Species: dog
Breed: French Bulldog
Sex: m, not neutered
Weight: 12.5 kg
Birth date: 2019-08-02 00:00:00
Primary diagnosis: Arythenoid cartilage mass
Situation: post surgery
Time since surgery: > 12 hrs
Recovered from anesthesia: yes
Medical history: The dog was already operated in 2021 because of his BOAS. Now he came to the clinic because he started having more difficulty breathimg since january, with a special inspiratory sound. It happens especially after exercise, but also while sleeping and it gets worse when it is warm. He also doesn't like to be touched at his neck. He is now here for a laryngoscopy. During the laryngoscopy a mass was discovered, they removed it and the larynx got swollen. They had to intubate him and keep him intubated until the next morning.
Medication: After surgery: Ampicillin-Sulbacatm 30mg/kg IV TID, Omeprazol 1 mg/kg IV TID, Cisaprid 0.5 mg/kg Rektal TID, Acepromazine 1x 0.01 mg/kg at 07. (Dexamethason 0.32 ml IV BID the day before filming him post operatively)
Anesthesia: Intervention on 16.05.2024: Laryngoscopy with removal of a mass at the level of the larynx + thorax x-rays. Premedication: Butorphanol 0.2 mg/kg IV, Acepromazine 0.01 mg/kg IV. Induction: Alfaxolon 1 mg/kg IV. Maintenance: Isofluran. (In total 5,8ml of Alfaxolone were given. Intubation was performed using a laryngeal mass guide. After removal of the mass, the dog was aspirated several times and ETT 5.5 was inserted. Throughout the procedure he breathed spontaneously, maintained with isofluran etAA 0.80-0.90, total flow 4 l/min. During removal of the mass, a second dose of butorphanol 0.2mg/kg was administered). Complications: hypotension, hypothermia, pain -> 2x Lidocain 1 mg/kg for the pain. (3 fluid boluses were administered throughout the procedure: 2x 10 ml/kg boluses and 1x 7 ml/kg. 0.5 mg/kg IV dexamethasone was administered at the same time as the mass removal and 0.5 mg/kg of the same drug after the extubation attempt. During extubation, dexamethasone spray was also administered locally. Buprenorphine 0.01 mg/kg and 2x bolus of Lidocaine 1mg/kg IV were given for the pain). Recovery could not be performed because 10 minutes after extubation the dog showed severe swelling of the upper airway. Therefore the dog intubated again. The airway was suctioned again due to the presence of copious blood, the lesion caused by the removal of the mass was swabbed several times with adrenaline-soaked swabs and a gauze pad soaked in the same medication was left inside the patient's mouth for about 40 min (removed before moving to the ips, where the dog remained intubated under observation overnight). 0.5 mg/kg IV dexamethasone was administered at the same time as the mass removal and 0.5 mg/kg of the same drug after the extubation attempt. During extubation, dexmethasone spray was also administered locally. The dog was kept intubated over night and was stable. (He needed twice a Glycopyrrolate Bolus to improve the BP otherwise stable. In the morning he started to be quite awake and needed to get some Propofol Boli to stay intubated. At 7.00 Dexmedetomidine was stopped, at 8.30 Alpfaxalaone was stopped and at 9.15 the dog was successfully extubated. Saturation was fine also withouth oxygen). Wake up phase: postoperative sedation: Acepromazine 0.01 mg/kg. Anaesthesia duration: 565 min. Omeprazole 1 mg/kg and Cisapride 0.5 mg/kg were also administered post mass removal. During the second procedure (thorax x-rays) the dog was stable.
Pain type: acute, nociceptive
Pain origin: Throat (larynx), paws
Estimated pain severity: 10