Etorphine-Ketamine Constant Rate Infusion for Maintenance of Anaesthesia in a Compromised White Rhinoceros (Ceratotherium simum)

A subadult white rhinoceros bull presented for oesophageal endoscopic evaluation and foreign body removal under general anaesthesia. The animal had a history of nasal and oral regurgitation of water and ingesta with weight-loss for 6 days prior to the procedure and had been diagnosed with oesophageal obstruction caused by a bailing wire. Anaesthesia was induced with intramuscular etorphine and azaperone delivered remotely by dart, followed by an intravenous bolus of ketamine. The trachea was intubated, and anaesthesia was maintained with an etorphine-ketamine constant rate infusion (CRI). The rhinoceros did not respond predictably to induction of anaesthesia and developed life-threatening systemic hypotension throughout the 90-minute procedure. A mega-vertebrate demand ventilator was successfully used to provide intermittent positive pressure ventilation when the rhinoceros developed apnoea. This case report describes the maintenance of anaesthesia of a white rhinoceros using an etorphine-ketamine CRI and the causes and management of hypotension and respiratory impairment observed in this patient.