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Complications of Anesthesia in Brachycephalic Dogs

  • August 17, 2018 12:36 PM EDT

    We have previously reported on the issue and complications of postoperative vomiting and regurgitation in dogs. More recently we have learned specifically about the incidence of this problem and other anesthetic risks in brachycephalic as compared to nonbrachycephalic dog breeds.

    Upper airway obstruction is a frequent complication in many brachycephalic dog breeds due to the anatomic abnormalities seen in many of these animals including stenotic nares, elongated soft palate, hypoplastic trachea, etc. As such, a commonly held belief is that “squashed or smush-faced” dog breeds are at a higher risk for complications associated with anesthesia, as airway compromise is more likely to develop and result in decreased oxygenation of the patient. Until recently evidence and statistics to support that belief (the increased risk of anesthesia) was lacking. 

    Complications in the intra- and post- anesthetic periods can be minimized through a variety of practices (standards of care) including the use of balanced anesthetic drug protocols and monitoring of patients including their heart rate and rhythm, respirations, core body temperature, and blood pressure. Additionally, it is common practice to keep brachycephalic dog breeds intubated as long as possible during anesthetic recovery to ensure a patent airway and prevent aspiration in the event of vomiting or regurgitation.

    A study was undertaken to compare the incidence of perianesthetic complications and risks of general anesthesia in a large group of brachycephalic and nonbrachycephalic dogs, and findings were recently published.  As has been shown previously, longer duration of anesthesia (compared to a shorter duration) and increasing ASA status was associated with a higher incidence of perianesthetic complications in all dogs.  In addition patients that underwent invasive (vs non-invasive) and orthopedic or radiologic (vs soft tissue) procedures were at a higher risk for complications. Intra- and post- anesthetic complications in all dogs included: hypotension, bradycardia, dysphoria, VPCs, prolonged recovery, stertorous breathing, vomiting, among others (including death).

    In this Specialty Update we focus on new information reported in this study regarding the risk for perianesthetic complications in brachycephalic as compared to nonbrachycephalic dog breeds. This information is helpful for better understanding the relative risk of anesthesia-induced complications (including death) in dog breeds including Boxers, Bulldogs, Pugs, Shih Tzus, Lhasa Apsos, and Mastiffs among others. Discussion also includes the Specialist's Spin and how this information will be applied in her practice as well as considerations for veterinarians and pet owners.  View Now (running time: 9 mins)