Post-anesthetic pulmonary edema in two horses.
Abstract: CASE 1: A two-year old, 462 kg Standard bred horse was anesthetized for arthroscopy and castration. During anesthesia, hyperemia of the mucosal membranes and urticaria were noticed. During 5 hours of anesthesia subcutaneous edema of the eyelids and neck region developed. In the recovery box, the orotracheal (OT) tube was left in situ and secured in place with tape. Following initial attempts to stand, the horse became highly agitated and signs consistent with pulmonary edema developed subsequently. Arterial hypoxemia (PaO(2): 3.7 kPa [28 mmHg]) and hypocapnia (PaCO(2): 3.1 kPa [23 mmHg]) were confirmed. Oxygen and furosemide were administered. The horse was assisted to standing with a sling. Therapy continued with bilateral intra-nasal oxygen insufflation. Ancillary medical therapy included flunixin meglumine, penicillin, gentamycin and dimethylsulfoxide. Following 7 hours of treatment the arterial oxygen tensions began to increase towards normal values. CASE 2: An 11-year old, 528 kg Paint horse was anesthetized for surgery of a submandibular mass. The 4-hour anesthetic period was unremarkable. The OT tube was left in situ for the recovery. During recovery, the horse was slightly agitated and stood after three attempts. Clinical signs consistent with pulmonary edema and arterial hypoxemia (PaO(2): 5 kPa [37.5 mmHg]) subsequently developed following extubation. Respiratory signs resolved with medical therapy, including unilateral nasal oxygen insufflation, furosemide, flunixin meglumine and dimethylsulfoxide. The diagnosis of pulmonary edema in these horses was made by clinical signs and arterial blood-gas analysis. While pulmonary radiographs were not taken to confirm the diagnosis, the clinical signs following anesthesia support the diagnosis in both cases. The etiology of pulmonary edema was most likely multifactorial.
Publication Date: 2010-03-17 PubMed ID: 20230564DOI: 10.1111/j.1467-2995.2009.00505.xGoogle Scholar: Lookup
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Summary
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The research article focuses on two case studies of post-anesthetic pulmonary edema in two horses; one a young Standardbred horse which developed symptoms after an arthroscopy and castration, and the other an older Paint horse with symptoms appearing after removal of a submandibular mass. The treatment approach, symptoms, and analysis of each case are elaborately discussed.
Case 1: Standardbred Horse
- The horse, initially healthy, was anesthetized for arthroscopy and castration. Throughout the procedure, hyperemia of the mucosal membranes and urticaria were noted.
- Over the course of 5 hours of anesthesia, the horse developed subcutaneous edema of the eyelids and neck.
- Post-operation, while trying to regain consciousness and stand up, the horse became highly agitated and revealed signs of developing pulmonary edema.
- There was a confirmation of arterial hypoxemia and hypocapnia through the animal’s blood gas analysis.
- The response involved administration of oxygen and furosemides, along with assistance to stand via a sling. Further treatments incorporated bilateral intra-nasal oxygen insufflation and other medications.
- The continuous effort for 7 hours gradually resulted in an increase of arterial oxygen tension towards normal.
Case 2: Paint Horse
- The 11-year-old horse was anesthetized for removal of a submandibular mass. Post-anesthesia, the horse appeared slightly agitated and tried to stand up three times before succeeding.
- Following these efforts, the horse developed clinical signs of pulmonary edema and arterial hypoxemia.
- Respiratory signs resolved through medical treatments similar to the first case, including unilateral nasal oxygen insufflation, furosemide, and other medications.
Diagnosis and Conclusion
- Across both cases, the diagnosis of pulmonary edema was made observing the clinical signs and through arterial blood-gas analysis.
- While pulmonary radiographs weren’t taken as part of the case studies, the post-anesthesia clinical signs provided enough rationale to support the diagnosis of pulmonary edema in both horses.
- The researchers concluded that the cause of pulmonary edema in these cases is likely multifactorial, suggesting the influence of multiple risk elements contributing to the veterinary condition.
Cite This Article
APA
Kaartinen MJ, Pang DS, Cuvelliez SG.
(2010).
Post-anesthetic pulmonary edema in two horses.
Vet Anaesth Analg, 37(2), 136-143.
https://doi.org/10.1111/j.1467-2995.2009.00505.x Publication
Researcher Affiliations
- Université de Montréal, 1500 Rue des vétérinaires, C.P. 5000, Saint-Hyacinthe, Q J2S 7C6, Canada. johanna.kaartinen@umontreal.ca
MeSH Terms
- Anesthesia, General / adverse effects
- Anesthesia, General / veterinary
- Animals
- Blood Gas Analysis / veterinary
- Horse Diseases / etiology
- Horses
- Male
- Pulmonary Edema / chemically induced
- Pulmonary Edema / veterinary
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