Complications secondary to endotracheal intubation in dogs and cats – A questionnaire-based survey among veterinary anaesthesiologists

Postural drainage and high flow nasal oxygen therapy in four cats with decompensated cardiogenic pulmonary oedema

CASE SERIES SUMMARY

This case series describes four cats with decompensated congestive heart failure and fulminant cardiogenic pulmonary oedema (CPE) that did not respond to conventional treatment and oxygen therapy, and subsequently developed hypoxaemic respiratory failure. The cats were anaesthetised to enable endotracheal intubation, manually ventilated with 100% oxygen and postural drainage was performed immediately to evacuate pulmonary oedema. Afterwards, the cats were extubated and transitioned to high-flow nasal oxygen (HFNO). HFNO allowed significant improvement in the respiration parameters without causing clinical complications. In three of the cats, the procedure was successful; duration of HFNO ranged between 4 and 44 h, and they were successfully weaned off the HFNO therapy. One cat required re-intubation due to HFNO-response failure and was ultimately euthanased. Another cat was euthanased 5 days later due to the severity of its underlying disease.

RELEVANCE AND NOVEL INFORMATION

This is the first report describing the combined technique of postural drainage and HFNO in cats with decompensated CPE. This combined technique could be a life-saving option for cats that fail to respond to conventional therapies and for which positive pressure ventilation is not an option.

Detection of Oronasal Fistula Using a Fluorescent Water Passing Test

The confirmation of a connection between the oral and nasal cavities provides a definitive diagnosis for an oronasal fistula (ONF). However, visual detection is difficult in patients with small fistulas. This study examined whether fluorescein sodium could be used to detect small ONFs. The study included 25 dogs that underwent dental examination and had confirmed periodontal pockets at the Amica Pet Clinic, Japan, between 2020 and 2022. Saline containing fluorescein sodium was injected into the periodontal pocket, termed a fluorescent "water-passing test," followed by detection of fluid discharge from the external naris using an examination light. Of the 25 dogs, 13 showed symptoms consistent with an ONF and of these, 12 were positive and one was negative on the fluorescent water-passing test. Of the 12 asymptomatic dogs, 3 tested positive and 9 tested negative on the fluorescent water-passing test. The fluorescent water-passing test enhanced visibility and facilitated the detection of small volumes of the discharged fluid. The results of this study confirmed the fluorescent water-passing test was useful for the detection of small ONFs.

Lidocaine-saturated cotton tip applicator used for laryngeal desensitization resulting in an iatrogenic tracheobronchial foreign body in two cats

Case series summary

Two cats were referred to a veterinary teaching hospital with a cotton tip applicator (CTA) tracheobronchial foreign body (FB) after induction of anesthesia for an elective dental cleaning. In both cases, a lidocaine-saturated CTA, utilized to desensitize the larynx before endotracheal (ET) intubation, broke when introduced into the oropharynx and was subsequently aspirated into the tracheobronchial tree. Both CTAs were successfully removed bronchoscopically, and the cats survived with no short- or long-term complications noted.

Relevance and novel information

Utilizing a lidocaine-saturated CTA to facilitate ET intubation in cats is not well described, and information on the relative risks and benefits of this specific method for laryngeal desensitization is lacking. This retrospective case series is the first to describe a complication of this technique and successful treatment. These cases highlight the risk inherent to using a CTA to desensitize the feline larynx.

Various Endoscopic Approaches for Removal of Proventricular Foreign Bodies in Parrots-Three Case Reports

Although the use of incision-free endoscopy for foreign body (FB) removal in dogs and cats has been extensively documented, its application in birds remains limited. Thus, we present the endoscopic removal of gastrointestinal (GI) FBs from psittacine birds, employing different patient positioning and anesthesia methods. Two blue-and-yellow macaws (Ara ararauna) and a Triton cockatoo (Cacatua galerita triton) were examined. X-ray imaging revealed FBs situated in the proventriculus in each case. The FBs, all identified as feeding tubes, were safely removed using grasping forceps during the endoscopic procedure, and no severe complications occurred. Based on the outcomes of each operation, the most suitable patient position may be ventral recumbency rather than dorsal recumbency, with the use of a mask or endotracheal intubation, depending on the anticipated operation time. However, a larger number of cases would be necessary to confirm the optimal patient positioning and anesthesia method.