This document outlines an anaesthetic plan for a caesarean section in a 6 year old, 20 kg pregnant English Bulldog. English Bulldogs are brachycephalic breeds that are more susceptible to respiratory complications during anaesthesia due to narrowed airways. Pregnancy also increases cardiovascular and respiratory demands as well as sensitivity to anaesthetic drugs. The plan aims to decrease drug exposure time, maintain hydration and oxygenation levels, and provide post-operative analgesia to the bitch and newborn pups while minimizing risks. Precautions are outlined to address anticipated complications such as hypotension, bradycardia and hypoxaemia during the procedure.

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