ANESTHESIA FOR BRACHYCEPHALIC BREEDS Talking Pointscvpba.org/wp-content/uploads/2017/09/Brachycephalics.pdf · ANESTHESIA FOR BRACHYCEPHALIC BREEDS Talking Points ... Epiphora Dental

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Sheilah Robertson Senior Medical Director Lap of Love Veterinary Hospice

ANESTHESIA FOR BRACHYCEPHALIC BREEDS Talking Points

Why are they so popular?

Welfare issues

Anesthesia risks

Anesthetic techniques

RANK BREED

1 LABRADOR RETRIEVER

2 GERMAN SHEPHERD

3 GOLDEN RETRIEVER

4 BULLDOG

5 BEAGLE

6 FRENCH BULLDOG

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Why are brachycephalic dogs so popular?

The (British / English) Bulldog

1800’s

Today

Breeding for Extremes

BULLDOG GERMAN SHEPHERD

Health issues

Breathing

Risk of heat stress*

Skin, Eyes

Aspiration pneumonia

Arthritis

Pulmonic Stenosis

>80% born by C-section

* Largest number of airline transport deaths

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Problems begin early

We can fix it.....

Weight loss

Soft palate

laryngeal saccules

Nares

Skin folds

Heart surgery

Screw tail

Keratitis

Epiphora

Dental disease

Dystocia

Skin infections

Facial dermatitis

Brachycephalic airway syndrome

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VARIABLE

mmHg

BD CONTROL

PaO2

PaCO2

PCV

SAP

MAP

DAP

86

36

48

178

123

95

100

33

44

153

108

83

Risks

Airway management

Regurgitation

Vomiting

Aspiration

Tracheal size

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Laser surgery

Handling

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Premedication Prokinetics

Metoclopramide Cisapride

?Sedation

Opioid

Butorphanol

Nalbuphine

Acepromazine

0.01-0.03 mg/kg

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IV access

1

23

IV access Pre-oxygenate 3 minutes

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Am J Vet Res 2009

Time to desaturation < 90%

Room air: 69 ± 10 seconds

Oxygen: 298 ± 42 seconds CaO2 = [1.34 x Hb x SaO2] + 0.003 x PaO2

Love & Kline

Altered pharmacokinetics

Reduced blood volume

Hypoventilation

Hypoxia

Cardiac work increased

Inflammatory response

Boveri et al

Medetomidine + butorphanol

PROPOFOL

NORMAL WEIGHT

2.24 ±0.53 mg/kg

OVERWEIGHT

1.83 ±0.36

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Induction

Propofol

+ midazolam or diazepam

Thompson & Rioja 2016

Panti et al 2016

Equipment

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LARYNGOSCOPE

Maintenance

Additional drugs

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Positioning

Monitoring

Ventilation?

99

Airway swelling

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Analgesia

NSAIDs (if no steroids used)

Local blocks

Locoregional blocks

Opioids

RECOVERY

12

3

4

5

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What breed is this?

Normal Affected NT

Courtesy of Dr. Bryden Stanley

NTUAS

https://cvm.msu.edu/

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QUESTIONS