Traumatic Endotracheal Intubation in the Cat

Background: Orotracheal intubation is a commonly performed procedure in the cat, but it is not without complications. Tracheal rupture has been reported in cats, but trauma to the arytenoids from intubation has not been documented.

Observations: An otherwise healthy, 5-year-old male domestic shorthair cat presented for total ear canal ablation to resolve intractable otitis media and externa. The cat was premedicated with glycopyrrolate, hydromorphone, and acepromazine. Anesthesia was induced with diazepam and ketamine, and maintained with isoflurane in oxygen. During orotracheal intubation, the larynx was poorly visualized and excessive force was used to perform intubation. Subsequently, blood was observed in the larynx and laryngoscopy revealed a tear lateral to the patient's right arytenoid which had been created during intubation. The larynx was re-intubated normally and the cat suffered no obvious ill effects from the trauma to the larynx.

Conclusions: Direct observation and proper technique must be employed during orotracheal intubation in cats in an attempt to avoid laryngeal trauma.