Peer-reviewed veterinary case report
Suspected air embolism associated with post-anesthetic pulmonary edema and neurologic sequelae in a horse.
- Journal:
- Veterinary anaesthesia and analgesia
- Year:
- 2007
- Authors:
- Holbrook, Todd C et al.
- Affiliation:
- Boren Veterinary Medical Teaching Hospital · United States
- Species:
- horse
Plain-English summary
A 523 kg Quarter Horse was put under anesthesia for surgery to remove one of its eyes. Everything went smoothly during the surgery, but after waking up, the cap on a catheter in its neck came loose, which likely allowed air to enter the bloodstream. This caused the horse to develop fluid in its lungs and low oxygen levels, but those issues improved with treatment. Unfortunately, the next day, the horse showed signs of balance problems and blindness. It received various treatments, including oxygen and medications, and after a week in the hospital, it was sent home and was back to normal neurologically after six weeks. While they couldn't confirm that air had entered the bloodstream, the sequence of events suggests it might have been a factor in the horse's complications.
Abstract
A 523 kg Quarter Horse was anesthetized for unilateral eye enucleation. The anesthetic period was unremarkable. During anesthetic recovery the cap on the jugular venous catheter became dislodged. Clinical signs of pulmonary edema associated with moderate arterial hypoxemia subsequently developed. Although pulmonary edema resolved with medical therapy, the day following anesthetic recovery, clinical signs of vestibular disease and blindness developed. Treatment included nasal oxygen insufflation, flunixin meglumine, furosemide, dexamethasone, thiamine, dimethylsulfoxide, antimicrobials, and phenylbutazone. The horse recovered and was discharged from the hospital after 7 days of treatment and was neurologically normal at 6 weeks. While venous air embolism was not confirmed in this case, the catheter cap complication followed by signs of pulmonary edema and neurologic sequelae support the presumptive pathogenesis of this horse's complications. Diagnostic confirmation of air embolism in horses with compatible acute clinical signs should be documented with echocardiography.
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Search related cases →Original publication: https://pubmed.ncbi.nlm.nih.gov/17444936/