Postobstructive negative pressure pulmonary oedema in a dog

A 4-month-old English bulldog was anaesthetised for investigation and management of chronic urinary incontinence. In the postanaesthetic period, the patient developed respiratory distress, with marked cough and increased inspiratory effort. Diagnostic imaging suggested pulmonary oedema. After excluding all other causes of cardiogenic and non-cardiogenic pulmonary oedema, it was hypothesised that the patient developed postanaesthetic negative pressure pulmonary oedema, suspected to have been exacerbated by tracheal intubation with an oversized endotracheal tube leading to laryngeal swelling and obstruction. The animal was treated with oxygen supplementation, corticosteroids and β-2 adrenergic receptor agonists. The patient recovered from the event and was discharged from the hospital after 48 hours. This article discusses in further details other management options of negative pressure pulmonary oedema. This is the first case report discussing the pathophysiology, critical care and management of postanaesthetic negative pressure pulmonary oedema in a dog.