Lindsay B, Cook D, Wetzel J-M, Siess S, Moses P
Department of Neurology, Veterinary Specialist Services, Underwood, Queensland, 4119, Australia.
Aust Vet J. 2020 May;98(5):173-180. doi: 10.1111/avj.12926. Epub 2020 Feb 9.
As ownership of brachycephalic dog breeds rises, the surgical correction of components of brachycephalic airway syndrome (BAS) is increasingly recommended by veterinarians. This study's objective was to describe the incidence of, and strategies for the management of post-operative respiratory complications in brachycephalic dogs undergoing surgical correction of one or more components of BAS.
Medical records of 248 brachycephalic dogs treated surgically for BAS were retrospectively reviewed for demographic information, procedures performed, post-operative complications and treatment implemented, hospitalisation time, and necessity for further surgery.
Pugs, Cavalier King Charles Spaniels and British Bulldogs were the most commonly encountered breeds. Dogs which experienced a complication were significantly older (mean was 5.5 years, compared with 4.1 years [P < 0.01]). Fifty-eight dogs (23.4%) had complications which included: dyspnoea managed with supplemental oxygen alone (7.3%, n = 18), dyspnoea requiring anaesthesia and re-intubation (8.9%, n = 22), dyspnoea necessitating treatment with a temporary tracheostomy (8.9%, n = 22), aspiration pneumonia (4%, n = 10), and respiratory or cardiac arrest (2.4%, n = 6). Five of the 22 dogs requiring anaesthesia and re-intubation deteriorated 12 or more hours after post-surgical anaesthetic recovery. The overall mortality rate in this study was 2.4% (n = 6). Age, concurrent airway pathology, and emergency presentation significantly predicted post-operative complications.
Our data show the importance of close monitoring for a minimum of 24 h following surgery by an experienced veterinarian or veterinary technician. Surgical intervention for BAS symptomatic dogs should be considered at an earlier age as an elective procedure, to reduce the risk of post-operative complications.
随着短头犬种的饲养数量增加,兽医越来越多地建议对短头气道综合征(BAS)的各个组成部分进行手术矫正。本研究的目的是描述接受BAS一个或多个组成部分手术矫正的短头犬术后呼吸并发症的发生率及管理策略。
回顾性分析248只接受BAS手术治疗的短头犬的病历,记录其人口统计学信息、所施行的手术、术后并发症及治疗措施、住院时间以及再次手术的必要性。
哈巴犬、骑士查理王小猎犬和英国斗牛犬是最常见的品种。发生并发症的犬年龄显著更大(平均5.5岁,而未发生并发症的犬平均4.1岁[P < 0.01])。58只犬(23.4%)出现并发症,包括:仅通过补充氧气治疗的呼吸困难(7.3%,n = 18)、需要麻醉和重新插管的呼吸困难(8.9%,n = 22)、需要临时气管切开术治疗的呼吸困难(8.9%,n = 22)、吸入性肺炎(4%,n = 10)以及呼吸或心脏骤停(2.4%,n = 6)。22只需要麻醉和重新插管的犬中有5只在术后麻醉恢复12小时或更长时间后病情恶化。本研究的总体死亡率为2.4%(n = 6)。年龄、并存的气道病变和急诊就诊显著预示术后并发症。
我们的数据表明,术后至少24小时由经验丰富的兽医或兽医技术人员进行密切监测非常重要。对于有BAS症状的犬,应尽早将手术干预作为择期手术考虑,以降低术后并发症的风险。