Management of severe hypotension in a dog undergoing transvenous pacemaker implantation following acepromazine and subsequent terbutaline administration

Abstract

This case report describes events that occurred under general anaesthesia of a dog undergoing transvenous pacemaker implantation for third-degree atrioventricular block. Following premedication with acepromazine and buprenorphine, general anaesthesia was induced with alfaxalone, and maintained with isoflurane in oxygen. The dog developed severe hypotension during the procedure with concurrent bradycardia before commencement of pacing. In order to increase the heart rate, terbutaline was administered intravenously. This was followed by a worsening of the hypotension, with only a small increase in heart rate. Blood pressure improved following noradrenaline infusion. The animal recovered uneventfully in intensive care, and was sedated due to its anxious temperament to avoid dislodgement of the pacemaker device in the postoperative period.