AUSTRALIAN BUSINESS AIMS TO CONTINUE TAKING PET ANESTHESIA TO NEW LEVELS

This article first appeared in Standard & Poors (S&P) Global Agribusiness Connect Daily Newsletter on Friday 8th December 2023

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Darvall has been looking to instil innovation in the pet anesthesia sector for many decades. S&P Global’s head of animal health Joseph Harvey spoke to the Australian firm’s chief executive Colin Dunlop about how this evolution has played out in recent years.

Colin Dunlop pointed out 20-30% of income at a veterinary hospital tends to be generated from an anesthetized animal. These procedures are often for the oldest and highest risk pets.

Dr Dunlop is an experienced veterinary anesthesiologist, who was previously president of the American College of Veterinary Anesthesia and Analgesia. He also pointed out the mortality risk of anesthesia for animals under 20kg is about 500 times higher than for humans.

Dr Dunlop stated: “It’s a high-risk procedure and it really is a fundamental issue. I think investment in anesthesia equipment is relatively lop-sided to the value it generates in the vet hospital. About 80-85% of pets are less than 10-15kg and more than half of those are below 5kg. Most of the equipment and techniques that get used are designed for 70kg people. We’ve known for a long time the way we do anesthesia is built around adult humans. It is really our goal to bring better quality and more reliable anesthesia to pets with low gas flows and lower emissions.”

He founded Advanced Anaesthesia Specialists, now known as Darvall, in 1995 as a supplier of pulse oximeters and other equipment. Innovation has always been on the agenda of Darvall – it has spent 15% of its annual sales on R&D over the last two decades, while remaining profitable. The firm received a grant from the Australian government in 2012 to help bring high-quality innovation to veterinary anesthesia. This marked a shift in strategy for Darvall, which started to seek R&D collaborations with third parties. Dr Dunlop started working with experts from fields such as engineering and electronics to develop next-generation anesthesia equipment that could be used on small animals. At the same time, the firm’s development was aided by the ongoing improvement in electronics.

The result was the company’s anesthesia delivery system, which came on the market in 2015 and became its lead platform for clinical anesthesiology. The platform has three components: a heated smooth wall tubing system, which warms the gas delivered to patients to prevent hypothermia; a low-flow and low-resistance rapid response rebreathing anesthesia circuit for patients from 2kg to 80kg that can recycle exhaled breath (also helping to reduce the risk of hypothermia); and a vaporizer specifically engineered for veterinary patients and accurate to the low gas flows used in small animals.

The Darvall technology can also help to reduce environmental impact. The rebreathing anesthesia circuit cuts the release of environmentally harmful anesthetic gas into the atmosphere by up to 90%.

Dr Dunlop noted: “We knew the system would be better than what was already out there but we didn’t know by how much it would be better, even for 1-2kg animals.”

The business now supplies this equipment and its wider portfolio all over the world. While the firm’s systems are sold in Australia, North America, Europe, Asia and the Middle East, Darvall has aspirations to further push its geographic boundaries. Dr Dunlop noted the company’s growth is being supported by the increasing prominence of sustainability and animal welfare topics during recent years.

While there are around 10 major anesthesia equipment suppliers in the human health sector, Dr Dunlop claimed Darvall is the only business of its kind operating in the veterinary industry, offering R&D, manufacturing and training. Many veterinary hospitals and clinics still use human anesthesia systems and, because there is no regulatory body governing the approval of technology in this field, Dr Dunlop suggested there is a lot of “low-end equipment” in this market.

Low-flow system

Darvall is an exponent of low-flow anesthesia. Traditional veterinary anesthetic techniques in small animals have used relatively high fresh gas flow rates that are well above the metabolic requirements of pets. This is not only highly wasteful of oxygen and inhalational anesthetic agents but also unnecessarily costly. These procedures can expose the veterinary team despite safety systems and are environmentally damaging.

Dr Dunlop claimed low-flow anesthesia enables a reduction in oxygen flow and inhalant agent consumption to less than 10% of the high-flow non-rebreathing systems typically used in patients under 10kg. The delivery of warm gas to the patient rather than the cold gases delivered by high-flow systems can help reduce anesthetic hypothermia, while a reduction in the outflow of inhalation agents from the safety valve enhances team safety and reduces environmental emissions. Dr Dunlop also pointed out low-flow anesthesia can help cut the use of oxygen concentrators, which he said are inefficient and carry high monetary and environmental costs.

Darvall is aiming to bring low-flow anesthesia to practices by increasing uptake of its veterinary-specific technology. Its portfolio features veterinary vaporizers capable of precise and reliable anesthetic delivery, low-volume low-resistance circle absorbers, precise oxygen flow meters and safety valves.

Dr Dunlop stated: “There are several systems available for low-flow anesthesia, but some are not suitable for all patients because of high resistance, slow response to vaporizer changes and the high gas flows required to prevent rebreathing of CO2 in patients below 10kg. Therefore, veterinary teams should be cautious in purchasing low-flow systems, only to find that they do not function effectively and safely in small patients at flows down to 200ml/min.”

Balanced approach

Dr Dunlop said veterinary anesthesia has changed for the better over the last 30 years. However, he also noted there is still room for improvement. He suggested a balance has to be struck when incorporating innovation into vet anesthesia. He believes care must be taken to ensure patient wellbeing is not jeopardized when seeking potential environmental benefits using low-flow anesthesia.

In the past, the safety of pets during anesthesia was measured by survival – keeping the patient asleep and immobile was the priority. More recently, pain management and temperature regulation have gained prominence. Other new considerations include the safety and welfare of the veterinary team, the environmental impact and sustainability.

Dr Dunlop said all of these issues should not be considered solely from one perspective, as this could be misleading and result in suboptimal outcomes. He noted a balanced approach should be taken to giving equal consideration to the multiple relevant criteria of patient wellbeing, operational efficiency, environmental sustainability and cost-effectiveness.

The chief executive pointed out one of the most critical potential issues in anesthesiology is an animal waking up during surgery – a situation that is very stressful for the staff.

He told S&P Global Animal Health: “The staff need to have confidence that an animal won’t wake up. They need to feel in control of the procedure. Sometimes they can feel like it’s just a leap of faith.”

Darvall set about trying to design improved equipment that would not only help practitioners anesthetize small and geriatric pets in a more successful and methodical way, but also elevate the skill and knowledge in the area of veterinary anesthesia.

Dr Dunlop pointed out another important issue related to pet anesthesia is in recovery, where many small animals suffer from cold and hypothermia. Darvall has strived to invest in heating technology to complement its anesthesia equipment portfolio. The company’s aim is to provide dedicated and easy-to-use technology that empowers vet clinics. Even though the most experienced level of veterinary anesthesiologists have knowledge levels akin to the human health sector, the tiers below – vet technicians and general practitioners – have fewer comprehensive skills in this area, mainly because of their need to be true ‘generalists’.

Dr Dunlop said: “We want to deliver reliability, predictability and simplicity. Our tech is sometimes being used by people with general knowledge and that is something we can help to improve. Tech can really be the bridge between the gap in training.”

Darvall aims to stay up to date with latest trends in the market to aid its credibility and relevance. Dr Dunlop is still a practicing veterinary anesthesiologist – he noted this insight enables him to understand the type of innovation needed to make the lives of veterinary practitioners easier.