Use of total intravenous anesthesia with propofol and a vaporizer-free ventilator to prevent recurrence of malignant hyperthermia in a dog.

TIVA with propofol and vaporizer-free ventilation safely prevents malignant hyperthermia recurrence.

This case report describes successful management of a 13-year-old Toy Poodle with a history of malignant hyperthermia (MH) during isoflurane anesthesia 4 years prior, who presented for oral examination and biopsy of a tongue mass. The dog previously experienced MH signs including rapid temperature elevation to 42.0°C and increased end-tidal CO2, successfully treated with active cooling and dantrolene. For the current procedure, total intravenous anesthesia (TIVA) with propofol was selected as a non-triggering alternative, combined with a vaporizer-free ventilator to completely eliminate inhalant anesthetic exposure. Premedication included buprenorphine and atropine sulfate, followed by propofol induction and maintenance infusion (0.4-0.5 mg/kg/min). Throughout the 37-minute anesthetic period, rectal temperature gradually decreased and end-tidal CO2 remained stable, with no detectable isoflurane exposure. Recovery was uneventful with only mild postoperative creatine kinase elevation. Whole-genome sequencing identified a missense RYR1 variant (p.Arg2435His) identical to known human MH-causing mutations, confirming genetic susceptibility. This case demonstrates that propofol-based TIVA with vaporizer-free ventilation can safely prevent MH recurrence in genetically susceptible dogs.

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