There are so, so many things that we take for granted. The sun, the sky and the sea. Walking, talking and breathing. Reading this column every week in the Greenock Telegraph. Falling asleep and waking up.

But sometimes we worry. Especially if falling asleep and waking up is associated with general anaesthesia.

Many of our pet owners are understandably concerned about the risks posed to their animal by anaesthesia and it can be difficult for veterinary surgeons to accurately quantify them.

We know, for example, that in humans there will be around one unexpected death for every 100,000 anaesthetics (0.001 per cent). Sounds pretty good. Unless you are the one, of course.

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Unfortunately, for a variety of reasons, mortality in pets is unquestionably higher. The Confidential Enquiry into Small Animal Fatalities (CEPSAF), carried out in 2008, showed that deaths from anaesthesia and sedation in dogs was one in 601 (0.17 per cent). This rose to one in 419 in cats (0.24 per cent) and one in 72 in rabbits (1.39 per cent).

A more recent study, carried out between February 2016 and December 2022, involving anaesthesia only in 55,022 dogs, found 378 deaths related to anaesthesia (0.69 per cent), with 81 per cent of these mortalities occurring in the immediately post-operative period. (It should be noted here that age and obesity were major contributing factors.)

I hope it will put your mind at rest a little to consider that there have been great improvements in anaesthetics, sedatives and pre and post-operative monitoring since then, so I expect current figures will be much more favourable. Horse owners will not be surprised that anaesthetic deaths in equines, even if very risky colic surgery is excluded, average around one in every 90 (1.1 per cent).

Neil McIntosh says anaesthetics in animals can't be made completely risk-free - but that the benefits must always be considered alongside the risks.Neil McIntosh says anaesthetics in animals can't be made completely risk-free - but that the benefits must always be considered alongside the risks. (Image: Mirko Sajkov/Pixabay.com) The sad fact of the matter is we cannot make anaesthesia for animals completely risk free, despite all our many and varied efforts. Hidden illness (especially in rabbits), gastro-oesophageal reflux (particularly in brachiocephalic breeds), inadvertent pre-op feeding and numerous emergency situations preventing anaesthetic planning all conspire against us.

But in considering the risks, we must also think about the benefits and the downside of not carrying out a particular procedure. I like to think that any proposed anaesthetic must either lengthen the life of the patient or improve its welfare. Or both!

Anaesthetics in themselves don't make patients better, but they do allow procedures to be carried out that can be life-saving. It seems like everything in life is a gamble and we must strive to reduce the odds wherever possible.

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I liken anaesthesia to crossing the road. If you look left and right and keep looking, the risk is reduced. Add traffic lights or lollipop people (they make me cross!) and safety is improved. The busyness of the road must be taken into account, too.

I was once at a meeting when a specialist anaesthetist asked the 50 vets that were present if any had experienced an unexpected anaesthetic death in the previous year. Four people raised their hands. When he enquired who had seen an unexpected road traffic collision death, we all put our hands up.

He nodded, and said: "Remember, you can't get run over while you are anaesthetised." He made a valid point.