Intubation in Cat & Dog

Question 1

what are the steps to intubate dogs

Answer 1

1. Choose appropriate size of cuffed endotracheal tube for your patient.

1. Pre – measure the tube from just beyond the incisors to the point of the shoulder.
2. With assistant providing appropriate positioning, pull tongue forwards and down whilst protecting underside from the lower incisors.
3. Visualise the soft palate and epiglottis. Use laryngoscope if available – the laryngoscope should be placed on the vallecula and not on the epiglottis. If the epiglottis is obscured by the soft palate, use the tip of the endotracheal tube to push the soft palate upwards.
4. Holding the endotracheal tube horizontally, advance the tip over the epiglottis.
5. As you advance through the larynx, rotate the tube vertically 90 degrees and insert tube into the trachea.
6. A narrow strip of bandage can be tied tightly around the endotracheal tube and then around the upper mandible behind the canine teeth. Alternatively, the bandage may be tied at the back of the patient’s head.
7. Inflate the cuff using a syringe and fold the inflating tube back on itself. A needle cap can then be used to seal the folded tube.
8. Perform appropriate checks to ensure that the cuff is inflated correctly and that the endotracheal tube has not been inserted into the oesophagus.

Question 2

how long is the length of the ET

Answer 2

should extend from just beyond the incisors to the point of the shoulder

should not advance past the point of the shoulder as this carries risk of insertion into main bronchi

Question 3

how do you check the placement of the tube

Answer 3

1. direct visualization
2. holding piece of hair at end of tube and watching for movement
3. squeezing bag to see if chest rises
4. capnograph to detec expired CO2 –> ideal method if capnograph available

pressing on chest –> not recommended as can give false positive if air present in stomach

Question 4

what are the steps on intubating cats

Answer 4

1. Choose appropriate size of uncuffed endotracheal tube for your patient. Size 4 or 5 uncuffed tube often suitable for adult cats.

1. Pre – measure the tube from just beyond the incisors to the point of the shoulder.
2. Spray the larynx with local anaesthetic, (1-2 sprays only). Wait 30 – 60 seconds. Intubation should only proceed once the larynx is relaxed and fully desensitised.
3. With assistant providing appropriate positioning, pull tongue forwards whilst protecting underside from the lower incisors.
4. Visualise the soft palate and epiglottis. Use laryngoscope if available – the laryngoscope should be placed on the vallecula and not on the epiglottis. If the epiglottis is obscured by the soft palate, use the tip of the endotracheal tube to push the soft palate upwards. Care should be taken not to cause trauma to the epiglottis.
5. Advance the endotracheal tube through the vocal cords into the trachea.
6. A narrow strip of bandage can be tied tightly around the endotracheal tube and then behind the patient’s head.
7. Perform appropriate checks to ensure that the endotracheal tube has not been inserted into the oesophagus.

Question 5

where should the ET extend from in the cat

Answer 5

just beyond the incisors to the point of shoulder

Question 6

what needs to be taken into consideration in cats

Answer 6

extremely sensitive and prone to laryngospasm

poor technique may cause edema and occlusion of airway

if cuffed tube is used in cat –> do not over-inflate the cuff as this may cause severe damage to trachea