Alfie – An unusual cause of cough
Alfie is a 20 month old working English Springer Spaniel. One Tuesday, he had been working a wheat field that had recently been harvested. Later that day he developed a cough. This progressed that night so that he seemed to be coughing continually. A visit to the local vet the next day resulted in a course of antibiotics but unfortunately did not result in an improvement and Alfie was still coughing. By Friday, he was very depressed and coughed continually. He was referred as an emergency to Simon Swift, RCVS recognised specialist in cardiology, at Northwest Surgeons that evening.
When he was examined by Simon he was an unhappy springer, with a soft moist cough and dull chest sounds on the left hand side. For a working springer, he was very subdued. He was admitted to the hospital and general anaesthesia was induced by Matt Gurney, European specialist in veterinary anaesthesia. A bronchoscope was passed into the trachea and advanced to the carina where it splits into left and right main stem bronchi supplying each lung. The left bronchus was completely obstructed by a large ear of wheat which was bathed in mucus and pus. Forceps were advanced down the biopsy channel of the bronchoscope and used to grasp the foreign body. Traction was applied and after some resistance, the object was withdrawn from the airway to loud applause from the assembled nurses! Re-examination of the airway showed some slight bleeding and pus in the airway beyond the obstruction. Fortunately no other foreign bodies such as grains were present in the lower airways.
Alfie recovered well from his anaesthetic and was discharge the next day with a two week course of antibiotics. He was rested from work until the end of his antibiotics and should be working cover again shortly.
Bronchoscopy can present a particular problem in dogs and cats. The size ofthe endoscope often adds complexity to the anaesthetic procedure. As a result, we cannot use anaesthetic gases and instead have to use intravenous injectable agents to maintain anaesthesia. Fortunately, our specialist in anaesthesia can manage that side of things so the clinician can concentrate on the bronchoscopy. In Alfie’s case, oxygen was entrained into the airway using a narrow catheter and Alfie’s oxygenation remained high throughout the procedure.
Matthew GurneyMatt graduated from the University of Liverpool in 2003 and spent the next two and a half years enjoying general practice. In 2006 he returned to academia to undertake a residency training in anaesthesia and critical care and he gained the Royal College of Veterinary Surgeons Certificate in Veterinary Anaesthesia in 2007. Matt joined Northwest Surgeons in early 2009 where he provides exemplary expertise in anaesthesia and his passion for pain management is of great benefit to many of our patients.Matt is a diplomate of the European College of Veterinary Anaesthesia & Analgesia and was awarded RCVS specialist status in 2013. Recently he has completed the postgraduate certificate in Veterinary Business Management through the University of Liverpool. Matt is the Vice President of the European College of Veterinary Anaesthesia & Analgesia.Upcoming CPD with MattEach year I run a local anaesthesia course with CPD Solutions. You can register here.For receptionists and practice managers, I am speaking at the Onswitch Cx Congress in June on 'How to reassure clients prior to anaesthesia'.In October I'm really pleased to be speaking alongside Sarah Heath, Clare Rusbridge and Gwen Covey-Crump discussing the interplay between pain and behaviour in Chester. More details here.CPD I'm attendingAn essential area of my pain management practice is acupuncture. In June this year the Western Veterinary Acupuncture Group is holding a day symposium in Scotland which will be a fantastic opportunity to update in this area. Find out more here.