Catheter‐associated air embolism of the brain in a hospitalised horse

Abstract

An 8‐year‐old, approximately 590 kg Belgian draft cross gelding was anaesthetised for tenoscopy and repair of a tendon sheath laceration. The horse remained hospitalised for several days. During post‐operative hospitalisation, the jugular catheter accidentally became disconnected from the extension set. The next day, the horse was blind bilaterally and circling to the left. Elevated cardiac troponin with mild tachycardia was also noted. The horse was treated supportively, but neurologic signs persisted, and after 3 weeks of no improvement humane euthanasia was elected. The most significant finding on gross postmortem examination was generalised cerebral oedema and gross malacia and haemorrhage of the left occipital cortex. Histopathology revealed regionally extensive grey and white matter necrosis in the left and right occipital cortices, consistent with an infarctive pathogenesis. The history and postmortem examination findings are compatible with air emboli in the brain. This is a rare but serious complication of intravenous catheter use in horses.