Temporary Tracheostomy

Placing a tracheostomy tube is occasionally a decision that needs to be made in an emergency situation, and is an understandingly scary and confronting situation for most owners. However, when required, it can be lifesaving. I have put together a series of pictures and videos to help you understand what the procedure is, what your dog will look like with a tube in place, and the care involved after tube placement. Please email us or call for a chat if you have further questions.

 

What is it?

A temporary tracheostomy is the surgical insertion of a breathing tube directly into the trachea (windpipe) in order to bypass the upper airway. The tube protrudes from the underside of the neck, and is left in place anywhere from 24 hours up to 3-4 days.

When is it needed?

There are two main situations where we would perform a temporary tracheostomy:

1. As a preemptive measure in high-risk patients prior to airway surgery

2. In any patient that is having life-threatening breathing concerns in the immediate post-operative period after airway surgery

 

Patients that are at higher risk of requiring a temporary tracheostomy include:

• Older patients (with each year over 2 years of age, the risk increases)
• Patients with severe BOAS symptoms, regardless of age
• Patients with Stage II  laryngeal collapse (though more common in dogs over 12 months of age, we do sometimes see it in younger dogs)
• Very anxious dogs (these guys often get quite stressed in the recovery period, and their panicky breathing can lead to airway swelling)

 

What care will my dog require once the tube is in?

Looking after a tracheostomy tube requires a high level of nursing care, especially in the first 24 hours. Dogs require 24 hours observation to monitor their breathing and ensure that the tube does not become obstructed with secretions. The tube needs to be cleaned and flushed every 2-3 hours. Some dogs require overnight emergency centre hospitalisation and nursing care, and severe cases may require mechanical ventilation. In patients that are stable and tolerating the tube well, owners can be taught how to maintain the tube overnight at home.

How is the tube removed?

Usually a mild sedation is given prior to tube removal. The tube is pulled out and the patient is carefully monitored afterwards. Stay sutures placed in the trachea at the time of initial tube placement allow easy replacement of the tube if the patient is still unable to breathe well without it. After removal, the wound in the neck is left to heal on its own.