Blind digital orotracheal intubation in two dogs with difficult glottis visualization.

Abstract

This report describes two cases of dogs in which a blind digital intubation technique was successfully used to manage difficult airways. A 9-year-old, 4.9 kg castrated male Poodle dog with history of cough and submandibular subcutaneous mass and a 13-year-old, 5.7 kg castrated male Poodle dog with dyspnoea and stridor were referred for computed tomography. In both dogs, a mass obstructing the glottis was identified following induction of anaesthesia, rendering it impossible to visualize the airway with laryngoscope use. Oxygen supplementation by face mask was ineffective and hypoxaemia worsened during repeated attempts to secure the airway. To facilitate digital intubation, the operator's nondominant index finger was introduced into the mouth, displacing the mass to access the epiglottis and palpate the glottis. The endotracheal tube was then inserted into the trachea with digital guidance, resulting in successfully secured airways in both dogs. Digitally facilitated intubation has not been described in detail or studied in small animal practice, although the technique is performed in larger animal species and in human medicine. As digital palpation provides tactile perception of key structures, blind digital intubation can be a valuable approach to facilitate intubation in dogs when direct visualization is obscured and endoscopy equipment not readily available.