About three weeks ago, a little male dog named Coreo came in for a regular neuter. Normally I don’t get called over to try to intubate by my techs, but this morning I did. For a moment, I thought they were playing a trick on me! He had a severe overbite so I could grab his tongue but the mouth wouldn’t open far enough to place the endotracheal tube in. An inch and a half just doesn’t cut it. We took some radiographs and woke him up. I wasn’t comfortable going forward with surgery if I couldn’t have airway access. If something had gone wrong, I wouldn’t have been able to control the situation.
Once he was awake, I went to take a look at the radiographs. Not only was he born with a congenital overbite, he also had a congenital malformation of the temporomandibular joint (jaw joint) on both sides. The only reason that he was doing was well as he was eating and drinking was because of the overbite allowing the tongue to grab the food. Dogs just never know they are disabled!
As the CT scan and surgery were not in the playing cards and Coreo was finding more things to hump, we agreed to go forward with the castration. I had one major concern; I still needed control of the airway. Since there could be more congenital problems, I needed to bypass the area. So, we did a temporary tracheostomy. I modified an endotracheal tube so it would fit into the trachea. It was cool being able to take the time to place one rather than doing it under the duress of an emergency.
I haven’t been so happy during surgery in quite a while. Every time I looked at Coreo’s oxygenation ranging between 97-98%, I just grinned. The recovery was pretty neat too. Once he woke up, we simply removed the tube. His muscles just covered the trachea sealing the hole and the skin will close shortly. Love my job!!!
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