Persistent hypotension resolved by neostigmine administration in a dog in which atracurium was used

Abstract

A dog with a large abdominal mass underwent coeliotomy. Before surgery, the dog was anaemic, hypoalbuminaemic and had a grade III out of VI left sided holosystolic heart murmur; no signs related to heart failure were detected on thoracic radiographs. After intramuscular administration of methadone, anaesthesia was induced intravenously (IV) with fentanyl and propofol and maintained with isoflurane in oxygen. Lungs were mechanically ventilated using a volume‐controlled setting. To manage ventilation asynchrony, atracurium was administered IV. Concurrent hypotension did not respond to lowering the isoflurane concentration, crystalloid and colloid boluses administration, and dobutamine infusion. Surgery lasted 40 minutes, and the mass was easily removed. At end of surgery, neostigmine was administered IV slowly, and a progressive improvement of arterial blood pressure was recorded. The animal was then allowed to breathe spontaneously, and isoflurane was discontinued. Recovery from general anaesthesia was uneventful.