Alfie – An unusual cause of cough
Alfie is a 20 month old working English Springer Spaniel. One Tuesday, he had been working a wheat field that had recently been harvested. Later that day he developed a cough. This progressed that night so that he seemed to be coughing continually. A visit to the local vet the next day resulted in a course of antibiotics but unfortunately did not result in an improvement and Alfie was still coughing. By Friday, he was very depressed and coughed continually. He was referred as an emergency to Simon Swift, RCVS recognised specialist in cardiology, at Northwest Surgeons that evening.
When he was examined by Simon he was an unhappy springer, with a soft moist cough and dull chest sounds on the left hand side. For a working springer, he was very subdued. He was admitted to the hospital and general anaesthesia was induced by Matt Gurney, European specialist in veterinary anaesthesia. A bronchoscope was passed into the trachea and advanced to the carina where it splits into left and right main stem bronchi supplying each lung. The left bronchus was completely obstructed by a large ear of wheat which was bathed in mucus and pus. Forceps were advanced down the biopsy channel of the bronchoscope and used to grasp the foreign body. Traction was applied and after some resistance, the object was withdrawn from the airway to loud applause from the assembled nurses! Re-examination of the airway showed some slight bleeding and pus in the airway beyond the obstruction. Fortunately no other foreign bodies such as grains were present in the lower airways.
Alfie recovered well from his anaesthetic and was discharge the next day with a two week course of antibiotics. He was rested from work until the end of his antibiotics and should be working cover again shortly.
Bronchoscopy can present a particular problem in dogs and cats. The size ofthe endoscope often adds complexity to the anaesthetic procedure. As a result, we cannot use anaesthetic gases and instead have to use intravenous injectable agents to maintain anaesthesia. Fortunately, our specialist in anaesthesia can manage that side of things so the clinician can concentrate on the bronchoscopy. In Alfie’s case, oxygen was entrained into the airway using a narrow catheter and Alfie’s oxygenation remained high throughout the procedure.
Matthew GurneyMatt graduated from the University of Liverpool in 2003 and spent the next two and a half years enjoying general practice. In 2006 he returned to academia to undertake a residency training in anaesthesia and critical care and he gained the Royal College of Veterinary Surgeons Certificate in Veterinary Anaesthesia in 2007. Matt joined Northwest Surgeons in early 2009 where he provides exemplary expertise in anaesthesia and his passion for pain management is of great benefit to many of our patients.Matt is a diplomate of the European College of Veterinary Anaesthesia & Analgesia and was awarded RCVS specialist status in 2013. Recently he has completed the postgraduate certificate in Veterinary Business Management through the University of Liverpool. Matt is the Vice President of the European College of Veterinary Anaesthesia & Analgesia.Upcoming CPD with MattEach year I run a local anaesthesia course with CPD Solutions. You can register here.CPD I'm attendingAn essential area of my pain management practice is acupuncture. In May this year the Western Veterinary Acupuncture Group is holding a day symposium in Scotland which will be a fantastic opportunity to update in this area. Find out more here.PublicationsHernon T, Gurney MA, Gibson S (2018). A retrospective study of feline trauma patients admitted to a referral centre. Journal of Small Animal Practice, 99, 617. http://doi.org/10.1136/vr.103859Gurney MA, Bradbrook CA. (2016) Common ECG abnormalities in the peri-op period. In Practice.Gurney MA & Milella, L. (2015) Dental & Oral Surgery. Chapter 20. In: BSAVA Manual of Small Animal Anaesthesia & Analgesia.Gurney MA, Leece EA. (2014) Analgesia for pelvic limb surgery. A review of peripheral nerve blocks and the extradural technique. Vet Anaesth Analg 41(5):445-58Madden M, Gurney M, Bright S. (2014) Amantadine, an N-Methyl-D-Aspartate antagonist, for treatment of chronic neuropathic pain in a dog. Vet Anaesth Analg. 41(4):440-1.Dutton TA, Gurney MA, Bright SR. (2014) Intra-articular mepivacaine reduces interventional analgesia requirements during arthroscopic surgery in dogs. J Small Anim Pract. 55(8):405-8.Gurney MA (2012) Options for intra-operative and early post-operative analgesia: an update. J Small Anim Pract. 53(7):377-86.Kibanda J, Gurney MA (2012) Comparison of two methods for management of intra-operative hypothermia Vet Rec. 170(15) 392.Vettorato E, Bradbrook C, Gurney M, Clark L, Corletto F. (2012) Peripheral nerve blocks of the pelvic limb in dogs: a retrospective clinical study. Vet Comp Orthop Traumatol 25(4):314-20Gurney M, Rysnik M, Comerford E, Cripps P, Iff I. (2012) Intra-articular morphine, bupivacaine or no treatment for postoperative analgesia following unilateral elbow joint arthroscopy. J Small Anim Pract. 53(7) 387-392.