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Anaesthesia considerations for a patient with suspected myasthenia gravis

02 December 2020
10 mins read
Volume 11 · Issue 10
Figure 1. Computed tomography highlighting a megaoesophagus (green arrow).

Abstract

This extended case reports explores the pre-, peri- and post-anaesthetic considerations in a 2-year 7-month-old male entire crossbreed with suspected myasthenia gravis after presenting with gastrointestinal signs and pelvic limb weakness. Myasthenia gravis is an immune-mediated neuromuscular transmission disorder, which greatly increases the risk of mortality in patients undergoing anaesthesia. Following specific nursing care, in this case no complications occurred and the dog went home 3 days later.

This extended patient care report highlights the nursing considerations required to safely and effectively manage a case with myasthenia gravis (MG) throughout the peri-anaesthetic period. It also focuses on the secondary conditions that may occur and outlines the nursing interventions and potential complications that can arise during the pre-anaesthetic and postanaesthetic stage. Veterinary nurse (RVN) knowledge of the condition is important in order to predict outcomes, minimise complications and maximise patient care. Autonomy of the RVN, gives further responsibility to understand and communicate potential problems with specialised diseases in order to correct, support and prevent further deterioration.

Species: Canine

Breed: Medium crossbreed

Age: 2 years 7 months

Sex: Male (entire)

Weight: 22.6 kg

This patient was considered class III for anaesthesia according to the American Society of Anesthesiologists (ASA) Physical Status Scale (moderate risk) (Academy of Veterinary Technician Anesthetists, 2013).

The patient presented to the primary care practice with diarrhoea, vomiting, regurgitation and pelvic limb weakness. The veterinary surgeon suspected neurological involvement and referred the patient to a specialist practice for further investigation. The history acknowledged a systolic heart murmur grade II/VI but no assessment from a cardiologist or echocardiogram was performed.

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