Rabbit Intubation

Intubating rabbits for anaesthesia can be tricky, and a worrying task for the general practice veterinarian who doesnt see many rabbits. A review by Molly Varga walks through all the options, with pictures included.

Check out this paper:

Varga, M. Airway management in the Rabbit. Journal ofExoticPetMedicine. 2017. 26,pp29–35.

Here is a summary of that review.

Intubation methods include;
  • Laryngoscope
  • Supraglottic Airway Devices
  • Otoscope
  • Blind

Laryngoscope

The ideal laryngoscope is called a flecknell laryngoscope – a straight flat laryngoscope that will allow you to depress the tongue and hopefully visualise the glottis. A stylet (plastic not metal) can be useful for this method.

Supraglottic Airway Devices

These devices operate like an et tube, but need to be lodged on top of the entry to the trachea, rather than advancing in. The tongue may appear cyanotic using this method, so place your pulse oximeter elsewhere.

Otoscope

In this method you a otoscope to visualise the glottis, using an otoscope in place of a laryngoscope. Once you have visualised the glottis you can either –
  • Place the et tube through the otoscope
  • Or place a urinary catheter as a guidewire, remove the otoscope, then thread your et tube over the urinary catheter. Resulting in one intubated rabbit!

Blind

With this method you use air sounds and flow through the tube to confirm placement. As the name suggests, you will not visualise the glottis. No equipment required, but does require finesse and skill.

Method for all choices –
Place your rabbit patient in sternal position and elevate the head and neck dorsally, without being 90 degrees to the surface the patient is on. Use your method of choice to gradually and carefully place the et tube until you have confirmation by airflow, sounds and condensation. Rabbits may cough when the et tube enters the trachea.

Hop to it!

References:
Varga, M. Airway management in the Rabbit. Journal ofExoticPetMedicine. 2017. 26,pp29–35.

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