Abstract
The objective of this prospective cohort study was to document the occurrence of post-operative hypoventilation in dogs undergoing decompressive ventral slot or hemilaminectomy for the treatment of intervertebral disc herniation (IVDH). Twenty dogs undergoing ventral slot surgery and 20 dogs undergoing hemilaminectomy surgery for the treatment of IVDH that presented to XX between 2017 and 2020 were enrolled. Dogs were anesthetized using a standard protocol. Blood gas samples were taken at up to 11 time points beginning during anesthetic recovery and continuing for a maximum of 72 h post-operatively. Dogs with cervical lesions that were non-ambulatory before surgery had more evidence of subclinical hypoventilation in the immediate peri-extubation period than dogs with less severe injuries or those undergoing hemilaminectomy surgery. We found no difference in the ventilation status in dogs undergoing cervical or thoracolumbar decompressive surgery for IVDH from 8 to 72 h post-operatively. Other markers of acid-base status indicated that subclinical hypoventilation within the peri-extubation period was transient and self-limiting. There was a moderate positive correlation between sedation scores and estimated PaCO2. These data suggest that dogs with severe cervical spinal cord injuries may be at risk for subclinical hypoventilation in the immediate peri-extubation period. Increased sedation may be correlated with decreased ventilatory status in dogs recovering from decompressive vertebral column surgery.
Highlights
Cervical myelopathies are associated with many perioperative complications attributed to the anatomic intimacy between the cervical spinal cord and vital structures, such as cardiovascular and respiratory tracts
40 client-owned dogs who were presented to the XX clinic between November 2017 and May 2020 were enrolled based on the following inclusion criteria: at least 1 year of age, at least 3 kg in body weight, presented for pain or neurologic dysfunction attributable to a cervical or thoracolumbar myelopathy that was determined to be due to intervertebral disc herniation (IVDH) by magnetic resonance imaging (MRI), and underwent decompressive surgery for the disc herniation under the same anesthetic event as the MRI
One of the tetraplegic dogs had clinical hypoventilation diagnosed at presentation by blood gas and clinical signs
Summary
Cervical myelopathies are associated with many perioperative complications attributed to the anatomic intimacy between the cervical spinal cord and vital structures, such as cardiovascular and respiratory tracts. Such complications include cardiac dysfunction and arrest, hypotension, aspiration pneumonia, hypoventilation, and seizure activity [1,2,3,4,5,6,7,8]. Java et al [4] reported that dogs that underwent cervical decompressive surgeries were six times as likely to develop post-operative pneumonia than post-operative patients with more caudal lesions. The incidence of post-operative aspiration pneumonia following the most common surgical approach to the canine cervical region, the ventral slot, was reported in a large retrospective study to be just 0.37% [8]
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