• 1. Poncet CM, Dupre GP, Freiche VG, et al. Prevalence of gastrointestinal tract lesions in 73 brachycephalic dogs with upper respiratory syndrome. J Small Anim Pract 2005;46:273279.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 2. Poncet CM, Dupre GP, Freiche VG, et al. Long-term results of upper respiratory syndrome surgery and gastrointestinal tract medical treatment in 51 brachycephalic dogs. J Small Anim Pract 2006;47:137142.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 3. Lorinson D, Bright RM, White RAS. Brachycephalic airway obstruction syndrome—a review of 118 cases. Canine Pract 1997;22(5/6):1821.

  • 4. Davies JA, Fransson BA, Davis AM, et al. Incidence of and risk factors for postoperative regurgitation and vomiting in dogs: 244 cases (2000–2012). J Am Vet Med Assoc 2015;246:327335.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 5. Fasanella FJ, Shivley JM, Wardlaw JL, et al. Brachycephalic airway obstructive syndrome in dogs: 90 cases (1991–2008). J Am Vet Med Assoc 2010;237:10481051.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 6. Monnet E. Brachycephalic airway syndrome. In: Slatter D, ed. Textbook of small animal surgery. 3rd ed. Philadelphia: Saunders Co, 2003;808813.

    • Search Google Scholar
    • Export Citation
  • 7. Ree JJ, Milovancev M, Maclntyre LA, et al. Factors associated with major complications in the short-term postoperative period in dogs undergoing surgery for brachycephalic airway syndrome. Can Vet J 2016;57:976980.

    • Search Google Scholar
    • Export Citation
  • 8. Hughes JR, Kaye BM, Beswick AR, et al. Complications following laryngeal sacculectomy in brachycephalic dogs. J Small Anim Pract 2018;59:1621.

  • 9. Cox MR, Martin CJ, Dent J, et al. Effect of general anesthesia on transient lower oesophageal sphincter relaxations in the dog. Aust N Z J Surg 1988;58:825830.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 10. Hashim MA, Waterman AE. Effects of acepromazine, pethidine and atropine premedication on lower oesophageal sphincter pressure and barrier pressure in anaesthetized cats. Vet Rec 1993;133:158160.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 11. Wilson DV, Evans AT, Miller R. Effects of preanesthetic administration of morphine on gastroesophageal reflux and regurgitation during anesthesia in dogs. Am J Vet Res 2005;66:386390.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 12. Gruenheid M, Aarnes TK, McLoughlin MA, et al. Risk of anesthesia-related complications in brachycephalic dogs. J Am Vet Med Assoc 2018;253:301306.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 13. Boesch RP, Shah P, Vaynblat M, et al. Relationship between upper airway obstruction and gastroesophageal reflux in a dog model. J Invest Surg 2005;18:241245.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 14. Riecks TW, Birchard SJ, Stephens JA. Surgical correction of brachycephalic syndrome in dogs: 62 cases (1991–2004). J Am Vet Med Assoc 2007;230:13241328.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 15. Lamata C, Loughton V, Jones M, et al. The risk of regurgitation during general anaesthesia in a population of referred dogs in the UK. Vet Anaesth Analg 2012;39:266274.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 16. Wilson DV, Evans AT, Mauer WA. Influence of metoclopramide on gastroesophageal reflux in anesthetized dogs. Am J Vet Res 2006;67:2631.

  • 17. Punto L, Mokka RE, Kairaluoma MI, et al. Effect of metoclopramide on the lower oesophageal sphincter. An experimental study in dogs. Med Biol 1977;55:6668.

    • Search Google Scholar
    • Export Citation
  • 18. Hughes SM. Canine gastrinoma: a case study and literature review of therapeutic options. N Z Vet J 2006;54:242247.

  • 19. Bersenas AM, Matthews KA, Allen DG, et al. Effects of ranitidine, famotidine, pantoprazole and omeprazole on intragastric pH in dogs. Am J Vet Res 2005;66:425431.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 20. Wilson DV, Tom Evans A, Mauer WA. Pre-anesthetic meperidine: associated vomiting and gastroesophageal reflux during the subsequent anesthetic in dogs. Vet Anaesth Analg 2007;34:1522.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 21. Papich MG. Metoclopramide hydrochloride. In: Saunders handbook of veterinary drugs: small and large animal. 4th ed. St Louis: Elsevier Inc, 2016;520522.

    • Search Google Scholar
    • Export Citation
  • 22. Orenstein SR, Shalaby TM, Decandry SN, et al. Famotidine for infant gastro-oesophageal reflux: a multi-centre, randomized, placebo-controlled, withdrawal trial. Aliment Pharmacol Ther 2003;17:10971107.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 23. Wilson DV, Walshaw R. Postanesthetic esophageal dysfunction in 13 dogs. J Am Anim Hosp Assoc 2004;40:455460.

  • 24. Pearson H, Darke PG, Gibbs C, et al. Reflux oesophagitis and stricture formation after anaesthesia: a review of seven cases in dogs and cats. J Small Anim Pract 1978;19:507519.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 25. Kortgen A, Niederprum P, Bauer M. Implementation of an evidence-based “standard operating procedure” and outcome in septic shock. Crit Care Med 2006;34:943949.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 26. Torrez CV, Hunt GB. Results of surgical correction of abnormalities associated with brachycephalic airway obstruction syndrome in dogs in Australia. J Small Anim Pract 2006;47:150154.

    • Crossref
    • Search Google Scholar
    • Export Citation

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Postoperative regurgitation and respiratory complications in brachycephalic dogs undergoing airway surgery before and after implementation of a standardized perianesthetic protocol

Renata S. Costa1Department of Clinical Sciences, Cummings School of Veterinary Medicine, Tufts University, North Grafton, MA 01536.

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Amanda L. Abelson1Department of Clinical Sciences, Cummings School of Veterinary Medicine, Tufts University, North Grafton, MA 01536.

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Jane C. Lindsey2Center for Biostatistics and AIDS Research, Harvard T. H. Chan School of Public Health, Boston, MA 02115.

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Lois A. Wetmore1Department of Clinical Sciences, Cummings School of Veterinary Medicine, Tufts University, North Grafton, MA 01536.

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Abstract

OBJECTIVE

To determine whether implementation of a standardized perianesthetic protocol was associated with reduced incidence of postoperative regurgitation, pneumonia, and respiratory distress in brachycephalic dogs undergoing general anesthesia for airway surgery.

ANIMALS

84 client-owned dogs.

PROCEDURES

A perianesthetic protocol that included preoperative administration of metoclopramide and famotidine, restrictive use of opioids, and recovery of patients in the intensive care unit was fully implemented for brachycephalic dogs in July 2014. Medical records of brachycephalic dogs (specifically Boston Terriers, French Bulldogs, English Bulldogs, and Pugs) undergoing anesthesia for airway surgery before (group A) and after (group B) protocol implementation were reviewed. Patient characteristics, administration of medications described in the protocol, surgical procedures performed, anesthesia duration, recovery location, and postoperative development of regurgitation, pneumonia, and respiratory distress were recorded. Data were compared between groups.

RESULTS

The proportion of dogs with postoperative regurgitation in group B (4/44 [9%]) was significantly lower than that in group A (14/40 [35%]). No intergroup differences in patient characteristics (including history of regurgitation), procedures performed, or anesthesia duration were found. Rates of development of postoperative pneumonia and respiratory distress did not differ between groups. A history of regurgitation was associated with development of postoperative regurgitation.

CONCLUSIONS AND CLINICAL RELEVANCE

Implementation of the described protocol was associated with decreased incidence of postoperative regurgitation in brachycephalic dogs undergoing anesthesia. Prospective studies are warranted to elucidate specific causes of this finding.

Abstract

OBJECTIVE

To determine whether implementation of a standardized perianesthetic protocol was associated with reduced incidence of postoperative regurgitation, pneumonia, and respiratory distress in brachycephalic dogs undergoing general anesthesia for airway surgery.

ANIMALS

84 client-owned dogs.

PROCEDURES

A perianesthetic protocol that included preoperative administration of metoclopramide and famotidine, restrictive use of opioids, and recovery of patients in the intensive care unit was fully implemented for brachycephalic dogs in July 2014. Medical records of brachycephalic dogs (specifically Boston Terriers, French Bulldogs, English Bulldogs, and Pugs) undergoing anesthesia for airway surgery before (group A) and after (group B) protocol implementation were reviewed. Patient characteristics, administration of medications described in the protocol, surgical procedures performed, anesthesia duration, recovery location, and postoperative development of regurgitation, pneumonia, and respiratory distress were recorded. Data were compared between groups.

RESULTS

The proportion of dogs with postoperative regurgitation in group B (4/44 [9%]) was significantly lower than that in group A (14/40 [35%]). No intergroup differences in patient characteristics (including history of regurgitation), procedures performed, or anesthesia duration were found. Rates of development of postoperative pneumonia and respiratory distress did not differ between groups. A history of regurgitation was associated with development of postoperative regurgitation.

CONCLUSIONS AND CLINICAL RELEVANCE

Implementation of the described protocol was associated with decreased incidence of postoperative regurgitation in brachycephalic dogs undergoing anesthesia. Prospective studies are warranted to elucidate specific causes of this finding.

Supplementary Materials

    • Supplementary Appendix s1 (PDF 173 kb)

Contributor Notes

Dr. Costa's present address is the Department of Specialty Medicine, College of Veterinary Medicine, Midwestern University, Glendale AZ 85308.

Address correspondence to Dr. Costa (RCosta@midwestern.edu).