Diane E. Mason, DVM, PhD, DACVA
College of Veterinary Medicine, Kansas State University, Manhattan, KS, USA
The objectives of this discussion are to indicate the best approach to the problem of the "difficult airway" encountered in the dog with brachycephalic syndrome. We will stress the importance of preanesthetic assessment of the patient to determine the degree of airway compromise prior to anesthesia. Intubation does not have to be a serious challenge with proper planning. It can be aided by adequate relaxation at induction and effective visualization with the help of accessories such as a laryngoscope, a good light source, availability of suction etc. There is flexibility in drug choice in sedation and induction and some differing opinions but there are some firm principles regarding the goals to achieve with anesthesia. A calm, relaxed patient and avoidance of excitement and struggling at induction AND recovery is of utmost importance. Many of the difficulties that occur with these patients actually happen at recovery or in the early postoperative period. Never be in a hurry to extubate. One must remain vigilant with these patients for a period of time after the endotracheal tube is removed and be prepared for an emergency re-intubation. Simple support such as holding the jaws open with a small bite-block and pulling the tongue forward with the head elevated and the neck extended until the dog is fully recovered will allow the dog to breathe better until it can manage its airway best on its own.