Cat developing lung problems after dental?

Re: Cat developing lung problems after dental?

Evelyn Barbour-Hill — Tue, 30 Jul 2013 19:27:11 GMT

[quote user="Anthony Todd"]Is it a copy on from human medicine where the patient is sitting up and things can literally fall down the trachea??[/quote]

No.

It stops water, mucus, gunk, blood, bits of calculus, bits of tooth, broken instruments, getting as far as the pharynx.

The cuff on the endotracheal tube is to minimise gas leakage. It's not a precaution against inhalation.

On completion of the GA session the cat's head should be kept down until reflexes return.

Immediately after tube removal the pharynx should be deliberately cleaned. Almost always there's a big gob of mucus up there tucked above the soft palate, which could if not removed slide down and quietly block the larynx.

I'm not sure whether any of this has anything to do with the unfortunate cat in question.

Re: Cat developing lung problems after dental?

Anthony Todd — Tue, 30 Jul 2013 16:49:32 GMT

[quote user="nikki"] Despite all the usual precautions [/quote]

Far be it for a dinosaur etc. etc. but it sounds to me as if something happened around the throat packing and tube removal.

Was the cat placed horizontally in a cage?

I was taught, and did teach, to hang the cat's head off the side of the table until the head was raising. Loads of gunk and blood etc thence dripped onto newspaper. Back legs were tied to the cleat on the other side of the table.

It was surprising how much stuff had no chance of going down the trachea......

Never thought throat packing was a good idea if the cat was tubed with a minimally inflated cuff, I mean why bother 'cos you'll never be able to pack it fluid tight.

Is it a copy on from human medicine where the patient is sitting up and things can literally fall down the trachea??

Re: Cat developing lung problems after dental?

Martin Atkinson — Tue, 30 Jul 2013 11:31:16 GMT

Are you sure there is no evidence of pneumo-mediastinum or emphysema due to a tracheal tear? Happened to a nurse in my practice once during a dental as the cat was turned over several times.

Re: Cat developing lung problems after dental?

Braden Collins — Tue, 30 Jul 2013 02:33:26 GMT

With the cyanosis on ET removal, could it have been laryngospasm and the crackles referred noise? Were AB's used at the time of the dental or any pre-treatment - thinking along the lines of a bacteraemia, which could lead to cardiac issues with an endocarditis or similar. Are you able to ultrasound the valves sufficiently? Have you done bloods, as they may indicate an infectious process or may lead you down another path.

I would be looking towards full bloods, blood culture, IV AB's and repeat cardiac ultrasound.

Re: Cat developing lung problems after dental?

nikki — Mon, 29 Jul 2013 22:43:09 GMT

It did happen to get a jab of DQ on Sat morning as it looked like it might die before any further investigations could be undertaken. Didn't seem to do much.

Re: Cat developing lung problems after dental?

Michael Woodhouse — Mon, 29 Jul 2013 22:30:09 GMT

Steroids.............

Re: Cat developing lung problems after dental?

nikki — Mon, 29 Jul 2013 22:26:05 GMT

Initially frusemide was given as suspected pulmonary oedema due to generalised lung pattern and he did seem to respond. Have attempted to stop it twice but the crackles seem to progress, his resp rate doubles and his cough gets worse. Bit of a weird case.

Re: Cat developing lung problems after dental?

Stephen Courtney — Mon, 29 Jul 2013 22:14:54 GMT

I would definitely add in a second antibiotic, probably baytril, if you feel unable to do a chest work up - I'd be wary of another GA etc for scopes rads and flushes, so this might be an idea.

Frusemide dries out the tubes but doesn't do much more, probably interferes with with ciliary clearance, and is bad for the kidneys - but does help the cough. Personally I'd only use it if there was definite pulmonary oedema, on a temporary basis

Sadly it seems likely the cat aspirated, but could be something else. Allergic, cardiac, neoplastic? But the signs suggest inflammation and infection. I'd be inclined to see how extra meds work first.