Nov. 3, 2025

🔓Your Game Plan for Brachycephalic Anaesthesia: Tips, Drugs, and Red Flags. With Dr Abbie Tipler

🔓Your Game Plan for Brachycephalic Anaesthesia: Tips, Drugs, and Red Flags. With Dr Abbie Tipler

Did you know that a brachycephalic dog with BOAS has a 433% higher anaesthetic risk than a dog with a normal nose?

Let me rephrase that: that Frenchie you’re spaying later this week is more than four times more likely to die on her surgery day than any of your other patients. 😳


Do we have your attention?!

Thanks mainly to the rising popularity of the French Bulldog, you’re probably anaesthetising these kinds of patients all the time.

So how do we reduce that risk? How do improve patient safety while decreeing your stress levels?!

At the Brachycephalic Care Unit, surgeon Dr Abbie Tipler and her team have polished brachycephalic anaesthesia down to a fine art, and in this episode, she shares all the gold.

From the days leading up to anaesthesia to selecting the safest mix of premed and anaesthesia agents, all the way to a calm, well-oxygenated recovery, this episode is the ultimate masterclass in brachycephalic anaesthesia.


Hit us up for the full show notes for this episode, as well as Dr Abbie’s brachycephalic pre-surgery history template, here. 


This episode is one of more than 600 from our subscriber-only clinical podcasts. If you like this style of learning, where I dig for all the pro tips and updates from some of the best specialists in the world, then you’ll love our clinical feed. Go check it out at thevetvault.com


Oh, and if you’d like to join me in Japan in February or the Maldives in April for the most fun you’ll ever have at a vet conference  - have a browse at vetsontour.com


Topics Covered:

Before the big day

  • Structured history taking: airway, gastrointestinal, sleep, and anxiety indicators
  • Understanding the link between upper airway obstruction and GI dysfunction
  • Assessing regurgitation, silent reflux, and aspiration risk
  • Pre-treatment protocols: omeprazole, metoclopramide, and diet adjustments
  • Identifying when to delay elective procedures for optimisation
  • Using C-reactive protein and radiographs to assess for aspiration pneumonia
  • Managing anxiety pre-hospitalisation with trazodone

Plan for the day of surgery

  • Fasting times and timing surgeries for optimal recovery monitoring
  • Strategies for minimising stress in brachycephalic patients pre-op
  • The role of early premedication and pain relief
  • Drug choices: the “Goldilocks” approach to sedation
  • Reducing regurgitation risk
  • Your pre-op pro tips
  • Extubation and recovery: positioning, monitoring, and oxygen weaning
  • The impact of cage-side nursing and owner-assisted recovery