veterinary

1. Anaesthesia for English Bulldog
Caesarean Section
Rachel Brown
Justine Dooey
Stephanie Harmon

2. Case Details
 6 year old English Bulldog
 20 kg bodyweight
 Heavily pregnant
 2 hours unproductive straining
 Caesarian section required

3. Main Considerations
 Brachycephalic
 Pregnant
 Pups

4. Brachycephalic Breed
 Brachycephalic Obstructive Airway Syndrome
 Stenotic nares
 Elongated soft palate
 Hypoplastic trachea
 Everted laryngeal saccules
 Increased Risk of Regurgitation and Aspiration

5. Effects of Pregnancy on Bitch
 Cardiovascular
 Increased cardiac workload
 Aortocaval compression → supine hypertension
 Respiratory
 Decreased total lung volume and function
 Higher O2 demand to CO2 production
 Rapid desaturation → hypoxaemia
 Gastrointestinal
 Delayed gastric emptying with decreased oesophageal sphincter tone
 Neurological
 ~35% increased sensitivity to anaesthetic agents
 Changes in Progesterone and Beta Endorphin levels have Sedative Effects
 Haematology
 Decreased HCT

6. Anaesthetic Effects on Pups In Utero
 Placental transfer of drugs to pups
 Cross the blood-brain barrier
 Respiratory Depression
 Hypotension
 Bradycardia
 Drug transfer from milk
• (Little research in dogs)

7. Anaesthetic Aims
 Be cautious of drug overdoses
 Decrease drug exposure time
 Increase drug elimination rate
 Maintain hydration and blood pressure
 Maintain oxygenation
 Provide analgesia without affecting pups
 Rapid recovery to decrease respiratory complications
 Maintain airway

8. Anticipated Complications
 Hypotension
 Provide I.V. fluids
 Keep isoflurane concentrations at a minimum
 Bradycardia
 Keep isoflurane at a minimum
 Hypoxaemia
 Provide 100% O2
 Hypothermia
 Bair hugger

9. Anaesthetic plan
 Try to Avoid Pre-Medication but if Necessary
 Acepromazine I.M.
 0.01mg/kg = 0.2mg= 0.1ml
 Pethidine I.M.
 2mg/kg = 40 mg = 0.8mls
 Pre-oxygenate 3-5 mins before induction
 Surgical clip and prep whilst awake in lateral recumbency
 Induction
 Propofol I.V.
 4mg/kg = 80mg; 10mg/ml; draw up 12ml
 Fast Intubation with cuffed tube – smaller ET tube than expected
 Maintenance
 Bain breathing system; Isoflurane and O2 4L/min
 Isoflurane MAC decreases 40% in pregnant animals
 IVFT 10ml/kg/hr = 200ml/hr Hartmann’s

10. Analgesia
 Midline Local Anaesthetic Block
 50% Lidocaine:Bupivacaine Intradermally
 4mg/kg = 80mg = 4ml
 1mg/kg = 20 mg = 4ml
 When Last Pup Out
 Methadone 0.2-0.5mg/kg 0.4-1ml I.M.
 Meloxicam 0.2mg/kg = 0.8ml S.C. – One off dose

11. Post Operative Care & Analgesia
 Bitch
 Keep ET tube in until fully awake to maintain airway
 Methadone every 4 hours as needed for pain
 1mg/kg = 20mg = 2ml S.C.
 Send home on Tramadol (not licensed)
 2-5mg/kg 2-3 times daily
 Pups
 Assess every 30 seconds
 Prevent hypothermia
 Provide 100% O2
 Mask or ET intubation if no spontaneous breathing

12. References
 Vullo, Cecilia, et al. "Anesthetic Management during Cesarean
Section in English Bulldogs." Journal of Life Sciences 8.1
(2014): 58-64.
http://www.davidpublishing.com/davidpublishing/Upfile/5/
27/2014/2014052708753330.pdf
 D. Flaherty, Anaesthesia for caesarean section BVMS 4
University of Glasgow Lecture.
 PREGNANT TIPS | PREGNANCY GUIDE. (n.d.). Retrieved
April 30, 2015, from http://pregnancy.pregnantshop.info/8-
week-pregnant-english-bulldog
 Pricing for our English Bulldogs. (n.d.). Retrieved April 30,
2015, from
http://www.bulldozeenglishbulldogs.com/Pricing.html