bull dog caesarian anaesthesia
TRANSCRIPT
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Anaesthesia for English Bulldog Caesarean Section
Rachel Brown Justine Dooey
Stephanie Harmon
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Case Details
6 year old English Bulldog
20 kg bodyweight
Heavily pregnant
2 hours unproductive straining
Caesarian section required
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Main Considerations Brachycephalic
Pregnant
Pups
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Brachycephalic Breed
Brachycephalic Obstructive Airway Syndrome Stenotic nares Elongated soft palate Hypoplastic trachea Everted laryngeal saccules
Increased Risk of Regurgitation and Aspiration
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Effects of Pregnancy on Bitch
Cardiovascular Increased cardiac workload Aortocaval compression → supine hypertension
Respiratory Decreased total lung volume and function Higher O2 demand to CO2 production Rapid desaturation → hypoxaemia
Gastrointestinal Delayed gastric emptying with decreased oesophageal sphincter tone
Neurological ~35% increased sensitivity to anaesthetic agents
Changes in Progesterone and Beta Endorphin levels have Sedative Effects
Haematology Decreased HCT
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Anaesthetic Effects on Pups In Utero
Placental transfer of drugs to pups Cross the blood-brain barrier Respiratory Depression Hypotension Bradycardia
Drug transfer from milk• (Little research in dogs)
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Anaesthetic Aims
Be cautious of drug overdosesDecrease drug exposure timeIncrease drug elimination rateMaintain hydration and blood pressureMaintain oxygenationProvide analgesia without affecting pupsRapid recovery to decrease respiratory
complicationsMaintain airway
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Anticipated Complications
Hypotension Provide I.V. fluids Keep isoflurane concentrations at a minimum
Bradycardia Keep isoflurane at a minimum
Hypoxaemia Provide 100% O2
Hypothermia Bair hugger
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Anaesthetic plan
Try to Avoid Pre-Medication but if Necessary Acepromazine I.M.
0.01mg/kg = 0.2mg= 0.1ml Pethidine I.M.
2mg/kg = 40 mg = 0.8mls Pre-oxygenate 3-5 mins before induction Surgical clip and prep whilst awake in lateral recumbency
Induction Propofol I.V.
4mg/kg = 80mg; 10mg/ml; draw up 12ml Fast Intubation with cuffed tube – smaller ET tube than expected
Maintenance Bain breathing system; Isoflurane and O2 4L/min
Isoflurane MAC decreases 40% in pregnant animals IVFT 10ml/kg/hr = 200ml/hr Hartmann’s
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Analgesia
Midline Local Anaesthetic Block 50% Lidocaine:Bupivacaine Intradermally
4mg/kg = 80mg = 4ml 1mg/kg = 20 mg = 4ml
When Last Pup Out Methadone 0.2-0.5mg/kg 0.4-1ml I.M. Meloxicam 0.2mg/kg = 0.8ml S.C. – One off dose
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Post Operative Care & Analgesia
Bitch Keep ET tube in until fully awake to maintain airway Methadone every 4 hours as needed for pain
1mg/kg = 20mg = 2ml S.C. Send home on Tramadol (not licensed)
2-5mg/kg 2-3 times daily
Pups Assess every 30 seconds Prevent hypothermia Provide 100% O2 Mask or ET intubation if no spontaneous breathing
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References
Vullo, Cecilia, et al. "Anesthetic Management during Cesarean Section in English Bulldogs." Journal of Life Sciences 8.1 (2014): 58-64. http://www.davidpublishing.com/davidpublishing/Upfile/5/27/2014/2014052708753330.pdf
D. Flaherty, Anaesthesia for caesarean section BVMS 4 University of Glasgow Lecture.
PREGNANT TIPS | PREGNANCY GUIDE. (n.d.). Retrieved April 30, 2015, from http://pregnancy.pregnantshop.info/8-week-pregnant-english-bulldog
Pricing for our English Bulldogs. (n.d.). Retrieved April 30, 2015, from http://www.bulldozeenglishbulldogs.com/Pricing.html