Midwest Anesthesia Consulting Veterinary Services LLC

10/27/2026

A closer look at Mac&Cheese’s RETROGRADE INTUBATION ⏮️

The use of this technique is in cases of difficulty intubation due to jaw immobility such as jaw fractures, TMJ abnormalities, and/or masticatory myositis.

✅STEPS:

1. Aseptically prep the cranial neck
2. Palpate cricothyroid membrane
3. Insert and advance in a rostral direction an appropriately sized IV catheter & then remove the stylet
4. Insert a guide wire in a rostral direction until it exits the oral cavity (or sometimes the nose as in Mac’s case!)
5. Use the guide wire to feed an appropriately sized ETT or cannula in a aboral fashion until it can be felt passing the glottis & ending at the level of the cricothyroid space
6. Remove the guide wire & concurrently advance the ETT aborally
7. Remove the IV catheter once ETT inserted to appropriate depth
8. Confirm airway security via EtCO2 on capnograph
9. Secure & leak test ETT as usual

Alternative intubation techniques from traditional orotracheal can be CRUCIAL to supporting critical patient like Mac & Cheese 🛟 Who’s used this technique before?! Share your case stories with us below! 👇

💨💉💊🩺 😴🐶🐱🦜🐰🐢

10/22/2026

Welcome MAC&CHEESE to the MACvet Mindset! 💕

Mac was found at 2wks old as a stray kitten & it was apparent to his family he was struggling to eat… that’s when they discovered he was unable to open his jaw normally! 🙀 He was diagnosed with TMJ Ankylosis or jaw joint fusion. Mac’s case was severe and was impacting his ability to gain weight & grow like a normal kitten should…

This is where we collaborated with the amazing team at Advanced Veterinary Dental Care and Oral Surgery to find a way to help Mac 🤓 Mac’s case presented some interesting anesthetic 💉& dental 🦷 challenges that were a great example of why a collaborative approach to medicine results in the best medicine outcomes 🤝 The biggest ax concern for Mac was the uncertainty of being able to intubate him to provide much needed breathing support that required an alternative intubation technique called RETROGRADE INTUBATION & utilizing a TIVA (total intravenous anesthesia) protocol to ensure he could have his procedure occur smoothly 🙌

Between our Dr.Gaby, dentistry specialist Dr.Laura Sasser, and her team of amazing nurses, Mac was able to get the care he needed to continue life as normal kitty 😸

Mac is a special patient for our team — cases like his where we’re able to support him AND his team achieve a successful outcome is why we do what we do at MACvet 🫶 We’re grateful to be able to continue supporting patients of AVDCOS and other veterinary teams!

💨💉💊🩺 😴🐶🐱🦜🐰🐢

10/19/2026

VETERINARY NURSE APPRECIATION WEEK 🙏💌

Vet Techs/Nurses are the spinal cord of veterinary care — we specifically said spinal cord & not back-bone because the cord, and not the spine nor brain, is what allows a body to move ✊ Without these veterinary professionals, doctors and hospitals could NEVER provide the care that we do.

They are active and critical pieces to the puzzle of veterinary medical care & deserve to be treated as such. It’s important pet parents appreciate what these nurses do for their animals & that veterinary hospitals/doctors support their nurses with continued learning opportunities & financial support for them to grow and feel fulfilled in their careers.

If you know or see a veterinary nurse, not just this week but all days, make sure to thank them for their dedication to such an exhausting, but vital, role in veterinary medicine 🫶

💨💉💊🩺 😴🐶🐱🦜🐰🐢

10/13/2026

09/28/2026

CAT EXTUBATION TIP:
🐱 Kitties are EARLY extubators! If you wait for a swallow reflex, as we do in dogs, then that might potentially put your feline patients at risk.

Everyone is frustratingly mindful that cats often have laryngospasm at intubation, but did you know this can come back to bite us during extubation too?! 🙀 If a cat is extubated in a more “awake” depth of anesthesia, this also means the nerves that fire and tell their larynx to close will also be more awake & ready. When cats are extubated too awake, this can result in the extubation process stimulating their laryngospasm to occur & result in asphyxiation now that the ETT is out and the airway is closed 😵

To minimize this from occurring, it is recommended to extubate feline patients on the “sleepier” side of depth, therefore minimizing those laryngeal nerves from being stimulated to spasm & close their larynx. “When” to extubate is usually when you see a tongue or an ear flick — this is often enough indication their swallow reflexes will be appropriate to minimize risk of aspiration AND ensures the risk of laryngospasm is minimized.

Always have a pulse oximeter to ensure they are breathing & oxygenating their best once extubated 😮‍💨

P.S. that gurgling sound was the suction tubing & NOT fluid in the ETT in this video 😅

💨💉💊🩺 😴🐶🐱🦜🐰🐢

09/25/2026

MACvet is supporting teams all across the country 🇺🇸

This past weekend we had the amazing opportunity to provide a full day of in-person anesthesia training to the Intermountain Pet Hospital teams of Idaho 🥔
Intermountain Pet Hospital - Overland Intermountain Pet Hospital Chinden Intermountain Pet Hospital - Nampa Intermountain Pet Hospital Middleton

What started out as a single DVM’s inquiry to get more anesthesia support for her team, turned into a collaborative learning day involving multiple teams to extend the knowledge across all IPH hospitals 🙌 It was so wonderful to see all levels of vet professionals - from assistants to managers to nurses to doctors - take time out of their weekends to learn & provide fantastic anesthetic care for their patients 🤓

Thank you to Zoetis Petcare Zoetis for sponsoring this much wanted learning event and sharing an insightful L&L on Librela 🦴 And a huge shout out to Dr.Ashley Kimbel of the IPH-Overland team for spearheading this amazing CE day! We know their future patients (and cutie kitty Reba who got RACE-approved training) will be receiving fantastic anesthetic care in the future!

💨💉💊🩺 😴🐶🐱🦜🐰🐢

09/09/2026

LATERAL INTUBATION TIP 🫡

Whether indicated for a certain situation, procedure, or CPR, it’s important all anesthetist’s feel comfortable with lateral orotracheal intubations.

Key ways to success, especially when holding onto those big ETTs, is to always “think parallel” — 70% of success is in the assistant keeping the maxilla/snout in parallel with the table & the other 30% is in the anesthetist keeping their laryngoscope blade also parallel with the table. For the laryngoscope, use a forearm-based ventral motion 💪 , rather than a wrist-based tilting motion (which be a tough muscle habit to break 😅)

Because of the lateral recumbency & the notable neck extension required for this form of intubation to occur successfully, it is contraindicated in patients with:
🙅🏻‍♀️ high intracranial/intraocular pressure
🙅🏻‍♀️ cervical spinal disease and/or pain
🙅🏻‍♀️ GERD (no more gravity to help minimize regurge)
🙅🏻‍♀️ atelectasis (one lung side is squished now)

Share below any other tips you find helpful in gaining comfort with lateral intubations 👇💬

💨💉💊🩺 😴🐶🐱🦜🐰🐢