Re: un-cuffed or cuffed ET tubes in cat dentals

Evelyn Barbour-Hill — Sun, 17 May 2009 20:11:51 GMT

Many dental surgeons use cuffed tubes in some cats with no trouble. Uncuffed do allow a larger diameter airway. However cuffed are fine in larger cats. I have never seen tracheal damage from a cuff in a cat. Before you jump down my throat, I don't say it doesn't occur, I say it has never happened to me that I know of. My suspicion is that it's caused by excessive inflation, careless handling or tubes in a poor state.

The primary purpose of the cuff is to close the airway to gas leakage so that the administration of oxygen and inhalational anesthetic is more efficient. It's not there to keep fluid out. Its protection against fluid ingress is useful of course but should not be relied on. Fluid (and foreign body) ingress must be guarded against by a proper throat pack. Use of a throat pack is mandatory. Improvised packs of cotton wool or gauze swabs are unreliable and inadvisable. Properly made packs are readily available and very cheap. Nothing should be put into the pharynx without an attached string to the exterior.

Have suction available and don't hesitate to use it.

So there really shouldn't be any "caught fluid" that's being kept out solely by the cuff. Having said that, cuffs should be deflated, and tubes removed, with care...... keeping the head horizontal or slightly down is a wise precaution.... if possible, under direct observation of the larynx. This will sometimes draw out a thick string of mucus along with the tube. Tipping the patient head down for a few moments afterward is another wise precaution.

While we are on the subject: don't forget that in the majority of cats a glob of rather tenacious mucus will have accumulated just dorsal to the soft palate. One should endeavour to remove this, lest the cat later choke to death in the recovery kennels. The mouth must be wiped out and inspected before the cat is removed from the operating table.