Evaluation of the V-gel^® Advanced Supraglottic Airway Device Across Different Ventilatory Modes in Anaesthetised Cats

Endotracheal intubation in cats carries risks; supraglottic airway devices (SADs) offer a less invasive alternative. This prospective clinical study evaluated the V-gel^® advanced in cats undergoing ovariohysterectomy, with the primary aim of intra-anaesthetic gas leakage; secondary aims were ease of placement, complications, and the effect of device re-use. Spirometric inspired/expired tidal volumes were recorded under predefined ventilatory settings; leakage was calculated and analysed. Of 52 cats enrolled, 47 were analysed. Leakage occurred in 13% during spontaneous breathing and rose to 41.8% with Continuous Positive Airway Pressure (CPAP) 5 cmH₂O; by contrast, controlled mechanical ventilation showed lower leakage, with the smallest values at Peak Inspiratory Pressure (PIP) of 12 cmH₂O and 16 cmH₂O (2.1% and 6.5%, respectively). Re-used devices leaked less than new ones (p = 0.003). Placement by students was straightforward after adequate depth was achieved. Complications included mild regurgitant material in three cats and pulmonary aspiration in two (one euthanised, one discharged after supportive care). The V-gel^® advanced enabled rapid airway management with leakage influenced by ventilation mode, airway pressure, and device re-use. Findings support cautious use during spontaneous breathing or CPAP, attention to fasting and fresh-gas flows, and further controlled comparisons with prior V-gel^® models and endotracheal intubation.