Dog with breathing trouble from blood clot in tracheotomy tube

Abstract

CASE DESCRIPTION: A 7-year-old Spaniel-crossbreed dog was evaluated for stertorous breathing and inspiratory stridor. CLINICAL FINDINGS: A temporary tracheotomy tube was placed prior to referral. Results of physical examination at our facility, including thoracic auscultation, were unremarkable. Examination of the larynx revealed a 2 x 2-cm nodular mass on the lateral aspect of the epiglottis and left arytenoid cartilage. Cytologic examination of the mass indicated septic suppurative inflammation and intracellular rod-shaped bacteria. During the procedures, decreased air movement through the temporary tracheotomy tube was detected, and the tube was replaced. A thrombus was found on the distal end of the temporary tracheotomy tube; the thrombus obstructed 90% of the tube lumen. Approximately 12 hours later, auscultation revealed decreased sounds in all lung fields. Cervical and thoracic radiography revealed an intraluminal soft tissue opacity distal to the tracheotomy tube. A thrombus that contained hair and plant material was removed from the trachea by use of an embolectomy catheter and videogastroscope. Approximately 30 hours after removal of the initial thrombus, the dog had an episode of respiratory distress. Cervical radiography revealed another intraluminal opacity. It was another thrombus, which also was removed by use of the videogastroscope. TREATMENT AND OUTCOME: Tracheoscopy was performed with a videogastroscope in an attempt to remove the thrombi. A Fogarty catheter was used to remove the initial intraluminal thrombus from the trachea. CLINICAL RELEVANCE: Airway obstruction resulting from an intraluminal thrombus in the trachea should be considered as a secondary complication after tracheotomy tube placement.