How to Perform a Tracheotomy in a Dog

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January 2024

In this VETgirl online veterinary continuing education video, Dr. Nancy Zimmerman, MS, CCRT, DACVS (with help from Dr. Jennifer Mahon, DACVECC too!) shows how to perform a tracheotomy in a dog. This video, filmed at the Oquendo Center of the Viticus Group, demonstrates an infrequently – but important – procedure that emergency veterinarians must be able to perform to stabilize an upper airway obstruction to allow appropriate delivery of oxygen to the critically ill patient. A tracheotomy is a surgical procedure that can be life-saving in the dyspneic patient. While not commonly performed, there are several reasons why a patient may require an emergency tracheotomy including upper airway obstruction (by bypassing the obstruction), severe neck trauma, etc. In these cases, a tracheotomy can provide immediate relief and allow for control of the airway.

This procedure (on a deceased patient*) demonstrates how to perform an emergency tracheotomy for a temporary tracheostomy. A longitudinal ventral midline incision is performed through the skin, subQ and between the ventral muscles of the neck.  This exposes the trachea.  Be careful not to cut the recurrent laryngeal nerves that lie on either side of the trachea and innervate the muscles of the larynx! Make sure to also avoid important structures such as the carotid artery, jugular vein, etc. A transverse incision is then made between tracheal rings involving no more than 180 degrees of circumference. Once the lumen of the trachea is exposed, insert a tracheotomy tube or endotracheal tube to secure the airway. Place stay sutures around the rings on either side of your tracheal incision to allow you to easily place your tracheostomy tube; this will also allow for it to be replaced if it gets dislodged or clogged.

NOTE: Sometimes you’ll hear the term tracheostomy versus tracheotomy being used interchangeably. Please note that this will vary by the exact procedure (and surgeon). In general,  an -otomy is an incision into an organ or space, while an -ostomy is a temporary or permanent hole in an organ or space. Therefore a tracheotomy is an incision to the trachea – typically  between two tracheal rings in order to place a tube in which then becomes a temporary tracheostomy.  A permanent tracheostomy typically involves removing a portion of multiple rings and the tracheal mucosa is then sutured to the skin to form a permanent stoma.  Tracheostomies are generally done if you want to put in a permanent or long term bypass of the larynx where as a tracheotomy is generally a short term emergency procedure. *In the live patient, this should be performed with aseptic technique in an intubated patient (if possible).

This specialized education is brought to you by an exclusive partnership between VETgirl and Viticus Group. Visit ViticusGroup.org for hands-on lab courses year-round covering orthopedic and soft tissue surgery, as well as dentistry, endoscopy and ultrasound. Use the discount code VETGIRL2024 when you register for a hands-on Academy course with the Viticus Group for $100 off the registration exclusively for VETgirl members.

Viticus Group

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  1. Excellent video, thank you!
    Would love to see a condensed 1 minute video for those truly emergent situations as a quick refresher.

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