NAME：Coco
GENDER: Female
AGE: 4
WEIGHT: 5KG
2.1 According to the BCS (Body Condition Scoring) body condition score of 4 points, overweight. Static observation of Coco breathing well, 26 times per minute, deeper, faintly heard the voice of the throat. Body temperature was 38.5 degrees Celsius. Heart rate was 186 beats per minute. In a good mental state. Oral mucosa was pink with a capillary refill time of less than 1 second.
2.2 The blood routine results were not significantly abnormal.
2.3 Abnormal biochemical results may be related to hunger, protein loss of intestinal diseases.
2.4 The coagulation function results were not abnormal.、
2.5 Cardiac ultrasound results: no abnormal flexion of the ventricular wall. No abnormal structural defects were observed. There is no obvious abnormality in cardiac structural function, so regular examination is recommended.
2.6 The ECG results showed no significant abnormalities.
2.7 X-ray of the throat needed to be dated. The sedative used was propofol, 8mg / kg. With an indwelling needle, preabsorb oxygen 3 minutes before sedation, and prepare 4.5,4,3.5 intubation. Slow through the indwelling needle to push intravenous propofol, the dog after 1 minute tongue color purple, throat sound, endotracheal intubation after oxygen and positive pressure ventilation support, after 20s the tongue color back to normal is pink, observe the soft palate will cover the epiglottic cartilage, the throat swelling, laryngeal cyst. The canine was breathing steadily for laryngeal X-ray shooting, and the laryngeal bone results were normal, no obvious abnormalities in the trachea, and skin folds caused by obesity.
After examination and analysis, it was determined that breathing problems caused by excessive soft palate. Explain the situation with the owner, and communicate the surgical plan, decided to use LunVet laser to remove the long soft palate, the advantages of high cutting accuracy, small tissue damage, no bleeding and so on.
4.Treatment
4.1 Preoperative medication
The operation time was on the evening of April 7,2022, and the anti-inflammatory drug cefazoline, 25mg / kg, was used before surgery. The painkiller meloxicam, 0.2mg / kg. The sedative Shutai was 1mg / kg. Induction anesthetic propofol, 6mg / kg, and deswelling drug dexamethasone 0.5mg / kg.
Turn on ultraviolet lamp disinfection 30min in advance, open laminar ventilation and filtration system during the operation, prepare basic equipment package and LunVet laser machine and convert it into laser knife.
Use preoperative anti-inflammatory drugs in the central disposal area, take the drug through intravenous injection, and wait for 10min after subcutaneous injection. The dog achieved the sedation effect, pre-inhalation oxygen intubation, connected to the gas anesthesia machine. After stabilization, he was moved to the operating room to continue the anesthesia with the gas anesthesia machine.
The pet lay supine, opened the mouth with gauze strips, pulled the tongue to the ventral side, and adjusted the shadowless lamp to expose the throat.
Use two thin lines to determine the soft palate needed to cut, pay attention to the position of the cutting, cutting too much will cause the pet to drink water choking , cut too little can not to achieve the effect. Pull the thin lines on both sides to expose the cutting area as shown in the figure 1 below. Cut a small wet gauze pad below the cutting area to prevent penetration into other tissues during laser cutting. Cut soft tissue with the custom protocol and infiltrate with lidocaine wet gauze after completion. The main purpose is to stop asthma and relieve cough. Because cough will further damage the tissue and increase the probability of local swelling, such as swelling will cause compression of the trachea, resulting in a high risk of asphyxia death, which requires special attention.Infiltration time should not be too long, more than ten minutes is appropriate, too long can lead to paralysis can not swallow. Finally, wipe the mouth with wet gauze, absorb oxygen and wait for the animal to wake up. During the awakening process, we must pay attention to the situation of the animal until it is fully awake. Wear a head cover to protect the throat to prevent the animal from scratching the throat due to discomfort.
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Closely observe the throat after the operation, and use laser physiotherapy for swelling, and pay attention to avoid the thyroid during operation. Cefazoline for 5 days, 25mg / kg twice a day.3 days of meloxicam, 0.1mg / kg, once a day.3 days of dexamethasone, 0.5mg / kg, once a day.
The postoperative condition was good, with no swelling at the cutting site, no breathing difficulties, and sleeping snoring.
LunVet laser surgery benefits of cutting of soft tissue:
Smaller wound
Great cutting results of the local tissue, the wound is small, small scar, no tissue contraction, easier to recover.
Less bleeding
During the process of laser cutting, proteins in the blood denatured and solidify after heating, which in hemostasis.
Avoid infection
Laser has the effect of directly killing bacteria and other microorganisms, so the postoperative infection rate is significantly reduced, and the surgical cutting effect of the infected wound surface is also good.
Less pain sensation
After laser surgery, there is less inflammatory response and less pain, which helps patients to improve the postoperative quality of life and accelerate healing.
Used in a variety of treatments
Electric knives should not be used close to metals (such as silver mercury, metal restorations, or implants), and laser surgery is safe for metals.
Elongated Soft Palate usually occurs in canine and feline, common method pug,French Bulldog, Pomeranian is relatively rare. It has a risk of suffocation and seriously affects the quality of life, but local swelling after surgery leads to a high risk of surgery, which is also a fear of many veterinarians, and the operation itself is not complicated.The overall effect of the laser surgery using the LunVet laser cutting is satisfactory. The laser cutting is simple to operate, and the accuracy is not damaged to the surrounding tissues, which is not comparable to other surgical tools. I used high frequency electric knife to remove the soft palate, which was easier to accidentally injure the surrounding tissues. LunVet surgical laser increased my confidence in this operation and reduced the risk of surgery.
