Seizures in 3 juvenile dogs after intravenous anesthetic drug withdrawal during weaning from mechanical ventilation suspected to be a sign of iatrogenic withdrawal syndrome

J Vet Emerg Crit Care (San Antonio). 2024 Mar-Apr;34(2):173-178. doi: 10.1111/vec.13366. Epub 2024 Feb 26.

Abstract

Objective: To describe seizure activity in juvenile dogs successfully weaned from long-term mechanical ventilation.

Case series summary: Three juvenile dogs (all approximately 3 months old) underwent long-term mechanical ventilation with IV anesthesia for suspected noncardiogenic pulmonary edema. Within 24 hours of extubation and within 10 hours of discontinuing midazolam continuous infusions, all dogs experienced seizures, which is 1 sign of iatrogenic withdrawal syndrome. Each dog was treated with an anticonvulsant protocol, and none experienced seizures after being discharged.

New or unique information provided: Each dog received IV anesthesia, including fentanyl, dexmedetomidine, midazolam, and propofol, during mechanical ventilation and subsequently experienced seizures after successful weaning from mechanical ventilation. Juvenile dogs may be at risk for seizures after weaning from mechanical ventilation and IV anesthesia. Neurological monitoring and further research into an appropriate weaning protocol may prove beneficial in juvenile dogs requiring prolonged anesthesia.

Keywords: anesthesia; canine; extubation; ventilatory support.

MeSH terms

  • Anesthetics, Intravenous
  • Animals
  • Dog Diseases* / chemically induced
  • Dogs
  • Iatrogenic Disease / veterinary
  • Midazolam / adverse effects
  • Respiration, Artificial* / veterinary
  • Seizures / chemically induced
  • Seizures / veterinary
  • Ventilator Weaning / methods
  • Ventilator Weaning / veterinary

Substances

  • Midazolam
  • Anesthetics, Intravenous