A common mistake with preoxygenation and brachycephalic dogs

How many veterinary professionals does it take to properly preoxygenate a brachycephalic dog? Amanda Shelby, RVT, VTS (Anesthesia; Analgesia), breaks it down and explains a common mistake practitioners make.

Transcript

Amanda Shelby, RVT, VTS (Anesthesia; Analgesia): Hi, guys—it’s Amanda Shelby back again here to talk about another session I’ll be giving at Fetch Charlotte, and then, hopefully, it will be available on demand for your viewing at a later time. If you couldn’t join me in person, this one is going to be about breaking cephalic breeds: how you can optimize their experience and anesthesia, as well as providing them adequate analgesia. Keep in mind—it’s more than just them not being able to breathe. Well, a lot of them have heart concerns, eye concerns, you know, those droopy eyelids and tropion things like that, so lubing becomes important. Orthopedic concerns, their body condition scores not necessarily ideal—even if it’s ideal for them and their breed standard—they have GI concerns, obviously, that make the airway even more compromised. So: a lot of things—skin concerns; placing a catheter is even stressful in them.

So, there are so many considerations when we go to anesthetize a brachycephalic. You attend this talk, you listen to this talk, and my key takeaways are going to be increasing your level of comfort when managing these patients; ensuring you’re mitigating against any increased risk associated with them in the anesthetic, peri‑anesthetic phase (pre, during, and post—all the way out the door to recovery); and then really giving you some tools to help minimize their already increased risk during and after anesthesia. So—that’s the hope—that you walk away a little more confident in providing them outstanding anesthesia, with appropriate analgesia, and optimizing their outcome in the brachycephalic patient.

Okay, everybody—I know we know with brachycephalics we preoxygenate. But here’s a common mistake people make with pre‑oxygenation: preoxygenation is most effective for a minimum of at least 3 minutes, up to the point of intubation. That means that it might take 3 people to intubate this brachycephalic patient—a restrainer, a person performing the intubation, and, if the restrainer can’t comfortably hold the oxygen mask appropriately on the face of the patient, then a third person to do that—and it’s up to the point of intubation. As soon as you take that oxygen mask away, the benefits start to subside. So, again, that’s just a common mistake and one key concept that you’ll get from attending this presentation.

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