Brachycephalic obstructive airway syndrome surgery on a dog with a mass in the laryngeal fold
Brachycephalic obstructive airway syndrome surgery on a dog with a mass in the laryngeal fold
A case study and nursing care analysis
DOI: https:// doi. org / 10.56496 / WUUV6588
Ana Carina Costa, PGCertAVN Anaesthesia and Analgesia, NCert Anaesth, NCert PhysioTech, RVN
ENVELOPE acosta @ rvc. ac. uk
Ana graduated as a veterinary nurse in 2012 and completed her Nurse Certificate in Physiotherapy in 2015, before moving from Portugal to the UK in 2017. She worked at The Queen ' s Veterinary School Hospital in Cambridge, then joined the Royal Veterinary College ' s Queen Mother Hospital for Animals anaesthesia team in 2019, where she has since been working and is part of the pain clinic and cardiothoracic anaesthesia teams. Ana also holds a Nurse Certificate in Anaesthesia and the PGCertAVN in Analgesia and Anaesthesia. She was a board member of the Portuguese Veterinary Nursing Association from 2020 to 2022, has been a speaker at several conferences and is a contributor to The Veterinary Nurses ' Practical Guide to Small Animal Anaesthesia.
Niamh Clancy, Dip AVN( SA), DipHE CVN, DipVN, PGCert VetEd, FHEA, RVN
ENVELOPE nclancy @ rvc. ac. uk
Niamh graduated from University College Dublin in 2011 with a diploma in veterinary nursing, before obtaining an advanced diploma from Myerscough College in 2015 and a postgraduate certificate in veterinary education from the Royal Veterinary College in 2019. She is an anaesthesia nurse at the Queen Mother Hospital for Animals and a Teaching Fellow at the School of Veterinary Nursing at the Royal Veterinary College, where she is also a deputy cocourse director of postgraduate and graduate certificates in advanced veterinary nursing, and develops and leads courses and modules in anaesthesia and analgesia. Niamh is the editor of, and a contributor to, The Veterinary Nurses ' Practical Guide to Small Animal Anaesthesia.
ABSTRACT A female French bulldog was referred for investigation of increased upper respiratory noise and effort. General anaesthesia was scheduled to allow examination of the airway and further treatment. A protocol was created taking into consideration the risk of respiratory distress, the potentially challenging endotracheal( ET) intubation, upper airway obstruction and consequent hypoxaemia.
On airway examination, an obstructive right-sided laryngeal fold mass was noticed. ET intubation was challenging but was achieved with no major problems. The ET tube was removed during excision of the mass, and anaesthesia was maintained with a total intravenous anaesthetic of propofol. Despite flow-by oxygen supplementation, pulse oximetry revealed that the dog was hypoxaemic. The patient ' s trachea was re-intubated and ventilation provided, restoring oxygen saturation.
The surgical and anaesthesia teams evaluated and discussed the risk of upper respiratory obstruction during the recovery period, and the potential need for a tracheostomy. After two attempts to remove the ET tube during the recovery period – during which the patient showed signs of respiratory distress – it was decided to proceed with a tracheostomy. In this case, the surgical and anaesthesia teams worked together efficiently and communicated well to prevent patient mortality.
Keywords anaesthesia, brachycephalic obstructive airway syndrome, upper airway management, total intravenous anaesthesia, gastro-oesophageal reflux
24 Veterinary Nursing Journal