Complications highly prevalent with canine tracheostomy
MedWire News: The use of tracheostomy tubes in dogs carries a high risk for postoperative complications, but nevertheless has a good outcome in the majority of animals, UK researchers believe.
They advise careful management of all dogs needing airway support and particular care for bulldogs and dogs that develop bradycardia during treatment.
The research was a retrospective database study involving all dogs that underwent temporary tube tracheostomy at a single veterinary practice over a 10-year period.
A total of 42 dogs were identified and included in the study. Twenty-seven were male, the most common breeds were bulldogs and Labradors, and reasons for tracheostomy included brachycephalic obstructive airway syndrome and paralysis, swelling, or lesions of the larynx or pharynx.
There were no intraoperative complications, report the study authors, writing in the Journal of Small Animal Practice.
Postoperatively, however, 36 dogs (86%) developed complications. The most frequent complications were, in descending order: pneumomediastinum (affecting 50% of dogs), tube/airway obstruction (26%), tube dislodgement (21%), aspiration pneumonia (21%), stoma swelling/edema (21%), and pneumothorax (18%).
Less-frequent complications included subcutaneous emphysema, hemorrhage, regurgitation, sinus bradycardia, vomiting, cough, head tremor, excessive serosanguinous discharge from stoma, seizures, and pyothorax.
In terms of outcomes, 25 dogs (60%) survived until the tracheostomy tube was removed while nine (21%) were euthanized due to underlying disease, four (10%) were euthanized due to complications, and four died during hospitalization.
Thus, overall, tracheostomy tube management was considered successful in 34 dogs (81%) and a failure in eight (19%).
Finally, the authors explored the features that influenced tracheostomy outcomes. By comparing dogs with a successful versus a failed procedure, they showed that bulldog breed, younger age, the presence of three or more complications, and the presence of bradycardia were each associated with an increased risk for complications.
In particular, bulldogs were particularly prone to tube dislodgment and were more likely to have an unsuccessfully managed tube than other breeds.
"The results of our study confirm the high incidence of complications occurring in dogs with tracheostomy tubes," write study authors Ian Nicholson (Royal Veterinary College, North Mymms) and Stephen Baines (The Willows Veterinary Centre, Solihull).
They conclude: "Several observations made in this study add support to the idea that careful avoidance of complications could improve the success of tube management."
By Joanna Lyford