Pulmonary oedema associated with anaesthesia for colic surgery in a horse.

This research article discusses a case where a horse developed pulmonary edema, characterized by fluid in the lungs, after being anesthetized for a surgical procedure to explore abdominal pain (colic).

Case Presentation and Anesthesia Complications

• The subject in question was a 506 kg Warmblood horse that was suffering from colic. To address this condition, an exploratory celiotomy, a surgical procedure to examine the horse’s abdomen, was deemed necessary.
• However, the anesthesia process wasn’t straightforward. The horse experienced arterial hypoxaemia – a medical condition where oxygen levels in the blood are lower than expected. This condition persisted throughout surgery and started from the point of anesthesia induction.

Post-Surgery Complications and Treatment

• After the surgical process, when the endotracheal tube was removed, the horse probably suffered some degree of airway obstruction due to a delay in naso-tracheal intubation – a procedure used to improve air exchange in the lungs.
• Following the airway obstruction, signs of pulmonary oedema (fluid accumulation in the air spaces of the lungs) were observed.
• In response to this, the horse was treated with furosemide – a diuretic, often used for treating edema – and oxygen to normalize the oxygen levels in the blood. At this point, the horse’s arterial oxygen pressure was measured at 6.5 kPa (49 mmHg), indicating arterial hypoxaemia. The fraction of inspired oxygen (FiO2) was estimated at 0.3 during this period.

Follow-Up and Post-Mortem Findings

• The treated horse managed to recover and was able to stand after about 45 minutes. During a follow-up anesthesia process three days later, the arterial blood gas analysis showed no signs of hypoxaemia.
• Regrettably, the horse was euthanized during this latter procedure. In the post-mortem examination, it was confirmed that the horse had developed pulmonary edema.
• The cause of this condition was suggested to be multifactorial, indicating a probable combination of factors such as the initial colic condition, effects of anesthesia, and possible ventilation issues during surgery.