Anesthesia and Perioperative Management of a Pneumonectomized Dog

Abstract

Although left- or right-sided pneumonectomy is tolerated by normal dogs, complications impacting the respiratory, cardiovascular, and gastrointestinal systems are not uncommon. Pneumonectomy in dogs results in secondary changes in the remaining lung, which include: decreased compliance and vital capacity; and increased pulmonary vascular resistance potentially leading to right ventricular hypertrophy. Such alterations make the anesthetic management of an animal with one lung particularly challenging. This report describes a dog with a history of left pneumonectomy due to Aspergillus fumigatus pneumonia 3 yr before presentation. The dog presented with a vaginal wall prolapse, and surgical resection of the protruding vaginal wall, ovariectomy, and prophylactic gastropexy were performed. Anesthesia was induced with midazolam, fentanyl, and propofol and was maintained with isoflurane using intermittent positive pressure ventilation and a constant rate infusion of fentanyl. Epidural anesthesia was also used. Recovery and postoperative management were uncomplicated. Intensive hemodynamic and respiratory monitoring and appropriate response and treatment of any detected abnormalities, taking into consideration the pathophysiologic alterations occurring in a pneumonectomized animal, are required for successful perianesthetic management.

Outcome After Pneumonectomy in 17 Dogs and 10 Cats: A Veterinary Society of Surgical Oncology Case Series

“…Approximately half (14/27) underwent pneumonectomy for neoplasia with 10 animals having pulmonary adenocarcinoma. This distribution is consistent with the 14 cases of pneumonectomy previously described in the veterinary literature, where 7 were treated for neoplasia.…”

“…Pneumonectomy, defined as surgical excision of the entire left or right lung, is an infrequent procedure in veterinary surgery. Several reports have described outcome after pneumonectomy in dogs and cats, although two reports did not focus on outcome with one study assessing the impact pneumonectomy on the right‐side cardiac function and the another report focusing on the anesthesia and perioperative management of a pneumonectomized dog . Factors associated perioperative mortality, complications, or successful outcome remain largely unknown in dogs and cats.…”

“…The primary indication for pneumonectomy in people for treatment of lung cancer . In the 14 cases of pneumonectomy thus far reported in the veterinary literature, 7 were for neoplasia …”