How do you spray local on a cats larynx?

RE: How do you spray local on a cats larynx?

bevs2251 — Fri, 06 Oct 2017 05:23:26 GMT

Xylocaine spray was taken off the market also several years ago in Australia. One bottle lasted years. I now use a human product called Co-Phenylcaine Forte spray (nasal spray) 50ml - Lignocaine HCl 50mg/ml (5%) and Phenylephrine HCl 5mg/ml (0.5%). Has a nozzle attachment. Works well but may take a couple of pumps. I spray the nozzle with alcohol afterwards. This spray was advised to us vets as the replacement for Xylocaine spray by the drug companies. Do you have something similar ?

I don't like squirting liquid lignocaine down the throat. Vets here often shoot up to 0.5ml into the cat's throat via a 1ml syringe (no attachments). Even one feline specialist uses liquid lignocaine. I haven't seen anyone just dribble it in. I worry about all that fluid possibly going straight into the lungs. Lignocaine liquid is cheap. However, as a locum and part-timer, having used xylocaine spray for at least 20 years, I won't use lignocaine liquid. I bought my own supply of the above spray (for approx Aus$80) to use at the cheapskate practices that use liquid lignocaine ! Claim it on tax !

RE: How do you spray local on a cats larynx?

bevs2251 — Fri, 06 Oct 2017 05:21:59 GMT

RE: How do you spray local on a cats larynx?

Kate Richardson — Thu, 05 Oct 2017 20:39:34 GMT

Adequate level of anaesthetic induction, good visualisation of larynx using laryngoscope if necessary, as near to horizontal with intubease nozzle as possible, primed before first spray, 1 spray only in most cats unless >6kg, 60 seconds before attempting to intubate. Size 5 ET tube down most cats.

RE: How do you spray local on a cats larynx?

Thomas Johnson — Thu, 05 Oct 2017 09:01:52 GMT

[quote user="Clive Ansell"]

[quote user="Michael Woodhouse"]Still against the law when we have a perfectly suitable licenced product....[/quote]

I must admit I had never thought of it in those terms; given it is not a medicine as such, is the use of Intubeaze bound by the cascade regs?

[/quote]

How is it not a medicine? It is a licensed veterinary product given to prevent stimulation of the laryngeal reflex.

RE: How do you spray local on a cats larynx?

bob lehner — Wed, 04 Oct 2017 20:49:01 GMT

[quote user="Clive Ansell"] must admit I had never thought of it in those terms; given it is not a medicine as such, is the use of Intubeaze bound by the cascade regs?[/quote]

Yes - it's on the VMD data base as a Veterinary Medicinal Product:

''SUMMARY OF PRODUCT CHARACTERISTICS

1. Name of the Veterinary Medicinal Product

Intubeaze 20 mg/ml oromucosal spray for cats''

RE: How do you spray local on a cats larynx?

Clive Ansell — Wed, 04 Oct 2017 17:23:18 GMT

[quote user="Michael Woodhouse"]Still against the law when we have a perfectly suitable licenced product....[/quote]

I must admit I had never thought of it in those terms; given it is not a medicine as such, is the use of Intubeaze bound by the cascade regs?

RE: How do you spray local on a cats larynx?

Michael Woodhouse — Wed, 04 Oct 2017 17:11:27 GMT

[quote user="Martin Atkinson"]At least the letter advises the use of injectable lidocaine in a syringe as we use it.[/quote]

Still against the law when we have a perfectly suitable licenced product....

RE: How do you spray local on a cats larynx?

Thomas Johnson — Wed, 04 Oct 2017 17:02:08 GMT

[quote user="Evelyn Barbour-Hill"]

[quote user="robloxley"] irritating however is the % of the bottle contents that you can never use at the end[/quote]

People say this, but we manage to use all but a few drops.

[/quote]

Same here, I find that if you're not getting any out but there's still some in the bottle you can, away from the cat, put the bottle at the right angle to get the plastic tube in the liquid, depress it once or twice to draw some up towards the nozzle, then back to the cat and you can get a spray or two out of it onto the larynx.

RE: How do you spray local on a cats larynx?

Evelyn Barbour-Hill — Wed, 04 Oct 2017 16:42:44 GMT

[quote user="robloxley"] irritating however is the % of the bottle contents that you can never use at the end[/quote]

People say this, but we manage to use all but a few drops.

RE: How do you spray local on a cats larynx?

Rob Loxley — Wed, 04 Oct 2017 14:01:35 GMT

[quote user="Neil Wheadon"]The intubeaze nozzle from Dechra are frankly as useful as a fridge in the arctic.[/quote]

Have not personally found them a problem; irritating however is the % of the bottle contents that you can never use at the end

RE: How do you spray local on a cats larynx?

Sarah Keir — Wed, 04 Oct 2017 13:56:24 GMT

[quote user="Neil Wheadon"]

The intubeaze nozzle from Dechra are frankly as useful as a fridge in the arctic.

Neil

[/quote]

You say the Neil but in fact when my husband lived in Antarctica for over 2 years, the freezers in which food stored where very important! It may of been a consistent minus 30 to 50 Celsius outside!

RE: How do you spray local on a cats larynx?

Martin Atkinson — Wed, 04 Oct 2017 11:49:40 GMT

[quote user="Bob Russell"]There was a specific warning that Xylocaine spray was not to be used in cats following its reformulation[/quote]That would explain it then. At least the letter advises the use of injectable lidocaine in a syringe as we use it.

RE: How do you spray local on a cats larynx?

Bob Russell — Wed, 04 Oct 2017 11:37:22 GMT

There was a specific warning that Xylocaine spray was not to be used in cats following its reformulation (I believe related to green house gasses etc).

It has been related to a number of serious ractions in cats.

http://veterinaryrecord.bmj.com/content/167/16/627.1

The old product was brilliant and lasted for ever! Goes against the grain to leave so much in the bottle when it stops working!

RE: How do you spray local on a cats larynx?

Martin Atkinson — Wed, 04 Oct 2017 11:13:16 GMT

[quote user="David Mills"]Meanwhile, back in the world where 1000s of animals cats are given intubeaze daily and no side effects noted... Are you sure it wasn't the meloxicam?[/quote]For once in my life (make a note of this because it doesn't happen often) I'll admit I was wrong. My nurses actually ordered a Xylocaine spray because Intubeaze was so expensive and that is 4% solution. Whatever we went back to the 2% lidocaine in a syringe.

And for your information, meloxican doesn't cause dysphonia, just renal failure.

RE: How do you spray local on a cats larynx?

David Mills — Wed, 04 Oct 2017 09:08:51 GMT

[quote user="Martin Atkinson"]We started using Intubeaze spray again recently but gave up again because the dose it delivered was too high and we ended up with a string of dysphonic cats for days afterwards plus our method costs a fraction of the Intubeaze[/quote]

Meanwhile, back in the world where 1000s of animals cats are given intubeaze daily and no side effects noted... Are you sure it wasn't the meloxicam?

I don't see the issue with Intubeaze at all apart from the annoying end-of-bottle issues. It works fine. Of course "reactivity" of the larynx is also related to depth of anaesthesia so it is maybe that which is the issue for people. What do people think they are clinically trying to achieve with Intubeaze?

Apparently the inventor of the bottle/product is now a happily retired millionaire.

RE: How do you spray local on a cats larynx?

Michael Woodhouse — Wed, 04 Oct 2017 00:07:58 GMT

The data sheet is pretty straightforward:

Give one or two sprays at the back of the throat. Each spray (approximately 0.1-0.2 ml) contains approximately 2-4 mg of lidocaine hydrochloride. (Approximately 72 sprays/vial).

Allow 30-90 seconds before attempting intubation, so that the larynx is relaxed.

Simple product to use, just make sure eccentric tube is submerged in the liquid.

We wipe the tube with the following after each use:

http://clinell.com/product/universal-range/#overview

We use them for tables and things that can't be autoclaved but come into contact with patients, such as thermometers, stethoscopes, ear speculae etc.

RE: How do you spray local on a cats larynx?

vetbl.locum — Wed, 04 Oct 2017 00:03:34 GMT

[quote user="Neil Wheadon"]

It's worthy of debate

The intubeaze nozzle from Dechra are frankly as useful as a fridge in the arctic.

The original local anaesthetic spray had a well designed metal nozzle that was bent at the end, so at least you could get the stuff somewhere close to where it's required. I've seen something like it in one place and Martin seems to use syringes which is a great idea (what do you put in them?)

Thoughts?

Neil

[/quote]

The original was too useful so was removed! :-)

Cannot remember why ?

RE: How do you spray local on a cats larynx?

Beats — Tue, 03 Oct 2017 20:57:01 GMT

I use intubeaze in current position and wipe it down with the alcohol swab I used on the venipuncture site after. Line nozzle up parallel with tube in bottle so it is in contact with actual liquid when then tipped forwards and test shot in case the last person fired air into it. O2 mask on while waiting 40secs before tubing (leaving someone else to tidy up :-) )

I much preferred 1ml syringe with bit of lidocaine and disposable cheapskate iv cannula on end to drip on to the laryngeal curtains in previous positions.

When locuming I saw various levels of intubeaze hygiene and the occasional outing of the famous banana-flavoured lidocaine spray rumoured to cause occasional anaphylaxis and death in cats.

RE: How do you spray local on a cats larynx?

Niall Taylor — Tue, 03 Oct 2017 19:55:02 GMT

RE: How do you spray local on a cats larynx?

Linda Filshie — Tue, 03 Oct 2017 19:32:40 GMT

Induce GA. Key bit: get the person doing the holding to get the head as horizontal as possible or the damn intubeaze doesn't spray properly. Pull tongue forward. Visualise larynx. Aim nozzle. Spray once. Wait 30-60s. Intubate. Job done.

RE: How do you spray local on a cats larynx?

Thomas Johnson — Tue, 03 Oct 2017 17:41:05 GMT

I don't have a problem with the Intubeaze nozzle, with the nurse supporting the head, appropriate traction on the tongue and using the tip of the nozzle to flick the soft palate out of the way if necessary it's relatively straightforward to spray onto the larynx. Then, as someone else said, spend 30 seconds tidying away the needle and syringe used for induction before introducing the ET tube.

We have a lot of the nozzles and after they've been used on one animal they get disinfected.

RE: How do you spray local on a cats larynx?

Evelyn Barbour-Hill — Tue, 03 Oct 2017 16:42:37 GMT

[quote user="Iain Richards"] In at corner of mouth[/quote]

Why at corner? Over the tongue like anything else. Of course nurse is supporting head at correct angle and your spare hand is easing the tongue forward.

[quote user="Iain Richards"]Put spray down, [/quote]

into disinfectant bath

[quote user="Iain Richards"]the damn tube isn't long enough![/quote]

I seem to manage fine

RE: How do you spray local on a cats larynx?

Iain Richards — Tue, 03 Oct 2017 15:25:02 GMT

Ensure the spray is working and that the bottom of the tune is under the level of the liquid in the bottle. In at corner of mouth, two sprays. Put spray down, clear up wrappers from cannula, syringe etc. This give the 30s you should wait before intubating! I hear form many nurses that vet don't wait long enough.

Then I repeat the above, because the damn tube isn't long enough!

RE: How do you spray local on a cats larynx?

Martin Atkinson — Tue, 03 Oct 2017 14:43:24 GMT

[quote user="Neil Wheadon"]Martin seems to use syringes which is a great idea (what do you put in them?) [/quote]Well being as you asked: Lidocaine 2% solution in a 1ml syringe and trickle 0.1ml through a skin button access needle of which we have many spare. Otherwise we've just cut the tip off a hypodermic needle. I am very aware of the risk of the needle shooting off down the trachea never to be seen again but it hasn't happened yet, just make sure it is pushed on very firmly. We started using Intubeaze spray again recently but gave up again because the dose it delivered was too high and we ended up with a string of dysphonic cats for days afterwards plus our method costs a fraction of the Intubeaze. One of my nurses put it to good use spraying on her painful tonsils!!