Inadvertent fatal carotid artery laceration at the time of jugular venipuncture in a healthy cat

Abstract

A 4-year-old female spayed Siamese was referred for an episode of collapse and tachypnea after routine jugular venipuncture. On presentation, the patient was obtunded, laterally recumbent, hypothermic, hypotensive, and tachypneic with increased respiratory effort. Point of care ultrasound (POCUS) was negative for peritoneal, pleural, and pericardial effusion but revealed an underloaded left ventricle. Point of care bloodwork revealed severe anaemia and hypoproteinemia (PCV/TS 20%/4 g/dl), concerning for acute haemorrhage given the normal bloodwork performed that morning (PCV/TS 42%/6.9 g/dl). Progressively dyspnoea and stridor were noted; the cat's neck was swollen and firm, and emergent intubation was performed. Bruising and a small amount of active haemorrhage from a puncture was noted around the right jugular vein so a neck wrap was placed to tamponade the bleeding, but the cat became progressively bradycardic and arrested. Post-mortem results were consistent with inadvertent laceration of the right carotid artery during routine jugular venipuncture.