Endotracheal tube obstruction with a blood clot following aspiration of rumen contents in a reindeer

Summary An apparently otherwise healthy female reindeer was anaesthetised for open reduction and fixation of a hip luxation. The animal developed ruminal bloat which was treated with passage of an orogastric tube that was left indwelling during the procedure. A fluid inspiratory noise was audible two hours after decompression, and clear fluid was suctioned from the airway. It showed no other signs of regurgitation and aspiration of rumen contents intraoperatively, and did not develop obvious respiratory compromise while mechanically ventilated. In recovery, the deer became apnoeic and cyanotic and died suddenly within minutes of being positioned in the recovery box. Just before dying, it coughed a large blood clot out of the endotracheal tube (ETT). Additional clots were found partially obstructing the ETT lumen once extubated postmortem. Evidence of aspiration was detected at postmortem examination, which also identified pulmonary haemorrhage.