and some of
them.
We sewed in active warmers andthey're low voltage heating
(05:05):
elements and those had likewires that we set up and
sometimes they had batteries,sometimes we had to find an
outlet, and so we compared thepassive without the heating
elements and the active with theheating element to just our
control group that got truncalone.
Speaker 4 (05:22):
Yeah, and just to add on to that a little bit, the
heated mittens worked prettywell, with the lowest recorded
temperature being 1.9 degreesFahrenheit warmer than the
controls, so we did see a littledifference there.
Speaker 6 (05:38):
Yeah, and the passive mittens worked pretty well too.
They had ended up being up to1.2 degrees Fahrenheit warmer
than our control group and, likeI said, they didn't have the
wires, so they were just alittle easier to use, especially
if you weren't next to a powersource or forgot your batteries
somewhere.
Speaker 4 (05:58):
There were also a few other things that played an
important role as well that wetried to look at, the first
being the temperature that thecat started at, so initial
temperature of the core at thetime of induction.
Also the temperature of theenvironment, whether it be the
OR or the prep area beforeheading into surgery and, not
(06:21):
surprisingly enough, the actualduration of anesthesia how long
each surgery took, how long eachpatient was receiving drugs and
under anesthesia.
One other factor was weightthat we looked into, but
surprisingly enough for oursample size, weight was not that
significant.
Speaker 2 (06:40):
One thing I really loved about your manuscript was
the figure where I think youwere showing like the techniques
you just described, and when wewere promoting this article on
social media too, it was reallycool to see the veterinary
community come together andshare their experience and say,
hey, now there's evidence behindthis and we can implement this
into our practice.
So really great clinicalrelevance, I think, too, with
this article.
Speaker 5 (07:00):
We had a group doing MRIs contact us because they
have very limited ability towarm their patients during the
procedure, and so that wasreally exciting to see that we
could maybe provide some goodevidence for something that
would help their patients.
Of course, I'd go with thepassive insulation, but yeah,
(07:20):
that's more than a degree warmerfor the lowest recorded
temperature.
Yeah, that's, you know, morethan a degree warmer for the
lowest recorded temperature isour precip.
You come up with a cutoff thatyou say this is clinically
meaningful before you run yourstudy, and one degree was what
we had decided on, just as sortof a consensus of what we
thought would be OK.
That's different.
No-transcript, very cool.
Speaker 2 (07:45):
And what are some of the important?
Speaker 5 (07:46):
take-home messages from this article.
In addition, to sort of again,if you're in a situation where
you have some limited heatingoptions, this could be a good
method to incorporate.
But I would say it also focuseson some things like minimizing
the time it takes in prep.
The first 45 minutes is whenthe core temperature decreases
the quickest and once thatheat's lost, so to speak, even
(08:09):
if it's still in the body, it'snot going to kind of get sucked
back into the core.
It will eventually be lost tothe environment.
It's much harder to get it backthan it is to try to keep it in
the cat to start.
So really being thoughtfulabout how your process is and
trying to make sure that you'reminimizing that downtime before
(08:33):
they can make it into surgery,if you're going to insulate the
extremities, make sure you usewell-insulating materials.
So the cotton toddler socksthrow them away or give them to
toddlers they're not helpful forthis purpose and I would say
keep your prep, or and recoveryareas as warm as you can stand.
(08:54):
Obviously you have to beconcerned about human health and
safety, but I've definitelybeen in ORs that I'm very
uncomfortable, uncomfortablycold, and so anytime you have a
greater differential between theambient air and your patients,
you are going to lose heat morequickly.
And then, finally, cats shouldbe as warm as possible before
(09:15):
inducing anesthesia.
So if you run atrap-neuter-return program,
maybe in the Northeast, and yourcats are arriving in the
morning, maybe a little bit onthe chillier side, if you can,
you know, give your patientstime to warm up.
There's some evidence that somesort of like warming of course,
(09:37):
you know, within physiologicappropriate range may be helpful
.
That's a little bit mixed, butdefinitely we don't want to send
them into anesthesia if they'realready cold, if we have a
chance to warm them up first.
Speaker 3 (09:52):
Yeah, really, really great information you guys.
Rachel, this is obviously, asSarah said earlier, a repeat
performance on the dog side ofthings.
What sparked your interest inthis insulation side of
anesthesia?
Speaker 5 (10:05):
Yeah.
So in addition to sort of themyth-busting approach to
inspiration for the cottontoddler socks, I was really
intrigued by a study done in the1990s that looked at active
warming of the extremities ofdogs and that was found to be
more beneficial than truncalwarming.
Bit deeper, there were somestudies that supported warming
(10:29):
the extremities of humansundergoing anesthesia, so I
thought that it was really worthchecking it out because, again,
we know that hypothermia doeslead to poorer outcomes for our
patients, so anything we can doto help support their core body
temperatures should be helpful.
Speaker 3 (10:48):
Yeah, super important for all of our clinicians.
You all have described tons ofreally interesting findings from
the article, but always when wedo these things, something
surprises us.
Was there something in thisarticle that you're like huh, I
didn't expect to find that.
Speaker 5 (11:05):
I didn't think the passive insulation was going to
work.
I didn't think the passiveinsulation was going to work.
I really did not expect to seeit perform almost as well as our
active warming.
I guess in some ways becauseagain there's some thought that
it's less than 20% of that firstdecrease in temperature is
(11:27):
again lost to the environment,and that's looking at people,
which we can.
We have a lot more radiantsurface and and things like that
, and so I I thought maybe wewould see 0.2, 0.5 degrees and,
um, this is why you run, reallyyou do research, because, uh,
what you guess is not always, uh, what the case.
Speaker 2 (11:47):
So that surprised me, rachel.
We're going to start callingyou our MythBuster author,
because last time you were hereyou're talking about vaccine
viral puncture.
Speaker 5 (11:57):
right, yeah, it is the uniting theme of a lot of my
research.
Yes, I can tell.
Speaker 2 (12:05):
So, rachel, what are the next steps for research in
insulation during anesthesia?
Speaker 5 (12:09):
Ah.
So I actually have found ahigh-tech material that I think
may have superior performancefor, even as compared to what
we've looked at before.
So it'd also be more convenientand easier to sanitize or
perhaps even autoclave than thedown.
The down was a littlechallenging to work with.
(12:31):
We actually used Matab's sewingmachine to sew these sort of
mittens, and you know there'sdown everywhere, there's still
down in my car, and so I thinkthat, and you know sort of and
using it repeatedly over time, Ithink would be challenging to
keep it clean.
So I'm kind of excited to takeit to the next step running some
(12:54):
of these fluid bag trialsactually this week and also
making sure it doesn't melt inthe autoclave.
Speaker 2 (13:01):
Very smart and AI is a really hot topic.
We asked you about this lasttime you were on the podcast.
We're going to ask you again doyou see a role for AI in this
particular area of research?
Speaker 5 (13:12):
Yeah, so maybe it wouldn't be my first thought,
but I know that when we were,john Mottob and I were all
sitting around and we pulled up,we looked at all this
literature when we're trying todecide what would we test in
vitro and see right, becauseeven though the fluid bag tests
were pretty easy to run, theystill took time and materials
(13:33):
and things like that.
And so we kind of did our bestguess, guided by this literature
search.
But I think that you know we'veseen in some areas like drug
discovery, or that you knowthere's be a wide range of
suggestions and suggestions youmight not have thought of, sort
of it comes at, I don't want tosay a different way of thinking,
(13:53):
but you know in some ways adifferent way of thinking, and
so I think definitely that couldhave broadened our horizons in
terms of the materials that weconsidered.
Speaker 2 (14:03):
And for those of you just joining us, we're
discussing how insulating theextremities of cats with highly
insulating materials duringanesthesia reduces core
temperature decline, withadditional benefit from active
warming, with our guests RachelJohn and Matab Matab and John as
veterinary students.
Speaker 3 (14:19):
How did any of your training or previous work help
you to prepare to write thisarticle?
We'll start with Matab and thengo to John.
Speaker 6 (14:26):
So in undergrad I worked in a research lab for
almost four semesters and it wascompletely different.
I thought coming into this Iwas like, oh, I've done research
, but it was a very pleasantsurprise to be able to do
research with live animals and,you know, really feel like, okay
(14:46):
, I don't have to wait years forthis research to be important,
like right now.
You know we have.
I left the insulating materialsin our surgery lab.
I was like anyone that wants touse them, please feel free.
You know we have the researchto back it up now and I think
just working as a tech you know,before veterinary school and
(15:07):
being able to have a felinehands-on experience really
helped me.
So, yeah, outstanding.
Speaker 3 (15:14):
How about you, John?
Speaker 4 (15:16):
Yeah, lisa, thank you very much for that question.
In my years of work prior tobeginning veterinary school, I
gained a lot of experience withsurgery and working with
anesthetized patients, so Ideveloped a very good
understanding of basictemperature trends in patients
under anesthesia and I alsodeveloped the understanding of
(15:39):
how important it is to usesupplemental warming devices to
try and prevent further heatloss that we can see.
Speaker 2 (15:46):
Yeah, super cool to see your previous clinical
experiences inform this research, so we look forward to seeing
what maybe you do in the futuretoo.
So this next set of questionsis going to be very important
for our listeners, rachel, whatis one piece of information the
veterinarian should know aboutinsulating the extremities of
cats during anesthesia?
Speaker 5 (16:05):
I would say that it can be helpful, but be sure to
use a highly insulating materialthat's well-fitted.
Speaker 2 (16:12):
Very well said, and Matab and John, what's one thing
clients should know about thistopic.
Speaker 4 (16:17):
I think that one thing clients should know about
this topic is that, when usedcorrectly, these warming devices
can only help their patientswhile under anesthesia.
Speaker 6 (16:28):
Yes, I think client education on hypothermia with
cats is really important, andjust knowing that it's just
going to keep getting better asthe research progresses with Dr.
Speaker 3 (16:38):
Kreisler.
Fantastic, you have a goodmentor.
As we wind down, we like to aska kind of a fun question.
So, rachel, for you, what isthe oldest or most interesting
item on your desk or in yourdesk drawer?
I?
Speaker 5 (16:54):
can say that actually I want to pick somebody else's
desk because I was chatting withanother veterinarian about a
different research project andthey had mentioned that their
mentor had recently cleaned outtheir desk.
They were retiring and theyfound a Parvo sample from seven
years ago and, of course, verycurious, they did find it was
(17:18):
still viable.
Obviously, probably a deskdrawer is an ideal environment
no UV light, climate, controlledbut I just thought that that
kind of rocked my world right,Because we think of it as maybe
up to two years.
But so I guess if you, ifyou've got any Parvo samples in
your desk, be very careful withthem.
Speaker 3 (17:37):
That's a little terrifying.
Yeah For John.
We'll ask if you could have asuperpower, what would it be and
why?
Speaker 4 (17:44):
If I were to have a superpower, my superpower would
probably be super speed, likethe flash or something like that
.
I think having super speed, Ican get anywhere where I want
very fast, and you can also flytechnically run on water.
There's a lot of science behindit and I think I'd be able to
accomplish a lot with it.
Speaker 3 (18:05):
Yeah, some people say like teleport, so that they can
get home to family or go to youknow, relatives or fun concerts
or whatever.
So then we'll transition overto you, matab, with the word
concert.
What was the first concert youattended?
Speaker 6 (18:21):
The first concert I attended, I was actually six
years old and it was my mom'sfavorite band and it was a
Persian band.
And it was a Persian band.
And I remember falling asleepon stage next to the boom box
because I was like this is justpast my bedtime.
I had a great time.
I remember that concertactually pretty vividly for six
years old.
Speaker 3 (18:42):
Wow, if you have trouble sleeping some night,
maybe just put some loud,booming music on.
Exactly.
Speaker 2 (18:49):
That's awesome.
Well, thank you all for beinghere today and also for sharing
your research, too, with Jabma.
We appreciate it.
Speaker 6 (18:55):
Thank you for having us.
Speaker 2 (18:57):
And to our listeners.
You can read Rachel John andMadtop's article on Jabma.
I'm Sarah Wright with Lucid48.
Be on the lookout for nextweek's episode and don't forget
to leave us a rating and reviewon Apple Podcasts or whatever
platform you listen to.
From the makers of vet-recommended Greenies dental
treats comes an easy way tosupport your dog's wellness.
Greenies Smart Essentials dryfood delivers complete, balanced
nutrition with science-backedrecipes.
Greenies Supplements, developedby a team of PhD animal
nutritionists, offers options tohelp support healthy joints,
(00:22):
digestion and more, Whether it'smealtime or mobility support
Greenies helps you care for yourdog from the inside out.
Learn more at Greeniescom.
Speaker 2 (00:35):
You're listening to Veterinary Vertex, a podcast of
the AVMA Journals episode.
We chat about how insulatingthe extremities of cats with
highly insulating materialsduring anesthesia reduces core
temperature decline, withadditional benefit from active
warming, with our guests RachelKreisler, matab Kanazarin and
John Boulis.
Speaker 3 (00:57):
Welcome listeners.
I'm Editor-in-Chief LisaFortier, and I'm joined by
Associate Editor Sarah Wright.
Today we have Rachel, john andMatav joining us.
Hey you guys, thanks so muchfor being here with us today.
We know a couple of you are vetstudents and very busy time of
the year, so really appreciateyour time today.
Speaker 2 (01:15):
Thank you for having us.
Speaker 4 (01:16):
Yeah, thank you for having us, it's not a problem.
Speaker 2 (01:19):
All right, let's dive right in.
So, rachel, you're a repeatguest on the podcast and we're
so excited to be chatting withyou today about cats.
So your Jabna article discusseshow covering the extremities of
cats undergoing anesthesia withhighly insulating materials
slows the core temperature.
Can you share with ourlisteners the background on this
article?
Speaker 5 (01:37):
Sure Thanks.
So I was.
This goes back actually acouple of years.
I was curious about theinsulation of extremities
because I'd noticed that a lotof clinics use cotton toddler
socks during anesthesia tosupport the maintenance of the
core body temperature.
And this really surprised me,because during the first 45
minutes or so followinginduction of anesthesia, the
(01:59):
greatest contributor to the dropwe observe in core body
temperature is actually just theaveraging of the warmer blood
from the core with the coolerblood from the extremities.
So the fancy term for this isthe redistribution hypothermia,
and for the most part heat's notbeing lost to the environment.
It's just again this sort ofaveraging of cooler and warmer
blood as the arteriovenousshunts go offline because of the
(02:21):
anesthesia.
And so it seemed true,especially for our cats.
They're furry, so they'reprobably not losing as much to
the environment as compared topeople.
They've got fur, so there'sless radiant loss and things
like that.
So a couple of years ago we rana study to see if cotton toddler
(02:41):
socks helped maintain core bodytemperature, and it turned out
they didn't help at all, noteven a little bit, not even a
fraction of a degree.
And in that same study we alsolooked to see if low voltage
heating elements inside thecotton toddler socks would help,
and they did, but it was onlyabout half a degree Fahrenheit
sort of at the end of the day,so not very impressive.
(03:03):
So I guess for all that work wewere like definitely there's no
reason to use cotton toddlersocks.
But when we were writing up ourmanuscript we were of course
making sure we looked at otherstudies and there was one that
used bubble wrap on theextremities of cats and also
covered their thorax, and theydid seem to find a difference.
(03:24):
But their cats didn't look likeour cats in terms of you know,
our patients are prepped at anaverage of 11 minutes and these
guys took about an hour and theyactually were hitting the
surgical table between 94 and 97degrees Fahrenheit, and that's
just not similar to us at all.
So we decided to run this studyand see if using better
(03:46):
insulating materials might makea difference.
So our first step was to run anin vitro study to determine the
best insulating materials, andI'll let Matab tell us a little
bit more about that.
Speaker 6 (03:58):
Yeah, so we warmed up four 500 milliliter lactated
ringer fluid bags in the foodwarmer and we actually used
these like barbecue probes tomeasure the temperature on the
inside to just for our whole,because it was very nice, it had
a online like portal or sentall of the data so we're able to
(04:22):
measure every minute to see howeverything was insulating.
And we used differentinsulating materials like bubble
wrap, wool, socks, and we usedown blankets and we did these
trials with nine differentvariations of materials and
thicknesses three times and wefound that the two layers of the
(04:44):
down blanket uh performed thebest and that's what we used to
make the kitten mittens and weuh the mittens were used to like
passively insulate theextremities of cats and some of
them.
We sewed in active warmers andthey're low voltage heating
(05:05):
elements and those had likewires that we set up and
sometimes they had batteries,sometimes we had to find an
outlet, and so we compared thepassive without the heating
elements and the active with theheating element to just our
control group that got truncalone.
Speaker 4 (05:22):
Yeah, and just to add on to that a little bit, the
heated mittens worked prettywell, with the lowest recorded
temperature being 1.9 degreesFahrenheit warmer than the
controls, so we did see a littledifference there.
Speaker 6 (05:38):
Yeah, and the passive mittens worked pretty well too.
They had ended up being up to1.2 degrees Fahrenheit warmer
than our control group and, likeI said, they didn't have the
wires, so they were just alittle easier to use, especially
if you weren't next to a powersource or forgot your batteries
somewhere.
Speaker 4 (05:58):
There were also a few other things that played an
important role as well that wetried to look at, the first
being the temperature that thecat started at, so initial
temperature of the core at thetime of induction.
Also the temperature of theenvironment, whether it be the
OR or the prep area beforeheading into surgery and, not
(06:21):
surprisingly enough, the actualduration of anesthesia how long
each surgery took, how long eachpatient was receiving drugs and
under anesthesia.
One other factor was weightthat we looked into, but
surprisingly enough for oursample size, weight was not that
significant.
Speaker 2 (06:40):
One thing I really loved about your manuscript was
the figure where I think youwere showing like the techniques
you just described, and when wewere promoting this article on
social media too, it was reallycool to see the veterinary
community come together andshare their experience and say,
hey, now there's evidence behindthis and we can implement this
into our practice.
So really great clinicalrelevance, I think, too, with
this article.
Speaker 5 (07:00):
We had a group doing MRIs contact us because they
have very limited ability towarm their patients during the
procedure, and so that wasreally exciting to see that we
could maybe provide some goodevidence for something that
would help their patients.
Of course, I'd go with thepassive insulation, but yeah,
(07:20):
that's more than a degree warmerfor the lowest recorded
temperature.
Yeah, that's, you know, morethan a degree warmer for the
lowest recorded temperature isour precip.
You come up with a cutoff thatyou say this is clinically
meaningful before you run yourstudy, and one degree was what
we had decided on, just as sortof a consensus of what we
thought would be OK.
That's different.
No-transcript, very cool.
Speaker 2 (07:45):
And what are some of the important?
Speaker 5 (07:46):
take-home messages from this article.
In addition, to sort of again,if you're in a situation where
you have some limited heatingoptions, this could be a good
method to incorporate.
But I would say it also focuseson some things like minimizing
the time it takes in prep.
The first 45 minutes is whenthe core temperature decreases
the quickest and once thatheat's lost, so to speak, even
(08:09):
if it's still in the body, it'snot going to kind of get sucked
back into the core.
It will eventually be lost tothe environment.
It's much harder to get it backthan it is to try to keep it in
the cat to start.
So really being thoughtfulabout how your process is and
trying to make sure that you'reminimizing that downtime before
(08:33):
they can make it into surgery,if you're going to insulate the
extremities, make sure you usewell-insulating materials.
So the cotton toddler socksthrow them away or give them to
toddlers they're not helpful forthis purpose and I would say
keep your prep, or and recoveryareas as warm as you can stand.
(08:54):
Obviously you have to beconcerned about human health and
safety, but I've definitelybeen in ORs that I'm very
uncomfortable, uncomfortablycold, and so anytime you have a
greater differential between theambient air and your patients,
you are going to lose heat morequickly.
And then, finally, cats shouldbe as warm as possible before
(09:15):
inducing anesthesia.
So if you run atrap-neuter-return program,
maybe in the Northeast, and yourcats are arriving in the
morning, maybe a little bit onthe chillier side, if you can,
you know, give your patientstime to warm up.
There's some evidence that somesort of like warming of course,
(09:37):
you know, within physiologicappropriate range may be helpful
.
That's a little bit mixed, butdefinitely we don't want to send
them into anesthesia if they'realready cold, if we have a
chance to warm them up first.
Speaker 3 (09:52):
Yeah, really, really great information you guys.
Rachel, this is obviously, asSarah said earlier, a repeat
performance on the dog side ofthings.
What sparked your interest inthis insulation side of
anesthesia?
Speaker 5 (10:05):
Yeah.
So in addition to sort of themyth-busting approach to
inspiration for the cottontoddler socks, I was really
intrigued by a study done in the1990s that looked at active
warming of the extremities ofdogs and that was found to be
more beneficial than truncalwarming.
Bit deeper, there were somestudies that supported warming
(10:29):
the extremities of humansundergoing anesthesia, so I
thought that it was really worthchecking it out because, again,
we know that hypothermia doeslead to poorer outcomes for our
patients, so anything we can doto help support their core body
temperatures should be helpful.
Speaker 3 (10:48):
Yeah, super important for all of our clinicians.
You all have described tons ofreally interesting findings from
the article, but always when wedo these things, something
surprises us.
Was there something in thisarticle that you're like huh, I
didn't expect to find that.
Speaker 5 (11:05):
I didn't think the passive insulation was going to
work.
I didn't think the passiveinsulation was going to work.
I really did not expect to seeit perform almost as well as our
active warming.
I guess in some ways becauseagain there's some thought that
it's less than 20% of that firstdecrease in temperature is
(11:27):
again lost to the environment,and that's looking at people,
which we can.
We have a lot more radiantsurface and and things like that
, and so I I thought maybe wewould see 0.2, 0.5 degrees and,
um, this is why you run, reallyyou do research, because, uh,
what you guess is not always, uh, what the case.
Speaker 2 (11:47):
So that surprised me, rachel.
We're going to start callingyou our MythBuster author,
because last time you were hereyou're talking about vaccine
viral puncture.
Speaker 5 (11:57):
right, yeah, it is the uniting theme of a lot of my
research.
Yes, I can tell.
Speaker 2 (12:05):
So, rachel, what are the next steps for research in
insulation during anesthesia?
Speaker 5 (12:09):
Ah.
So I actually have found ahigh-tech material that I think
may have superior performancefor, even as compared to what
we've looked at before.
So it'd also be more convenientand easier to sanitize or
perhaps even autoclave than thedown.
The down was a littlechallenging to work with.
(12:31):
We actually used Matab's sewingmachine to sew these sort of
mittens, and you know there'sdown everywhere, there's still
down in my car, and so I thinkthat, and you know sort of and
using it repeatedly over time, Ithink would be challenging to
keep it clean.
So I'm kind of excited to takeit to the next step running some
(12:54):
of these fluid bag trialsactually this week and also
making sure it doesn't melt inthe autoclave.
Speaker 2 (13:01):
Very smart and AI is a really hot topic.
We asked you about this lasttime you were on the podcast.
We're going to ask you again doyou see a role for AI in this
particular area of research?
Speaker 5 (13:12):
Yeah, so maybe it wouldn't be my first thought,
but I know that when we were,john Mottob and I were all
sitting around and we pulled up,we looked at all this
literature when we're trying todecide what would we test in
vitro and see right, becauseeven though the fluid bag tests
were pretty easy to run, theystill took time and materials
(13:33):
and things like that.
And so we kind of did our bestguess, guided by this literature
search.
But I think that you know we'veseen in some areas like drug
discovery, or that you knowthere's be a wide range of
suggestions and suggestions youmight not have thought of, sort
of it comes at, I don't want tosay a different way of thinking,
(13:53):
but you know in some ways adifferent way of thinking, and
so I think definitely that couldhave broadened our horizons in
terms of the materials that weconsidered.
Speaker 2 (14:03):
And for those of you just joining us, we're
discussing how insulating theextremities of cats with highly
insulating materials duringanesthesia reduces core
temperature decline, withadditional benefit from active
warming, with our guests RachelJohn and Matab Matab and John as
veterinary students.
Speaker 3 (14:19):
How did any of your training or previous work help
you to prepare to write thisarticle?
We'll start with Matab and thengo to John.
Speaker 6 (14:26):
So in undergrad I worked in a research lab for
almost four semesters and it wascompletely different.
I thought coming into this Iwas like, oh, I've done research
, but it was a very pleasantsurprise to be able to do
research with live animals and,you know, really feel like, okay
(14:46):
, I don't have to wait years forthis research to be important,
like right now.
You know we have.
I left the insulating materialsin our surgery lab.
I was like anyone that wants touse them, please feel free.
You know we have the researchto back it up now and I think
just working as a tech you know,before veterinary school and
(15:07):
being able to have a felinehands-on experience really
helped me.
So, yeah, outstanding.
Speaker 3 (15:14):
How about you, John?
Speaker 4 (15:16):
Yeah, lisa, thank you very much for that question.
In my years of work prior tobeginning veterinary school, I
gained a lot of experience withsurgery and working with
anesthetized patients, so Ideveloped a very good
understanding of basictemperature trends in patients
under anesthesia and I alsodeveloped the understanding of
(15:39):
how important it is to usesupplemental warming devices to
try and prevent further heatloss that we can see.
Speaker 2 (15:46):
Yeah, super cool to see your previous clinical
experiences inform this research, so we look forward to seeing
what maybe you do in the futuretoo.
So this next set of questionsis going to be very important
for our listeners, rachel, whatis one piece of information the
veterinarian should know aboutinsulating the extremities of
cats during anesthesia?
Speaker 5 (16:05):
I would say that it can be helpful, but be sure to
use a highly insulating materialthat's well-fitted.
Speaker 2 (16:12):
Very well said, and Matab and John, what's one thing
clients should know about thistopic.
Speaker 4 (16:17):
I think that one thing clients should know about
this topic is that, when usedcorrectly, these warming devices
can only help their patientswhile under anesthesia.
Speaker 6 (16:28):
Yes, I think client education on hypothermia with
cats is really important, andjust knowing that it's just
going to keep getting better asthe research progresses with Dr.
Speaker 3 (16:38):
Kreisler.
Fantastic, you have a goodmentor.
As we wind down, we like to aska kind of a fun question.
So, rachel, for you, what isthe oldest or most interesting
item on your desk or in yourdesk drawer?
I?
Speaker 5 (16:54):
can say that actually I want to pick somebody else's
desk because I was chatting withanother veterinarian about a
different research project andthey had mentioned that their
mentor had recently cleaned outtheir desk.
They were retiring and theyfound a Parvo sample from seven
years ago and, of course, verycurious, they did find it was
(17:18):
still viable.
Obviously, probably a deskdrawer is an ideal environment
no UV light, climate, controlledbut I just thought that that
kind of rocked my world right,Because we think of it as maybe
up to two years.
But so I guess if you, ifyou've got any Parvo samples in
your desk, be very careful withthem.
Speaker 3 (17:37):
That's a little terrifying.
Yeah For John.
We'll ask if you could have asuperpower, what would it be and
why?
Speaker 4 (17:44):
If I were to have a superpower, my superpower would
probably be super speed, likethe flash or something like that
.
I think having super speed, Ican get anywhere where I want
very fast, and you can also flytechnically run on water.
There's a lot of science behindit and I think I'd be able to
accomplish a lot with it.
Speaker 3 (18:05):
Yeah, some people say like teleport, so that they can
get home to family or go to youknow, relatives or fun concerts
or whatever.
So then we'll transition overto you, matab, with the word
concert.
What was the first concert youattended?
Speaker 6 (18:21):
The first concert I attended, I was actually six
years old and it was my mom'sfavorite band and it was a
Persian band.
And it was a Persian band.
And I remember falling asleepon stage next to the boom box
because I was like this is justpast my bedtime.
I had a great time.
I remember that concertactually pretty vividly for six
years old.
Speaker 3 (18:42):
Wow, if you have trouble sleeping some night,
maybe just put some loud,booming music on.
Exactly.
Speaker 2 (18:49):
That's awesome.
Well, thank you all for beinghere today and also for sharing
your research, too, with Jabma.
We appreciate it.
Speaker 6 (18:55):
Thank you for having us.
Speaker 2 (18:57):
And to our listeners.
You can read Rachel John andMadtop's article on Jabma.
I'm Sarah Wright with Lucid48.
Be on the lookout for nextweek's episode and don't forget
to leave us a rating and reviewon Apple Podcasts or whatever
platform you listen to.
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