Hypoventilation After Placement of an External Splint in a Cat With Severe Pectus Excavatum Managed With Pressure Support Ventilation.

Postoperative hypoventilation after pectus excavatum repair requires mechanical ventilation and careful weaning protocols.

This case report documents the first reported instance of postoperative hypoventilation in a feline following surgical correction of severe pectus excavatum. A 20-week-old male Maine Coon cat presenting with lethargy, decreased appetite, and increased respiratory effort was diagnosed with severe caudal pectus excavatum via CT imaging. Following external splint placement for surgical correction, the patient developed persistent hypoventilation requiring mechanical ventilation support. Management involved total intravenous anesthesia with pressure support ventilation and daily spontaneous breathing trials to assess respiratory improvement. The cat was successfully extubated after 73 hours of mechanical ventilation. The external splint was removed after 6 weeks with complete resolution of clinical signs and radiographic improvement. The authors hypothesize that hypoventilation resulted from sudden alterations in thoracic volume combined with diaphragmatic dysfunction secondary to the severe preexisting thoracic malformation. This case highlights the importance of careful postoperative monitoring following pectus excavatum correction and the potential utility of light anesthetic protocols with pressure support ventilation in managing postoperative respiratory complications.

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