Surgical management of laryngeal collapse associated with brachycephalic airway obstruction syndrome in dogs

Objective: To describe the use of cricoarytenoid lateralisation combined with thyroarytenoid caudo- lateralisation (arytenoid laryngoplasty) for the management of stage II and III laryngeal collapse in dogs. Methods: A retrospective study of a consecutive series of 12 dogs suffering from life-threatening stage II or III laryngeal collapse associated with brachycephalic airway obstruction syndrome. Results: Pre-operatively, either stage II collapse (2/12) or stage III collapse (10/12) was confirmed on visual examination. In all cases, a left-sided arytenoid laryngoplasty was performed. Two dogs were euthanased postoperatively as a result of persistent life-threatening respiratory compromise. The procedure resulted in subjective enlargement of the rima glottidis and an associated improvement in respiratory function in the remaining 10 dogs. Follow-up, long-term outcome (median, 3·5 years) in these dogs indicated that all owners considered that the surgery had resulted in marked improvements in their dog's respiratory function, tolerance to exercise, and quality of life. Clinical Significance: Combined cricoarytenoid and thyroarytenoid caudo-lateralisation may be a useful procedure for treatment of stage II and III laryngeal collapse in the dog.     

Duodenal obstruction caused by infection with Pythium insidiosum in a 12-week-old puppy

Pythium insidiosum is an aquatic fungus-like organism that causes a serious chronic granulomatous disease called pythiosis in animals and humans in tropical and subtropical regions of the world. In North America, pythiosis is most often diagnosed in the Gulf Coast states. Early recognition of the disease is crucial to successful treatment, which includes surgical resection of granulomatous lesions and administration of antifungal agents. Despite increasing availability of diagnostic tests, intestinal pythiosis is insidious and is often not detected until lesions are extensive. Intestinal pythiosis was diagnosed in a 12-week-old puppy from South Carolina examined because of vomiting, diarrhea, and anorexia. Pythiosis was not initially suspected because of the young age of the patient and because pythiosis is uncommon in this area.     

Upper respiratory tract obstruction caused by a pharyngeal abscess in a filly

A 3-year-old Thoroughbred filly had a pharyngeal abscess causing obstruction of the upper respiratory tract. Diagnosis was made by a combination of endoscopy, biopsy, cytology, and radiography. Treatment with antimicrobials and analgesics resulted in successful resolution of the abscess.     

Chronic upper airway obstruction caused by laryngeal adenocarcinoma in a cat

An eight-year-old spayed female cat developed upper respiratory obstruction, abnormal vocalisation and anorexia over a period of a few months. Examination under general anaesthesia revealed unilateral laryngeal distortion by a soft tissue mass; there was no radiographic evidence of metastatic disease at this time. Over the next four months the upper respiratory obstruction became more severe as a result of progressive laryngeal stenosis and metastatic lung masses were observed radiographically four months after initial examination. Necropsy revealed an infiltrating laryngeal adenocarcinoma with metastases in the upper cervical lymph node and lungs. This case illustrates the value of early biopsy diagnosis to spare the patient the distress of progressive upper respiratory obstruction.     

Concurrent Cryptosporidium and parvovirus infections in a puppy

Cryptosporidium parvum, an intestinal coccidian parasite, was isolated from faeces and intestinal biopsies of a 9-week-old puppy with acute parvoviral gastroenteritis. Gene sequence analysis identified a Cryptosporidium genotype not previously recorded in Australia. The puppy recovered after treatment with crystalloid fluids, synthetic and natural colloids and jejunostomy tube feeding.     

Description of original endoscopic findings and respiratory functional assessment using barometric whole-body plethysmography in dogs suffering from brachycephalic airway obstruction syndrome

The clinical features of brachycephalic airway obstructive disease in 11 brachycephalic dogs are described in this study. The respiratory strategy was assessed before (n=11) and after (n=6) surgery using barometric whole-body plethysmography (BWBP), with the relationship between BWBP variables and the severity of the clinical signs assessed by the use of a respiratory score based on clinical, radiographic and endoscopic findings. Partial collapse of the left main bronchus was a common finding not previously described as part of the brachycephalic airway obstructive disease syndrome. Epiglottic cysts, laryngeal granulomas and nasopharyngeal turbinates in English Bulldogs were other previously unreported findings. No significant correlation between the respiratory score and any of the BWBP variables was detected. Compared to healthy dogs, brachycephalic dogs had a significantly lower Te/Ti ratio (expiratory time over inspiratory time), peak inspiratory flow (PIF) per kg bodyweight (BW), significantly higher peak expiratory flow (PEF) per kgBW, PEF/PIF, and enhanced pause. These variations are compatible with upper airway obstructions primarily in the extrathoracic airways. Following surgery, a significant decrease in PEF/PIF was detected. The study showed that BWBP could be used to characterise the respiratory strategy in brachycephalic dogs before and after surgery.     

Comparison between dexmedetomidine and acepromazine in combination with methadone for premedication in brachycephalic dogs undergoing surgery for brachycephalic obstructive airway syndrome

ObjectiveTo compare dexmedetomidine with acepromazine for premedication combined with methadone in dogs undergoing brachycephalic obstructive airway syndrome (BOAS) surgery.Study designRandomized, blinded clinical study.AnimalsA group of 40 dogs weighing mean (± standard deviation) 10.5 ± 6 kg, aged 2.6 ± 1.9 years.MethodsDogs received either acepromazine 20 μg kg^–1 (group A) or dexmedetomidine 2 μg kg^–1 (group D) intramuscularly with methadone 0.3 mg kg^–1. Anaesthesia was induced with propofol and maintained with sevoflurane. Sedation (0–18), induction (0–6) and recovery (0–5) qualities were scored. Propofol dose, hypotension incidence, mechanical ventilation requirement, extubation time, additional sedation, oxygen supplementation, regurgitation and emergency intubation following premedication or during recovery were recorded. Data were analysed using t tests, Mann-Whitney U or Chi-square tests.ResultsGroup A dogs were less sedated [median (range): 1.5 (0–12)] than group D [5 (1–18)] (p = 0.021) and required more propofol [3.5 (1–7) versus 2.4 (1–8) mg kg^–1; p = 0.018]. Induction scores [group A: 5 (4–5); group D 5 (3–5)] (p = 0.989), recovery scores [group A 5 (4–5); group D 5(3–5)](p = 0.738) and anaesthesia duration [group A:93 (50–170); group D 96 (54–263) minutes] (p = 0.758) were similar between groups. Time to extubation was longer in group A 12.5 (3-35) versus group D 5.5 (0–15) minutes; (p = 0.005). During recovery, two dogs required emergency intubation (p > 0.99) and five dogs required additional sedation (p > 0.99). Oxygen supplementation was required in 16 and 12 dogs in group A and D, respectively (p = 0.167); no dogs in group A and one dog in group D regurgitated (p = 0.311).Conclusions and clinical relevanceDexmedetomidine 2 μg kg^–1 produces more sedation but similar recovery quality to acepromazine 20 μg kg^–1 combined with methadone in dogs undergoing BOAS surgery.     

Upper airway obstruction in performance horses. Differential diagnoses and treatment

Abnormalities of the nasal cavity, pharynx, larynx, and trachea result in respiratory noise and exercise intolerance. Clinical features of common upper respiratory conditions of performance horses are reviewed with emphasis on diagnosis, treatment, and risk factors that affect the outcome of surgical treatment.     

Mycotic endophthalmitis in a dog caused by Candida albicans

A case of mycotic endophthalmitis in the dog caused by Candida albicans is presented. The 3-year-old dog had a history of bloody diarrhea 3 months previously. The dog presented with acute signs of unilateral panuveitis. Aqueocentesis, vitreocentesis, and routine blood tests were performed but did not contribute to the diagnosis. The posterior segment could not be visualized because of flare and fibrin. On day 7 ultrasonography showed retinal separation which progressed to vitreous compartmentalization and abscessation by day 14. Three weeks after onset, glaucoma developed and enucleation was performed. Histology revealed the yeast Candida to be the causative agent. Post-enucleation serum Candida antibody titer was 1 : 640 (human threshold 1 : 120), as determined by agglutination test. A relapse of enteric signs 3 months later led to the diagnosis of chronic lymphocytic enteritis. An hematogenous route of infection is suspected.     

Use of a laryngeal mask airway in a brachycephalic dog with masticatory myositis and trismus

An 8-month old, male, neutered bulldog was presented for investigation of a 2-day history of trismus. Endotracheal intubation was impossible as the dog was only able to open his mouth approximately 2 cm. A laryngeal mask airway was blindly inserted after induction of general anesthesia to maintain the patient on inhalational anesthesia and improve respiration for computed tomography and muscle biopsy. The dog recovered from anesthesia uneventfully.     

Recurrent rectal prolapse caused by colonic duplication in a dog

A 9-month-old female Shar Pei cross-bred dog was presented with a history of recurrent rectal prolapse over 7 months. Repeated reduction and anal purse string sutures and subsequent incisional colopexy failed to prevent recurrent rectal prolapse. Digital rectal examination following reduction of the prolapse identified a faeces-filled sac within the ventral wall of the rectum and an orifice in the ventral colonic wall, cranial to the pubic brim. A ventral, communicating tubular colonic duplication was diagnosed by means of a barium enema. Surgical excision of the duplicated colonic tube was performed via a caudal ventral midline laparotomy. At 20 weeks post-operation, there has been no recurrence of rectal prolapse.     

Upper airway obstruction. General principles and selected conditions in the dog and cat

This article presents an overview of the clinical features of upper airway obstructive disorders. It includes more detailed discussions of certain common conditions such as brachycephalic airway syndrome, laryngeal paralysis, and upper airway obstruction due to trauma, foreign bodies, extraluminal masses, and tumours of the larynx and trachea.