Help with ET tubes in cats

RE: Help with ET tubes in cats

joanne newnham/rance — Thu, 22 Dec 2016 15:28:16 GMT

i was trained using milton sterilisation tablets, soaking the tubes for 30mins after cleaning and only recently been in practice where they use meddis.. never used lube for the tubes but used intubeeze, and this has always worked well. meddis was always used to as part of the endoscope cleaning protocol with a 30min contact time so cleaning an et tube is effectively the same. after drying, the cuff and patency of the tube was always checked to avoid undetected obstructions.. good old fashioned blow down the tube...

RE: Help with ET tubes in cats

Steph MacPherson — Thu, 22 Dec 2016 01:50:44 GMT

We use uncuffed ET tubes for all our routine Sx size 2 - 2.5 or a 3 for bigger cats. We do a LOT of prepubertal desexing where the kittens weigh a kilo. (Apart from dentals of course.) We use 0.1ml local applied topically to the larynx and wait a few minutes. We don't use any KY or lube. To clean they are extubated, rinsed in cold water, and I soak in Milton tablets - 1 tab per 1 litre of water. They are then rinsed again, wiped through with a pipe cleaner and left to dry before storing in a dust free drawer. I would not use anything like Hibiclens as it is irritant to mucous membranes. We have no issues with gurgling post op or coughing. In my training clinic where I taught for many years we used Atropine as a PM and that caused gurgling in recovery as it can make the saliva quite viscous.

RE: Help with ET tubes in cats

Karen Carver — Wed, 21 Dec 2016 12:05:48 GMT

is it after any op? spay/dental/stitch up? We started using Silkospray for lubricating ET tubes and found it much nicer than (and less messier) than lube. Although you need to spray it over a sink, if it gets on the floor it's like an ice rink!

RE: Help with ET tubes in cats

PSA-David — Fri, 09 Dec 2016 11:42:49 GMT

[quote user="Sal the 1st"]bit old fashioned maybe but what is wrong with milton tablets or liquid (or supermarket equiv) - damn site cheaper than anything else I have found and I figure if its safe for baby's bottles [/quote]

think this might be to do with it not being VMD authorized for veterinary pathogens such as KC virus?

RE: Help with ET tubes in cats

molladog — Fri, 09 Dec 2016 08:34:59 GMT

It's all about the rinsing......must really rinse well and leave in clean water for at least 30mins, solved our problem we had a few years ago.

RE: Help with ET tubes in cats

Shauna Whelan — Thu, 08 Dec 2016 21:16:41 GMT

Have you a particular length of time you leave in Milton? What concentration of Milton do you use?

RE: Help with ET tubes in cats

Shauna Whelan — Thu, 08 Dec 2016 21:13:13 GMT

Heya did you ever find a solution to this? I experience the same thing. We use Milton steriliser

Re: Help with ET tubes in cats

Juliet Drummond DAVN (med) RVN D32/33 — Thu, 05 Jan 2012 17:12:29 GMT

sorry i forgot to say, we soak in meddis for 20 - 30 mins ( we use a timer to prevent leaving for too long, we never leave them in meddis overnight)

Re: Help with ET tubes in cats

Juliet Drummond DAVN (med) RVN D32/33 — Thu, 05 Jan 2012 17:10:52 GMT

[quote user="Liv"]

After speaking to one of the partners, he would prefer if we continued to use meddis for the sterilising, unless i can find some good evidence to prove milton is as effective!

Juliet, out of interest which ET tubes do you use?

We probably will go ahead buying new ones, use meddis but also soak after in water!

Thanks again

[/quote]

hi, the majority of our tubes are non rubber, clear pvc, but we do have some red magill tubes in the larger sizes still in use. i err on the side of caution by soaking both types of tube, even though i don't thing the pvc tubes absorb the meddis as much as the rubber magill tubes.

Re: Help with ET tubes in cats

Leanne Henderson — Thu, 05 Jan 2012 13:37:33 GMT

I have used Meddis in the past (Magill ET tubes) and we found that occasionally if they were left too long, it degraded the tube/cuffover time. Also we were told to ensure that the tubes were rinsed thoroughly, as mentioned by others here, they will feel sticky and it has the obvious odour!

Good luck!

Re: Help with ET tubes in cats

Liv — Sun, 01 Jan 2012 10:11:55 GMT

After speaking to one of the partners, he would prefer if we continued to use meddis for the sterilising, unless i can find some good evidence to prove milton is as effective!

Juliet, out of interest which ET tubes do you use?

We probably will go ahead buying new ones, use meddis but also soak after in water!

Thanks again

Re: Help with ET tubes in cats

Juliet Drummond DAVN (med) RVN D32/33 — Sat, 31 Dec 2011 19:07:21 GMT

we use meddis to disinfect our tubes after cleaning,

we soak our tubes in fresh cold water for a minimum of 1 hour after rinsing the meddis off. this solved the gurgly cat problem for us.

i used to use milton, but i dislike the brown residue it left on the tubes and face masks, it also causes metal items to rust (e.g e.t. cleaning brushes)

Re: Help with ET tubes in cats

Liv — Sat, 31 Dec 2011 09:01:30 GMT

Thank you for all your comments guys.

Some people use washing up liquid to wash them first as well.

I was concerned that it was the meddis that was causing the irritation and maybe not being rinsed well enough. I am going to write a new protocol for washing them, using washing up liquid, then soak in milton, then a thorough soak/ rinse in water.

Maybe it is our old red ET tubes, so am going to put it to the partners to purchase some of the PVC uncuffed tubes for the cats. Dogs there is no problem with gurglyness.

I had been thinking about using milton, just wasnt sure whether it would be as effective as the meddis.

Will give it a go, and fingers crossed, no more gurgly cats!

Thankyou

Re: Help with ET tubes in cats

Sal the 1st — Fri, 30 Dec 2011 19:20:15 GMT

bit old fashioned maybe but what is wrong with milton tablets or liquid (or supermarket equiv) - damn site cheaper than anything else I have found and I figure if its safe for baby's bottles ........ the other advantage is there is no greasy sticky residue. I have used hibi in the past I have used meddis - I have seen a cat nearly die after it was intubated using a tube partially obstructed with a lump of dried meddis.

I know you cant soak metal items in milton but it isnt so difficult to remove metal connectors from larger tubes.

Re: Help with ET tubes in cats

Stuart Ford-Fennah — Fri, 30 Dec 2011 12:57:10 GMT

Hi Liv,

I can see two maybe three potential issues with your protocols,
Using hibiscrub to clean isnt a good idea with things whihc come in contact with mucous memebranes (trachea and oral cavity in this case) so i would either use medizyme and make sure you really do rinse throughly! or use something like fairly liquid to soak and clean if you want a cheaper option.

as for disinfection I would use meddis (we currently use meddis) ans soak for 30 mins and make sure the tubes are rinsed really erally well otherise you will get residue left befind whihc will build up over time - might be an idea to replace your old tubes with new ones - really cheap for JAK or AAS if you get the PVC ones whihc we like - they eventually get brittle but at £1 each they do really well - make sure you blow up the cuffs when cleaning otherwise you get debris and disinfectant in the creases. Also witht he PCV tumes they seem to be less likly to hold the residue than the red rubber ones and the tube wall thickness tends to be thinner so you cna fit a bigger tube (internal diameter) in the little patients

There was a study done when i was at uni which surgested the best technique to use was fairly liquid then surgical spirit however there was limited data - like most small studies.

Hope that helps

Stu

Re: Help with ET tubes in cats

Carol Cottrell — Fri, 30 Dec 2011 09:40:14 GMT

Hi there,

We use clear uncuffed tubes for all anaesthetics (small cuffed for dentals), few drops of lidocaine, no KY or any lube & once finished scrub inside & outside with tube brush/ nailbrush having sprayed & rinsed with Trigene 1/100 then leave to soak in Meddis for 30mins before rinsing & leaving to drain. We really like the clear, 2 holed tubes as much easier to ensure clean/not blocked & it's very unusual for us to get a gurgly reaction other than with the occasional dental.

Carol :)

Re: Help with ET tubes in cats

Celine — Thu, 29 Dec 2011 18:41:31 GMT

I've had this exact problem when I worked in a practice where the tubes were cleaned, then left in meddis - I think we figured out that they are only meant to be in for about 20 mins, and frequently ours were soaking until the end of the day when they would be rinsed and left to dry. My argument was always that I could smell the meddis very strongly on them even after rinsing well / soaking in water for a bit, and the concentration was correct but think they stayed in too long. We changed the protocol so that they were put in in batches with a timer set beside them and from memory we didn't have any more problems.