Plus-Hex CLINICAL
Patient signalment
Table 1. Pre-anaesthetic assessment results.
Species Dog |
|
Parameter |
Result |
Breed |
French bulldog |
Age |
4 years |
Sex |
Female, neutered |
|
|
Heart rate
Respiratory rate
|
80 beats per minute with synchronous and strong peripheral pulses
20 breaths per minute
|
Weight 12.8 kg |
|
Mucous membranes |
Pink and dry |
Body condition score 5 / 9 |
|
Capillary refill time |
< 2 seconds |
ASA physical status classification |
IV / V |
Rectal temperature |
38.6 ° C |
Code status
Presentation
Resuscitate
The patient( not pictured in this report) was presented with a history of progressive increased upper respiratory noise and effort, for further investigation. After medical evaluation, it was suspected that the dog had laryngeal collapse associated with brachycephalic obstructive airway syndrome( BOAS). The dog had been rescued from a puppy farm 3 years before presentation, had intermittent episodes of vomiting and diarrhoea, and had an anal gland cyst treated 3 months previously. No other recent health issues were reported.
Veterinary investigations
On admission, the patient presented with signs of respiratory distress, with severe upper respiratory noise, marked inspiratory effort and an irregular respiratory pattern. An intravenous 22 G catheter was aseptically placed in the patient ' s right cephalic vein, and a constant-rate infusion( CRI) of dexmedetomidine( Dexdomitor, Zoetis) at a rate of 0.5 μg / kg / hour was started to reduce stress. Venous blood gas analysis, packed cell volume and total protein were unremarkable. The patient was scheduled for an airway examination and surgical management of the BOAS under general anaesthesia.
Owing to the patient ' s history of vomiting and the breed-related risk of regurgitation during the anaesthetic, omeprazole 1 mg / kg( Omeprazole, Sandoz), maropitant 1 mg / kg( Prevomax, Dechra) and a CRI of metoclopramide 1 mg / kg / day( Vomed, Dechra) were pre-emptively started intravenously( IV).
On pre-anaesthetic assessment( Table 1), the patient was settled in her kennel and was bright and alert. However, marked upper respiratory stertor and stridor sounds were noted on thoracic auscultation. There was also a mild increase in inspiratory effort. Sinus arrhythmia was noticed on cardiac auscultation in conjunction with the breathing pattern observation.
On the American Society of Anesthesiologists( ASA) physical status classification, the patient was classified as grade IV due to the moderate / severe respiratory signs.
An anaesthetic machine was set up with a circle breathing system and an induction tray was prepared( Table 2).
Table 2. Anaesthetic equipment list.
Equipment
A range of small endotracheal( ET) tubes, 4.5 – 6 mm
Cuff inflator Stylet Laryngoscope and tie
A rigid dog urinary catheter size 6 Fr with a 2.5 ml syringe( without the plunger) connected to a female adaptor of an ET tube size 7.0 mm
Electrocardiogram pads Size 3 blood pressure cuff Eye lubricant
Methadone 0.2 mg / kg( Synthadon, Animal Care) was administered IV and the dexmedetomidine CRI was maintained at 0.5 μg / kg / hour, providing an adequate sedative effect as pre-anaesthetic medication. Preoxygenation using the flow-by technique was provided at 4.0 l / min for 5 minutes and the patient ' s head was kept elevated. Propofol 2 mg / kg( PropoFlo, Zoetis) was given IV to allow examination of the airway and assessment of laryngeal motion, followed by an increment of 1 mg / kg to allow endotracheal( ET) intubation.
On oral examination, an obstructive, small, right-sided laryngeal fold mass was observed, the soft palate was elongated and the laryngeal saccules were everted. The motion of the larynx was observed to be normal.
Volume 40( 3) • June 2025
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