Arytenoid lateralization for management of combined laryngeal paralysis and laryngeal collapse in small dogs

Subtotal Epiglottectomy and Ablation of Unilateral Arytenoid Cartilage as Surgical Treatments for Grade III Laryngeal Collapse in Dogs

Stage III laryngeal collapse is defined as the collapse of the corniculate processes of the arytenoid cartilages and the destructuration of the dorsal portion of the rima glottidis. The primary cause is chronic upper airway obstruction, and the condition is often present in brachycephalic dogs. The treatment is still controversial; the patients are generally treated with a permanent tracheostomy. This article reports the authors’ experience with 16 dogs affected by stage III laryngeal collapse treated with subtotal epiglottectomy and the ablation of unilateral arytenoid cartilage. Before the surgery, all of the dogs underwent an effort test to classify the clinical severity of the disease and an endoscopic examination of the airways to determine the stage of severity of the laryngeal collapse. One month after surgery, the effort test was repeated in order to evaluate the clinical outcome. One year after surgery, the owners of 12 patients rated their dogs as follows: excellent in five cases, good in five cases, and fair in two cases. According to this pilot study, epiglottectomy associated with the photoablation of unilateral arytenoid cartilage increases airway flow, and thus may be considered a valid surgical procedure to treat dogs affected by grade III laryngeal collapse.

Brachycephalic airway syndrome: management of post-operative respiratory complications in 248 dogs

OBJECTIVE

As ownership of brachycephalic dog breeds rises, the surgical correction of components of brachycephalic airway syndrome (BAS) is increasingly recommended by veterinarians. This study's objective was to describe the incidence of, and strategies for the management of post-operative respiratory complications in brachycephalic dogs undergoing surgical correction of one or more components of BAS.

METHODS

Medical records of 248 brachycephalic dogs treated surgically for BAS were retrospectively reviewed for demographic information, procedures performed, post-operative complications and treatment implemented, hospitalisation time, and necessity for further surgery.

RESULTS

Pugs, Cavalier King Charles Spaniels and British Bulldogs were the most commonly encountered breeds. Dogs which experienced a complication were significantly older (mean was 5.5 years, compared with 4.1 years [P < 0.01]). Fifty-eight dogs (23.4%) had complications which included: dyspnoea managed with supplemental oxygen alone (7.3%, n = 18), dyspnoea requiring anaesthesia and re-intubation (8.9%, n = 22), dyspnoea necessitating treatment with a temporary tracheostomy (8.9%, n = 22), aspiration pneumonia (4%, n = 10), and respiratory or cardiac arrest (2.4%, n = 6). Five of the 22 dogs requiring anaesthesia and re-intubation deteriorated 12 or more hours after post-surgical anaesthetic recovery. The overall mortality rate in this study was 2.4% (n = 6). Age, concurrent airway pathology, and emergency presentation significantly predicted post-operative complications.

CONCLUSION

Our data show the importance of close monitoring for a minimum of 24 h following surgery by an experienced veterinarian or veterinary technician. Surgical intervention for BAS symptomatic dogs should be considered at an earlier age as an elective procedure, to reduce the risk of post-operative complications.

Laryngeal stent for acute and chronic respiratory distress in seven dogs with laryngeal paralysis

Background:

Laryngeal paralysis, failure of arytenoid cartilage, and vocal fold abduction are commonly seen in older medium to large breed dogs. Observation of laryngeal function in dogs and cats is performed by transoral visualization. There are a variety of surgical techniques; aspiration pneumonia is the most common complication associated with surgical correction of laryngeal paralysis. The aim of this case series is to report on the placement of a laryngeal silicone stent in seven dogs with laryngeal paralysis and its use as an alternative treatment of respiratory distress caused by laryngeal paralysis and/or its use for laryngeal stenosis as complication of laryngeal paralysis surgery.

Case description:

Seven dogs presented with either episode of gagging, mild-to-severe inspiratory distress, or cyanosis because of a laryngeal paralysis or laryngeal stenosis. In each case, the laryngeal paralysis was diagnosed by direct laryngoscopy. They were treated with a silicone laryngeal stent (Stening^®) that substantially improved the clinical signs. Each dog had a different outcome because of other pathologies; however, the laryngeal pathology was successfully treated with the stent.

Conclusion:

The placement of the laryngeal stent is an easy technique to learn and practice, it could avoid the life-threatening complications of the laryngeal paralysis at the acute phase, and it could be a noninvasive and long-term alternative therapy for laryngeal paralysis in dogs. The results in these clinical cases are encouraging for considering the laryngeal stent as a therapeutic alternative.