Anaesthetic management and complications of canine adrenalectomies: 41 cases (2007–2017)

Abstract

Little information is available about the management of adrenalectomies in veterinary anaesthesia. The aim of this study was to describe the anaesthetic techniques, the complication rate and outcome of these cases. Data were collected retrospectively from patients' records. Descriptive statistics were performed with Student's t-tests and Chi-square tests where appropriate. Forty-one cases were included. The mean age was 124.7 ± 29.4 months and the median body weight was 23.1 kg (5.3–69 kg). Carcinoma was the most common diagnosis (34.1%). Premedication was most commonly achieved with methadone alone (70.7%) IV. Propofol was the most common induction agent (39%). An infusion of opioids (80.4%) and an epidural injection of morphine (70.7%) were the most common analgesic techniques. Hypotension was the most common complication observed (51.2%). The mortality rate was 14.6%. The lowest recorded oesophageal temperature was statistically associated with the incidence of haemorrhage (P = 0.025). The invasion of the vena cava (P = 0.001) was significantly associated with haemorrhagic complications. The survival rate was better when patients received hydrocortisone intra-operatively (P = 0.026). This study highlights some possible association between the anaesthetic management and the outcome of the procedure.

Perioperative use of thoracic epidural anaesthesia, dexmedetomidine and magnesium sulphate infusion in a dog undergoing neuroendocrine tumour resection

“…16,26 The most common intraoperative complications are hypertension (58%-60%), hypotension (52%), cardiac arrhythmias (31%) and haemorrhage (26%). 19,27 The administration of phenoxybenzamine, an α-adrenergic receptor antagonist, for 2 weeks prior to adrenalectomy reduced the mortality rate by probably blunting the hypertensive crisis caused by a catecholamine storm. 19 In this case, phenoxybenzamine was not administered as the surgery was scheduled only 3 days after admission and, therefore, it was considered unlikely that adequate desired effects would have been achieved.…”

“…After PCC removal, postoperative complications occurred in 44.4%, while postoperative death occurred in 20%-25% of dogs. 19,22,27 Intensive postoperative monitoring is advocated. Within two postoperative days, the dog developed anaemia and a pRBC transfusion was administered.…”

Anaesthetic Management of a Labrador Retriever Undergoing Adrenalectomy for Phaeochromocytoma Excision, a Case Report

“…Phaeochromocytomas are catecholamine-producing neoplasia arising from the chromaffin cells of the adrenal medulla ( 1 – 3 ). In dogs, although uncommon (0.1% of all tumours) ( 4 ), it is the second most diagnosed adrenal tumour after adenocarcinoma ( 5 ). Clinical signs are non-specific and result from the excessive production of catecholamines ( 4 , 6 ).…”

Preoperative autologous blood donation and transfusion in dogs undergoing elective surgical oncology procedures with high risk of hemorrhage

“…Many scheduled canine surgical oncology cases such as craniectomy, 30 mandibulectomy, 31,32 maxillectomy, 33 hemipelvectomy, 34 thyroidectomy, 35 adrenalectomy, 36 and liver lobectomy 37 have high risk of hemorrhage. Preoperative autologous blood donation and transfusion are alternatives to allogeneic transfusion in these cases.…”

“…27,28 To the best of the authors' knowledge, only one case series (in 15 cats before craniectomy) exists in the veterinary medicine literature in which the use of PABD and autologous transfusion was documented. 29 Many scheduled canine surgical oncology cases such as craniectomy, 30 mandibulectomy, 31,32 maxillectomy, 33 hemipelvectomy, 34 thyroidectomy, 35 adrenalectomy, 36 and liver lobectomy 37 have high risk of hemorrhage. Preoperative autologous blood donation and transfusion are alternatives to allogeneic transfusion in these cases.…”