Description and evaluation of a novel transoral endoscopic arytenopexy in canine cadavers

OBJECTIVE

To describe the transoral endoscopic arytenopexy (TEA) and evaluate its effects on the rima glottis area (RGA) and laryngeal epiglottic-glottic seal (LEGS). We hypothesize the TEA will be a feasible surgical technique and the TEA will provide a significant increase in RGA with minimal change to the LEGS.

STUDY DESIGN

Canine cadaveric model.

ANIMALS

Fifteen medium- to large-breed canine cadavers.

METHODS

Endoscopic photos of the larynx were taken with the epiglottis open for baseline RGA measurement and closed for baseline measurement of exposed RGA and LEGS. A custom endoscopic gag port (EGP) facilitated the TEA, performed by suturing the lateral aspect of the left arytenoid soft tissues to adjacent pharyngeal wall across the piriform recess. Endoscopic photos were repeated to measure changes in RGA and LEGS. A computerized planimetric analysis program was used to calculate baseline RGA and LEGS. The RGA was reported in % change from baseline. The LEGS was reported as intact or altered. A nonparametric Wilcoxon signed-rank test was used to compare baseline to post-TEA RGA.

RESULTS

The mean baseline RGA was 0.52 ± 0.28 cm³ and mean post-TEA RGA was 0.78 ± 0.37 cm³ (p-value < .0001). The LEGS remained intact post-TEA in all cadavers.

CONCLUSIONS

The TEA was technically feasible and resulted in an increase in RGA while maintaining the LEGS.

CLINICAL SIGNIFICANCE

The TEA may provide a minimally invasive addition to the established techniques for reducing airway resistance while minimizing the impact on the LEGS.

Effects of a novel, 3D printed bilateral arytenoid abductor on canine laryngeal airway resistance ex vivo

Background

Laryngeal paralysis is a disease process most commonly seen in older, large breed dogs. When both arytenoid cartilages are affected dogs can develop life-threatening respiratory compromise, therefore surgical intervention is recommended. While there are multiple surgical procedures that have been described to treat laryngeal paralysis, there remains a considerable risk for postoperative complications, most commonly aspiration pneumonia. The objective of this ex vivo experimental study was to evaluate the effects of a novel, 3D printed bilateral arytenoid abductor on laryngeal airway resistance in canine cadaver larynges. Laryngeal airway resistance was calculated for each specimen before (control) and after placement of a 3D printed, bilateral arytenoid abductor. The airway resistance was measured at an airflow of 10 L/min with the epiglottis closed and at airflows ranging from 15 L/min to 60 L/min with the epiglottis open. The effects of the bilateral arytenoid abductor on laryngeal airway resistance were evaluated statistically.

Results

With the epiglottis open, median laryngeal airway resistance in all larynges with a bilateral arytenoid abductor were significantly decreased at airflows of 15 L/min (0.0cmH2O/L/sec), 30 L/min (0.2cmH2O/L/sec), and 45 L/min (0.2cmH2O/L/sec) compared to the controls 15 L/min (0.4cmH2O/L/sec; P = 0.04), 30 L/min (0.9cmH2O/L/sec; P = 0.04), and 45 L/min (1.2cmH2O/L/sec; P = 0.04). When the epiglottis was closed, there was no significant difference in laryngeal resistance between the control (18.8cmH₂O/L/sec) and the abducted larynges (18.1cmH₂O/L/sec; P = 0.83).

Conclusions

Placement of a bilateral arytenoid abductor reduced laryngeal resistance in canine cadaver larynges compared to the controls when the epiglottis was open. With the epiglottis closed, there was no loss of laryngeal resistance while the device abducted the arytenoid cartilages. The results of this ex vivo study is encouraging for consideration of further evaluation of the bilateral arytenoid abductor to determine an appropriate material and tolerance of this device in vivo.

Comparison of immediate and short-term outcomes of cricoarytenoid and thyroarytenoid lateralization in dogs with idiopathic laryngeal paralysis

OBJECTIVE

To compare the immediate and short-term outcomes of thyroarytenoid lateralization (TAL) and cricoarytenoid lateralization (CAL) for the treatment of canine laryngeal paralysis in dogs.

STUDY DESIGN

A prospective, clinical trial.

ANIMALS

Fourteen client-owned dogs referred to our hospital because of bilateral laryngeal paralysis.

METHODS

Dogs with confirmed laryngeal paralysis were randomly assigned to the CAL or TAL group. Video images of the rima glottidis obtained preoperatively, immediately postoperatively (t0), and 15 days postoperatively (t1) were digitized. The rima glottidis area was measured using image-analysis software. An increase in the rima glottidis area was expressed as a percentage of the preoperative area.

RESULTS

The rima glottidis area increased by a mean of 152% at t0 and 127% at t1 for the TAL group and 205% at t0 and 199% at t1 for the CAL group compared with preoperative values. The increase in the rima glottidis area differed (P < .05) between the 2 groups at all postoperative time points. A reduction of the area occurred at t1 in both groups. There was no difference between t0 and t1 (P > .05) in the CAL group but there was a large difference (P < .05) in the TAL group.

CONCLUSION

Cricoarytenoid lateralization and TAL were both effective for surgical abduction of the arytenoid cartilage. Although a reduction (P < .05) in the rima glottidis area occurred in the TAL group at t1, we observed no associated clinical signs.

CLINICAL SIGNIFICANCE

Cricoarytenoid lateralization and TAL result in good short-term outcomes in dogs with laryngeal paralysis.

Laryngeal silicone stent as a treatment option for laryngeal paralysis in dogs: a preliminary study of 6 cases

Background

Laryngeal paralysis is a common idiopathic degenerative neurological disease in older medium-to-large breed dogs, with surgical correction of the obstruction being the treatment of choice.

Objectives

This study evaluated the use of laryngeal silicone stents to treat canine laryngeal paralysis in dogs where classic surgical treatment was not accepted by the owners.

Methods

Dogs diagnosed with laryngeal paralysis, for which the owners refused arytenoid lateralization surgery as a first-line treatment, were treated with laryngeal silicone stents.

Results

Six dogs with bilateral laryngeal paralysis were included in the study. All dogs showed improvement in clinical signs immediately after the procedure. No clinical signs or radiographic changes were noted in four out of six dogs in the follow-up visit performed 1 wk later. One dog was suspected of aspirating water while drinking, but the signs disappeared after repositioning the stent. Another dog had a relapse of stridor due to caudal migration of the stent. This dog underwent arytenoid lateralization surgery because larger stents are not commercially available. At the time of writing, between seven and 13 mon after stent placement, no significant incidents have occurred in four dogs, and all owners report a satisfactory quality of life.

Conclusions

Laryngeal silicone stenting is an interesting alternative for treating dogs with acquired laryngeal paralysis when the owners refuse classic arytenoid lateralization surgery. Furthermore, stent placement can be a temporary solution to stabilize these dogs until a permanent surgical treatment can be performed.

Anatomic characterization of the location of the esophageal ostium relative to the rima glottidis on CT in adult Labrador Retrievers

OBJECTIVE

To characterize the anatomic location of the esophageal ostium relative to the rima glottidis in adult Labrador Retrievers with the use of CT.

ANIMALS

98 CT scans of 75 adult Labrador Retrievers.

PROCEDURES

A search of the medical records database identified records of Labrador Retrievers that underwent CT of the head and neck between January 1, 2015, and December 31, 2018. Evaluators, blinded to each other's results, reviewed CT images and measured esophageal area at the level of the rima glottidis. For each dog, the left esophageal percentage (LEP) was calculated as the esophageal area left of the rima glottidis midline divided by the overall esophageal area at that level. Variables (age, sex, patient position, intubation status, and maxillary support during CT) were evaluated for association with LEP. The CT images of dogs that had multiple scans were assessed for within-patient variance.

RESULTS

Mean LEP was 56.2 ± 18.1% for all dogs. Only right lateral recumbency was significantly associated with LEP, with a lower LEP for dogs positioned in right lateral recumbency (42.4 ± 12.7%), compared with left lateral (63.0 ± 7.4%) or sternal (57.3 ± 18.8%) recumbency. No association was detected between LEP and other variables assessed. Eleven dogs had multiple CT scans; within-patient variance for LEP was ± 26.6%.

CONCLUSIONS AND CLINICAL RELEVANCE

Results indicated that, although most dogs had an LEP > 50%, the esophageal ostium was fairly centrally located in most dogs and may be more mobile than previously thought. Additional research is warranted to assess this mobility and whether the esophageal ostium location, relative to the larynx, affects the incidence of aspiration pneumonia in dogs undergoing surgical treatment for geriatric-onset laryngeal paralysis and polyneuropathy.

Laryngeal paralysis secondary to cervical bite injuries in five dogs

CASE HISTORIES

Medical records of a veterinary hospital in Belgium were reviewed for dogs (n = 5) that presented between 2016 and 2019 with laryngeal paralysis secondary to bite wounds to the cervical region received while fighting with other dogs. The time elapsed between the trauma and presentation was from a few hours up to 5 days.

CLINICAL FINDINGS AND TREATMENT

Bilateral laryngeal paralysis was identified in three dogs and unilateral laryngeal paralysis in two dogs via endoscopic assessment of laryngeal function. The primary concomitant lesions included tracheal injury in 3/5 dogs and oesophageal injury in 1/5 dogs. One dog with bilateral laryngeal paralysis was treated medically as no signs of dyspnoea were present. Surgical management was elected in 4/5 dogs based on evaluation of their clinical status and lesions revealed by endoscopic examination of upper gastrointestinal and respiratory tracts. Dogs underwent surgical procedures that were determined to be appropriate for treatment of the lesions identified on clinical examination, diagnostic imaging, and endoscopy. The cervical region was explored through a ventral midline approach in 2/4 cases, to close tracheal perforations. Temporary tracheostomy was performed in 2/4 cases. Procedures to correct brachycephalic airway obstructive syndrome were performed in 2/4 cases. Cricoarytenoid lateralisation was performed in 2/4 dogs. Dogs were hospitalised for 2-10 days and received antimicrobial therapy before surgery and for 2-3 weeks after surgery. Physical examination and respiratory function were normal in 3/5 dogs 4-6 months after discharge. Information regarding outcomes for two cases was obtained from the owners by telephone assessment 1-6 months after surgery. The owner of each dog reported the respiratory function to be excellent.

DIAGNOSIS

Uni- or bilateral, transient or permanent laryngeal paralysis with concomitant oesophageal, tracheal, or laryngeal lesions following cervical dog bite injuries diagnosed by endoscopic examination of upper gastrointestinal and respiratory tracts.

CLINICAL RELEVANCE

This case series describes the diagnosis and management of dogs with laryngeal paralysis secondary to cervical dog bite injuries. To the authors' knowledge, this is the first published report documenting bilateral laryngeal paralysis secondary to cervical dog bite injuries. Clinicians should be aware of this pathology and the importance of investigating laryngeal function in dogs presenting with cervical bites, particularly those with inspiratory dyspnoea. Upper airway and digestive endoscopy are recommended for complete assessment of cervical traumatic injuries.

Effect of doxepin on quality of life in Labradors with laryngeal paralysis: A double-blinded, randomized, placebo-controlled trial

Background

Laryngeal paralysis commonly affects older Labrador retrievers. Currently, dogs with severe disease require surgical intervention, most commonly arytenoid lateralization. Anecdotally, doxepin has been proposed to help dogs with laryngeal paralysis.

Hypothesis

Doxepin will improve quality of life measures assessed by owners of Labrador retrievers with laryngeal paralysis not requiring emergency surgery.

Animals

Twenty‐two Labrador retrievers with laryngeal paralysis.

Methods

Dogs were randomized to receive doxepin (3‐5 mg/kg q12h PO) or placebo for 28 days. Owners completed quality‐of‐life assessments before and after completing the study. Data were compared between groups using Rank‐Sum tests or Fisher's exact tests.

Results

The 2 groups of dogs did not differ at baseline except for owner‐perceived degree of ataxia (owners of dogs receiving doxepin considered them more ataxic than owners of dogs receiving placebo). After 28 days, owner‐assessed quality of life measures did not differ between dogs receiving doxepin or placebo (dogs worsening: doxepin = 2, placebo = 1; dogs unchanged: doxepin = 6, placebo = 7; dogs improved: doxepin = 4, placebo = 2; P = .84). Dogs receiving placebo had a greater improvement in client‐assessed overall health than dogs receiving doxepin (mean ranks: doxepin = 4.36, placebo = 6.64; P = .04). The study was terminated at this interim analysis.

Conclusions and Clinical Importance

Doxepin did not appear to improve any measures of owner‐assessed quality of life in Labrador retrievers with laryngeal paralysis.

Outcome and postoperative complications in 73 dogs with thyroid carcinoma with gross vascular invasion managed with thyroidectomy

Excellent outcomes have been reported following thyroidectomy for thyroid carcinoma in dogs, but outcomes for thyroid carcinomas with gross vascular invasion are poorly described. This study describes the clinical outcomes and complications in dogs with thyroid carcinomas with gross vascular invasion undergoing thyroidectomy. Medical records of dogs that underwent thyroidectomy between January 1st 2010 and December 31st 2019 were reviewed at 10 hospitals. Signalment, diagnostic data, primary and adjuvant treatments performed, and outcome were abstracted. Survival was calculated using Kaplan-Meier analysis. Multiple logistic regression was used to identify variables associated with disease-specific survival. Seventy-three dogs were included, of which 58 underwent unilateral thyroidectomy and 15 underwent bilateral thyroidectomy. Complications were reported in five dogs (three major, two minor; 6.8%) intraoperatively and 12 dogs (two major leading to death, 10 minor; 16.4%) postoperatively. Seven (9.6%) dogs developed locoregional recurrence at a median of 238 days postoperatively (range: 15-730 days). Distant metastasis was suspected or confirmed in nine dogs (12.3%) at a median of 375 days postoperatively (range: 50-890 days). Twenty-seven dogs (37%) received adjuvant therapy (chemotherapy: n = 21; radiotherapy: n = 6). Thirty-nine dogs were euthanized or died, with 20 deaths related to disease (n = 10) or of unknown cause (n = 10), 19 due to unrelated causes, and nine lost to follow-up. Median overall and disease-specific survival were 621 days and not reached respectively. One-year disease-specific survival rate was 82.5%. No variables were associated with disease-specific survival in our dataset. Surgery may be considered for loco-regional therapy in dogs with thyroid carcinoma with gross vascular invasion.

Evaluation of the effectiveness of preoperative administration of maropitant citrate and metoclopramide hydrochloride in preventing postoperative clinical gastroesophageal reflux in dogs

OBJECTIVE

To investigate the prophylactic effectiveness of preoperative administration of maropitant citrate and metoclopramide hydrochloride in preventing postoperative clinical gastroesophageal reflux (GER) in dogs and to identify risk factors for clinical postoperative GER in dogs.

ANIMALS

93 client-owned dogs undergoing surgery at the Washington State University Veterinary Teaching Hospital between March 2016 and February 2017.

PROCEDURES

Dogs were randomly assigned to either the intervention group (preoperatively received maropitant and metoclopramide) or the control group (did not preoperatively receive maropitant and metoclopramide). After surgery, all dogs were recovered and monitored, and occurrences of GER were noted. The prophylactic effectiveness of maropitant and metoclopramide was evaluated, and univariate and multivariate logistic regression analyses were performed to identify variables associated with postoperative clinical GER in dogs.

RESULTS

No meaningful difference in the incidence of clinical GER during the postoperative period was detected between the control and intervention groups. Results indicated that variables associated with significantly increased odds of postoperative clinical GER included the male sex (OR, 9.2; 95% confidence interval [CI], 1.26 to 195.0), an overweight BCS (OR, 12.3; 95% CI, 2.1 to 135.1), gastrointestinal surgery (OR, 30.5; 95% CI, 3.0 to 786.9), and requirement for a dexmedetomidine constant rate infusion after surgery (OR, 9.6; 95% CI, 1.3 to 212.5).

CONCLUSIONS AND CLINICAL RELEVANCE

Findings indicated that incidence of clinical GER during the postoperative period was not lower for dogs that received preoperative prophylactic administration of metoclopramide and maropitant, compared with incidence dogs that did not receive the prophylactic treatment. Further research is required into alternative measures to prevent postoperative clinical GER in dogs.

Long-term outcome and risk factors associated with death or the need for revision surgery in dogs with permanent tracheostomies

OBJECTIVE

To evaluate long-term outcomes and identify factors associated with death or the need for revision surgery in dogs with permanent tracheostomies (PTs).

DESIGN

Retrospective cohort study.

ANIMALS

69 client-owned dogs that received a PT between January 2002 and June 2016 at 1 of 4 veterinary teaching hospitals.

PROCEDURES

Medical records were reviewed, and data extracted included signalment, history, clinical signs, radiographic and laryngeal examination findings, presence of esophageal abnormalities, date and reason for receiving a PT, postoperative complications, cause of death, and survival time. Dogs surviving < 2 weeks after receiving a PT were excluded.

RESULTS

Major complications occurred in 42 of 69 (61%) dogs, with aspiration pneumonia (13 [19%]), skinfold occlusion (13 [19%]), and stoma stenosis (12 [17%]) being most common. Revision surgery was performed in 24 of 69 (35%) dogs, most commonly because of stoma stenosis or skinfold occlusion (9/24 [38%] each). Brachycephalic dogs were more likely (OR, 3.5; 95% confidence interval, 1.2 to 10.2) to require revision surgery than were nonbrachycephalic dogs. The overall median survival time was 1,825 days, and dogs that received corticosteroids before receiving a PT, had tracheal collapse, or were older had shorter survival times.

CONCLUSIONS AND CLINICAL RELEVANCE

Results of the present study indicated that creation of a PT was a viable treatment option for obstructive upper airway diseases in dogs and that long-term survival after receiving a PT was possible; however, a PT may not reduce the risk of aspiration pneumonia in dogs.

Late-onset laryngeal paralysis: Owner perception of quality of life and cause of death

Background

Late‐onset laryngeal paralysis (LoLP) is an idiopathic disease of older dogs, and is common in the Labrador Retriever. Owner perspective of how LoLP affects their pet's quality of life (QOL), the degree to which LoLP is perceived to be a life‐limiting disease, and how a glottic opening procedure affects these perceptions is not known.

Objectives

(a) To determine owner's perception of late‐onset laryngeal paralysis (LoLP) with respect to their dog's QOL; (b) To determine whether LoLP is considered by owners to be a life‐limiting disease; (c) To evaluate whether a glottic opening procedure altered QOL and perceived cause of death in affected dogs.

Methods

Owners of Labrador Retrievers with LoLP completed a questionnaire. Questions were asked pertaining to a dog's LoLP, including clinical progression and perception of cause of death, and whether a glottic opening procedure was undertaken. Owners also completed a pet‐owner administered QOL survey.

Results

Seventy‐six owners participated. Overall, 94% of owners felt their dog's LoLP affected QOL, and 47% of owners felt LoLP was a large contributing factor in their dog's death. Dogs that underwent a glottic opening procedure were reported to have a better QOL, and the contribution of LoLP towards their death was less than dogs that did not have surgery.

Conclusion

Owners of Labrador Retrievers with LoLP perceive LoLP to be a life‐limiting disease that negatively impacts their dog's QOL. Arytenoid lateralization surgery had a positive impact on QOL in affected dogs.

Laryngeal Disease in Dogs and Cats: An Update

Laryngeal diseases are manifested by obstructive breathing patterns reflecting functional or mechanical upper airway obstruction. Laryngeal paralysis is the most common disease of the larynx. Diagnosis requires close attention to anesthetic plane and coordination of respiratory effort with laryngeal motion. Surgical arytenoid lateralization improves clinical signs and quality of life in dogs; however, aspiration pneumonia is a recognized complication, and generalized neuropathy can progress. Laryngeal collapse can result from any cause of chronic upper airway obstruction but is most often associated with brachycephalic obstructive airway syndrome. Although uncommon, laryngeal neoplasia has a guarded to grave prognosis regardless of treatment.

A RAPGEF6 variant constitutes a major risk factor for laryngeal paralysis in dogs

Laryngeal paralysis (LP) is the inability to abduct the arytenoid cartilages during inspiration, resulting in a partial to complete airway obstruction and consequent respiratory distress. Different forms of LP with varying age of onset exist in dogs. Hereditary early onset forms were reported in several dog breeds. In most breeds, hereditary LP is associated with other neurologic pathologies. Using a genome-wide association study and haplotype analyses, we mapped a major genetic risk factor for an early onset LP in Miniature Bull Terriers to a ~1.3 Mb interval on chromosome 11. Whole genome sequencing of an affected Miniature Bull Terrier and comparison to 598 control genomes revealed a 36 bp insertion into exon 15 of the RAPGEF6 gene (c.1793_1794ins36). The imperfect genotype-phenotype correlation suggested a complex mode of inheritance with a major genetic risk factor involving a recessive risk allele. Homozygosity for the insertion was associated with a 10- to 17-fold increased risk for LP. The insertion allele was only found in Miniature Bull Terriers and Bull Terriers. It was absent from >1000 control dogs of other dog breeds. The insertion sequence contains a splice acceptor motif leading to aberrant splicing in transcripts originating from the mutant allele (r.1732_1780del). This leads to a frameshift and a premature stop codon, p.(Ile587ProfsTer5), removing 64% of the open reading frame. Our results suggest an important role of RAPGEF6 in laryngeal nerve function and provide new clues to its physiological significance.

Laryngeal paralysis (LP) leads to respiratory distress in affected dogs and can be fatal in severe cases. Many different forms of LP with different etiologies exist. Striking breed predispositions suggest that genetic factors contribute to some forms of LP. During the last years, dog breeders noticed an increased prevalence of an early onset LP in Miniature Bull Terriers. We mapped a major risk locus for this specific form of LP to a ~1.3 Mb interval on dog chromosome 11. Whole genome sequence analysis of an affected dog and comparison to 598 control genomes revealed a single protein-changing genetic variant in the critical interval. This variant, a 36 bp insertion into a coding exon of the RAPGEF6 gene, creates a cryptic splice site and leads to the expression of an aberrantly spliced transcript with a premature stop codon. This suggests that the insertion results in a loss-of-function allele. Dogs that are homozygous for the insertion have a 10- to 17-fold increased risk to develop LP. The genotype-phenotype association is not perfect, suggesting that other genetic and/or environmental factors also contribute to the development of LP. Our results suggest an important role of RAPGEF6 in laryngeal nerve function.

Aerodigestive disorders in dogs evaluated for cough using respiratory fluoroscopy and videofluoroscopic swallow studies

Aerodigestive diseases, hybrid disorders representing a pathologic link between respiratory and alimentary tracts, may manifest with respiratory signs without gastrointestinal signs. These are underdiagnosed in dogs due to poor clinical recognition and diagnostic limitations. We hypothesize that a subset of dogs presenting for cough without gastrointestinal signs would have occult aerodigestive disorders identified using videofluoroscopic swallow study (VFSS). Data were retrospectively obtained from 31 client-owned dogs presenting for cough, with thoracic radiographs, and a VFSS between April 2015 and December 2017. Exclusion criteria were cough of cardiac origin or gastrointestinal signs within 6 months. Swallow study parameters included pharyngeal/esophageal motility, laryngeal obstruction/defects, penetration-aspiration, reflux, excessive aerophagia, megaesophagus (ME), lower-esophageal sphincter achalasia-like syndrome (LES-AS), and sliding hiatal hernia (HH). The median (interquartile range) duration of cough was 4 (2-8) months. Thoracic radiographs were unremarkable in 11 dogs, with aspiration pneumonia suspected in seven. In 25/31 dogs (81%), VFSS abnormalities were detected and some dogs had more than one defect: pharyngeal (n=10) or esophageal hypomotility (n=10), reflux (n=9), penetration-aspiration (n=8), excessive aerophagia (n=6), laryngeal obstruction (n=3), ME (n=3), HH (n=2), and LES-AS (n=1). A respiratory disorder causing cough was identified in 17 dogs with VFSS abnormalities (laryngeal obstruction/defect and airway disease including chronic or eosinophilic bronchitis, tracheal/mainstem bronchial collapse, bronchiectasis, and bronchomalacia). An alimentary disorder identified on VFSS in absence of a discrete respiratory disorder causing cough was diagnosed in eight dogs. In conclusion, canine aerodigestive disorders can manifest as cough without alimentary signs. VFSS is a useful diagnostic to determine the contribution of esophageal/gastrointestinal pathology in dogs with cough.

Outcome of two variations of a surgical technique performed for canine unilateral arytenoid lateralisation

Background The purpose of this study is to compare the rate of aspiration pneumonia and survival time of dogs undergoing two unilateral arytenoid lateralisation (UAL) techniques.Methods Eighty dogs diagnosed with laryngeal paralysis were treated by one of two UAL techniques: (1) a standard technique (ST) and (2) an anatomic preservation technique (APT). Outcome was assessed by in clinic re-examination and an owner follow-up questionnaire.Results Minor complications were reported for 22 per cent of dogs undergoing ST and 26 per cent for APT. Major complications were 7 per cent for ST versus 23 per cent for APT. Postoperative aspiration pneumonia was reported for 7 per cent of cases in ST and 17 per cent in APT. The median survival time for ST was 636 days and was 1067 days for APT. Cause of death was related to the laryngeal paralysis in 22 per cent, neurological deterioration in 16 per cent and for non-associated reasons in 59 per cent of cases. There was no statistically significant difference in the rate of aspiration pneumonia or survival time among the treatment groups. Owners reported that their dogs improved after both surgical procedures, with 90 per cent of the owners satisfied with the surgical outcome. Eighteen per cent of the dogs suffered recurrence of clinical signs.Conclusions In this study, there was no significant difference in risk of aspiration pneumonia or survival time following arytenoid lateralisation by either an ST or an APT.

Intraoperative and major postoperative complications and survival of dogs undergoing surgical management of epiglottic retroversion: 50 dogs (2003-2017)

OBJECTIVE

To report intraoperative and major postoperative complications in dogs treated surgically for epiglottic retroversion (ER), compare the incidence of major postoperative complications between procedures, and report survival of surgically treated dogs.

STUDY DESIGN

Multi-institutional retrospective study.

SAMPLE POPULATION

Fifty dogs treated with 78 procedures.

METHODS

Medical records of dogs diagnosed and surgically treated for ER from 2003 to 2017 at 11 institutions were reviewed. Complications were divided into intraoperative and major postoperative complications.

RESULTS

Intraoperative complications occurred during 2 of 78 (2.6%) procedures. Thirty-six major postoperative complications were documented in 22 dogs after 36 of 74 (48.7%) procedures. Postoperative complications occurred after 7 of 12 (58.3%) nonincisional epiglottopexy, 23 of 43 (53.5%) incisional epiglottopexy, 2 of 4 (50%) partial epiglottectomy, 2 of 12 (16.7%) subtotal epiglottectomy, and 2 of 3 (66.7%) other surgical procedures. Epiglottopexy failure was the most common major postoperative complication. The incidence of major postoperative complications did not differ between procedures (P = .1239), although, when combined, epiglottopexy procedures (30/55) had a higher incidence of complications than epiglottectomy procedures (4/16; P = .048). Thirty (60%) dogs were alive at a median of 928 days (range, 114-2805), 8 (16%) were lost to follow-up after 411 days (range, 43-1158), and 12 (24%) were dead/euthanized after 301.5 days (range, 3-1212). Median survival time was not reached after a median of 716 days.

CONCLUSION

Although intraoperative complications were uncommon, major postoperative complications were common, especially after epiglottopexy procedures.

CLINICAL SIGNIFICANCE

Although surgical treatment of ER is associated with a high rate of major postoperative complications, especially epiglottopexy procedures, long-term survival can be achieved.

Juvenile-onset polyneuropathy in American Staffordshire Terriers

BACKGROUND

The only hereditary neurologic disorder described so far in American Staffordshire Terriers is adult-onset cerebellar degeneration secondary to ceroid lipofuscinosis. We have seen several dogs with a newly recognized neurological disease characterized by locomotor weakness with or without respiratory signs and juvenile onset consistent with degenerative polyneuropathy of genetic origin.

OBJECTIVES

To characterize a novel polyneuropathy in juvenile American Staffordshire Terriers.

ANIMALS

Fourteen American Staffordshire Terriers presented with clinical signs consistent with juvenile-onset polyneuropathy at 5 veterinary hospitals between May 2005 and July 2017.

METHODS

Case series. Dogs were included retrospectively after a diagnosis of degenerative polyneuropathy had been confirmed by nerve biopsy. Clinical, pathological, electrophysiological, histological data, and outcome were reviewed and a pedigree analysis performed.

RESULTS

All dogs displayed clinical signs of neuromuscular disease with generalized motor and sensory involvement, associated with focal signs of laryngeal paralysis (10/14 dogs) and megaesophagus (1/14 dogs). Histopathological findings were consistent with degenerative polyneuropathy. Follow-up was available for 11 dogs, and 3 dogs were euthanized shortly after diagnosis. In these 11 dogs, the disease was slowly progressive and the animals maintained good quality of life with ability to walk. Pedigree analysis was mostly consistent with an autosomal recessive mode of inheritance.

CONCLUSIONS AND CLINICAL IMPORTANCE

Juvenile polyneuropathy, associated with laryngeal paralysis, is a newly described entity in American Staffordshire Terriers, and results from degenerative neuropathy. When surgery for laryngeal paralysis is performed, lifespan may be similar to that of normal dogs even though affected dogs have locomotor disturbance.

Aspiration Pneumonia in the Dog: A Review

OBJECTIVE

To review the human and veterinary literature pertaining to aspiration pneumonitis and pneumonia.

MATERIAL AND METHODS

Data sources included scientific reviews and original research publications from the human and veterinary literature. All reviews and studies that added to the understanding of aspiration pneumonia were included.

RESULTS

Compared to human medicine, aspiration pneumonia can be difficult to diagnose in the canine patient and is often a diagnosis of presumption. Multiple risk factors exist increasing the likelihood of aspiration pneumonia and a thorough understanding of these can aid in prevention. Treatment recommendations center primarily on supportive care, oxygen therapy and antibiotic administration.

CLINCIAL SIGNIFICANCE

Aspiration pneumonia is a common finding in the canine patient and a thorough understanding of the disease will lead to better treatment outcomes. Further studies on treatment and prevention in veterinary medicine are warranted.

Comparison of bacterial cultures of the larynx between dogs with laryngeal paralysis and normal dogs

OBJECTIVE

To document the most common types of bacteria isolated from the canine larynx and to compare isolates, degree of growth and susceptibility patterns between dogs with laryngeal paralysis and dogs with normal laryngeal function.

METHODS

Laryngeal swabs were collected from each patient and submitted for bacterial culture and susceptibility testing. Dogs with laryngeal paralysis (n=23) underwent a unilateral arytenoid lateralisation and control dogs (n=24) underwent an elective orthopaedic procedure. Results of the cultures were compared between groups.

RESULTS

Bacterial organisms isolated from the larynx were similar to those normally found in the oropharynx, trachea and lungs. The most common bacteria isolated from the larynges of all dogs were Escherichia coli, Klebsiella species and Pasteurella species. Pure colonies were more commonly seen in dogs with laryngeal paralysis while mixed colonies were more commonly seen in control dogs. Antimicrobial resistance was similar between study and control dogs.

CLINICAL SIGNIFICANCE

The laryngeal flora appears to contain bacteria that are commonly isolated from the oropharynx, trachea and lungs. Differences in antimicrobial susceptibility were not identified between study and control dogs.