VSPN AOW : Anesthesia Case of the Mo... |
Anesthesia Case of the Month. Anesthesia mumps (acute transient sialadenopathy) in a dogJ Am Vet Med Assoc. July 2017;251(2):159-162.
Companion NotesCase report of anesthesia mumps (acute transient sialadenopathy) in a dog - not previously reported in veterinary patients
Overview on anesthesia mumps - in human medicine: - rare prevalence in patients undergoing general anesthesia: 0.2% - in 1 report of incidence with retrosigmoid and far-lateral craniotomy: 0.84% - cause is unclear - in 1 report, dehydration is a common cause in children - usually resolves spontaneously - supportive therapy may be helpful - warm compresses - adequate hydration - antimicrobials may be indicated when crepitus is evident - severe swelling occurs rarely that may require reintubation or tracheostomy
Case report of a 7-month-old, 1.3 kg (2.87 lb), intact, sex:M dog - at referral for microhepatica - historical signs, physical examination and testing from referring clinician (rDVM) - presentation for anorexia, weakness and growth retardation - physical examination: signs of hypoglycemic shock and blindness - presumptive diagnosis: portosystemic shunt - at referral for CT to confirm diagnosis of portosystemic shunt - preanesthetic medication not administered due to pup’s condition - propofol induction with isoflurane maintenance in oxygen - rebreathing circle system - temporary apnea induced to facilitate detailed CT images - induced with manual hyperventilation - end-tidal carbon dioxide at 25-30 mmHg for 1 minute - bradycardia developed after first manual breath - corrected with glycopyrrolate - diagnosis: extrahepatic portoazygos shunt - re-presentation 1.5 months later for surgical therapy (ameroid ring constrictor) - CBC and biochemistry: leukocytosis and thrombocytosis - increased aspartate transaminase - increased alkaline phosphatase - hyperphosphatemia - elevated ammonia - low creatinine - hypoproteinemia - premedication - tramadol, 1 mg/kg IV - ranitidine, 2 mg/kg IV - cefazolin, 44 mg/kg IV - preanesthetic blood glucose relatively low - saline solution with 2.5% glucose given during surgery - propofol induction with isoflurane maintenance in oxygen - bradycardia developed immediately after anesthetic induction - glycopyrrolate, 10 µg/kg sc - dorsal recumbency with head and neck positioned naturally to the side - atracurium, 0.2 mg/kg IV to ease surgical access - total duration of anesthesia: 2 hours 12 minutes - total volume of IV fluids during anesthesia: 28.1 mL - after extubation with dog in sternal - swelling of submandibular region, bilateral, noticed immediately - not present before anesthesia - resolved in 3 days with supportive treatment - differential diagnosis for the submandibular swelling - anaphylactic reaction - no other clinical signs consistent with this present - hemorrhage and hematoma - cytology of fluid specimens revealed saliva - air from an iatrogenic tracheal tear - no dyspnea or subcutaneous emphysema - mandibular sialocele (preoperative serum amylase normal) - acute transient sialadenopathy diagnosed by exclusion (anesthesia mumps) - treatment of anesthesia mumps - manual massage, 15 minutes - neck bandage to apply gentle compression - swelling smaller the next day and no additional treatment done - spontaneously resolved over 3 days - outcome 12 days postop: no evidence of recurrence
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VSPN AOW : Anesthesia Case of the Mo... |
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