A 5-year-old, female neutered French Bulldog presented under anaesthesia with an endotracheal tube (ETT) lodged in the larynx. Cuff inflation and deflation, application of lubricant, ETT rotation, and repeated traction did not allow ETT removal. The ETT was successfully removed under neuromuscular blockade with manual laryngeal stabilisation: the left thumb pressed against the epiglottis intraorally and the left index and middle fingers gripped the larynx externally to immobilise the larynx. The right-hand applied traction to the ETT, which could then be extracted. The dog's larynx obstructed on recovery from anaesthesia with suspected temporary laryngeal paralysis. The dog was managed with a tracheostomy tube for 3 days and made a good recovery. The dog presented in respiratory distress 4 weeks later with tracheal stenosis that was successfully treated with tracheal resection and anastomosis. This case report describes the use of neuromuscular blockade and manual laryngeal stabilisation to remove a lodged ETT and reflects on the subsequent complications.

This case report describes the use of a lidocaine-ketamine-propofol total intravenous anesthesia (TIVA) protocol in two chinchillas (Chinchilla lanigera). Two 4-year-old, 0.60 and 0.63 kg, intact female chinchillas underwent general anesthesia for dentistry. The first chinchilla presented for occlusal adjustment, but mucopurulent vaginal discharge was identified following sedation. Diagnostic findings were most consistent with an open pyometra, and an exploratory laparotomy with ovariohysterectomy was performed. Histopathology confirmed uterine adenocarcinoma. The second chinchilla underwent intraoral extraction of the right mandibular fourth cheek tooth because of advanced periodontal disease. Both chinchillas were premedicated with buprenorphine, dexmedetomidine, midazolam, and ketamine, followed by intravenous induction of anesthesia with an initial popofol bolus (0.5 mg kg[-1]), lidocaine (2 mg kg[-1]), ketamine (1.6 mg kg[-1]), and additional propofol titrated to effect (1.5 and 0 mg kg[-1] for chinchillas 1 and 2, respectively). Chinchilla 1 was administered one additional intravenous propofol bolus (0.5 mg kg[-1]) during ovarian pedicle manipulation. Anesthesia was maintained with TIVA, using constant rate infusions of lidocaine (100 μg kg[-1] minute[-1]), ketamine (0.6 mg kg[-1] hour[-1]), and propofol [1.6 mg kg[-1] hour[-1] (chinchilla 1) and 2.0 mg kg[-1] hour[-1] (chinchilla 2)]. Orotracheal intubation was achieved in both chinchillas using a 2.0 mm uncuffed endotracheal tube. Both chinchillas maintained spontaneous ventilation, although decreased respiratory rates, mild hypercapnia, and intraoperative hypothermia occurred. Recovery was uneventful in both cases. These cases suggest that this anesthetic protocol may provide satisfactory anesthesia for both short- and intermediate-duration procedures in chinchillas; however, further investigation is warranted to evaluate its safety and efficacy in a larger population. A review of the literature indicates this is the first report describing lidocaine-ketamine-propofol TIVA in chinchillas and the first report of uterine adenocarcinoma in this species.

A 13-year-old intact male mixed-breed dog with a left-sided adrenal gland mass presented for an anesthetized computed tomography scan to aid with surgical planning. The dog had previously undergone transvenous implantation of a single-chamber, right-sided permanent pacemaker placed for treatment of a high-grade second-degree atrioventricular block. The pacemaker mode was changed from variable rate response (ventricular pacing, ventricular sensing, inhibited response, and rate modulation) to fixed demand (ventricular pacing, ventricular sensing, and inhibited response) in preparation for anesthesia, and the rate was set to 95 beats minute[-1]. The dog was premedicated with intravenous (IV) butorphanol tartrate (0.3 mg kg[-1]) and anesthesia was induced with propofol (1.25 mg kg[-1], IV) and midazolam (0.3 mg kg[-1], IV). Anesthesia was maintained with isoflurane delivered in oxygen. Following induction of anesthesia, there was a decrease in the mean arterial blood pressure from 108 mmHg to 45 mmHg, which was effectively treated with a bolus of lactated Ringer's solution (5 mL kg[-1], IV) and infusions of dopamine (12 μg kg[-1] minute[-1]) and norepinephrine (0.1 μg kg[-1] minute[-1]). After starting dopamine and norepinephrine infusions, mean arterial blood pressure increased to 80 mmHg, and the ventricular rate decreased to 60 beats minute[-1]. Interrogation of the pacemaker revealed a change in T-wave morphology, which resulted in T-wave oversensing. Decreasing the lead sensitivity of the pacemaker corrected oversensing and restored the paced ventricular rate to 95 beats minute[-1].