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Unsuccessful resuscitation with epinephrine in a dog with suspected severe perioperative anaphylaxis
Author(s) -
Sasaki Kazumasu,
Mutoh Tatsushi,
Shiga Takuya,
Gómez de Segura Ignacio Álvarez
Publication year - 2017
Publication title -
veterinary record case reports
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.165
H-Index - 4
ISSN - 2052-6121
DOI - 10.1136/vetreccr-2017-000440
Subject(s) - medicine , anesthesia , epinephrine , butorphanol , anaphylaxis , perioperative , cardiopulmonary resuscitation , isoflurane , propofol , midazolam , resuscitation , allergy , sedation , immunology
An 11‐month‐old ASA 1 male miniature dachshund was anaesthetised for neutering. Butorphanol and midazolam were administered as preanaesthetic medication along with cefazolin. Anaesthesia was induced with propofol and maintained with isoflurane. Latex products (surgical gloves and a breathing bag) were used intraoperatively. Intraoperative vital signs were within normal ranges. Approximately 5 min after extubation, the dog developed intense urticarial erythema, hypotension and pulmonary oedema. First‐line treatment with repeated intramuscular epinephrine, oxygenation, fluid loading, corticosteroids and antihistamines to address severe hypotension was unsuccessful. Additional vasopressin, continuous epinephrine infusion, mechanical ventilation and cardiopulmonary resuscitation proved unsuccessful and the owners opted for euthanasia. The causative agent remains unclear; serological or skin tests were not performed. This is the first report of severe perioperative anaphylactic shock in a dog unresponsive to current therapeutic recommendations based on epinephrine administration. Further research is warranted to advance clinical guidelines for managing anaphylaxis in dogs.