Tracheal resection and anastomosis for congenital stenosis in a dog

A one-year-old Cocker Spaniel dog was presented for the investigation of exercise-related stridor and respiratory embarrassment evident since birth. Radiography demonstrated a segmental tracheal stenosis at the thoracic inlet which was found to result from the congenital absence of tracheal rings at this point. The stenotic segment was resected at surgery and an end-to-end tracheal anastomosis performed. The dog now enjoys normal respiratory and exercise function with minimal narrowing of the trachea at the site of the anastomosis.     

Surgical management of atypical lateral tracheal collapse in a dog

A FOUR-year-old spayed miniature poodle was presented for evaluation because of a chronic cough which had been present from eight weeks of age. The condition had gradually worsened until exercise intolerance, inappetence and abdominal breathing occurred. The dog was thin and weighed only 1.5 kg. Auscultation revealed tachycardia, a normal respiratory rate and wheezing noises - more prominent on inspiration and localised to the cervical portion of the trachea. There was marked inspiratory and expiratory effort. Tracheal sensitivity was moderate and palpation induced a dry hacking cough. Radiography demonstrated mild thickening of the bronchial wall and pulmonary hyperinflation. Expiratory/inspiratory radiographs failed to demonstrate dynamic tracheal collapse. On fluroscopy, substantial changes in tracheal calibre were not apparent. Bronchoscopy was performed and the tracheal lumen was normal up to 12.5 cm from the incisors. At this point, there was lateral tracheal collapse to about 30 per cent. There was dynamic collapse with respiratory effort. The bronchoscope could be passed beyond the narrowing (consisting of five tracheal rings) to a trachea of normal size. No pathogens were found on tracheal lavage. Surgery was undertaken through a midline, ventral approach. Six specially made tracheal ring prostheses were individually inserted around the trachea and inside the recurrent laryngeal nerve. Each prosthesis was sutured in four places to the tracheal ring, to give external support. The dog improved clinically and 11 months after surgery, bronchoscopy was again performed. The trachea was narrowed to approximately 60 per cent but there was no dynamic collapse of the airway. Twenty-seven months after surgery the dog continued to lead a healthy active life.     

Tracheal perforation secondary to suture irritation in a dog following a ventral slot procedure

An eight-year-old springer spaniel was presented with acute-onset subcutaneous emphysema of five days' duration. The dog had undergone ventral slot decompression of the C5-C6 intervertebral disc space eight weeks before presentation. Cervical tracheoscopy demonstrated perforation of the dorsal tracheal membrane of the distal cervical trachea. Perforation of the dorsal tracheal membrane secondary to suture knot irritation was confirmed by exploratory surgery. Repair of the perforation was performed by plication of the dorsal tracheal membrane. The dog was re-presented nine days after the initial surgery with acute recurrence of subcutaneous emphysema. Air leakage at the plicated dorsal tracheal membrane was observed at exploratory surgery, and a bipedicle sternothyroideus muscle flap was used to support the plicated membrane. Recovery was uneventful and 10 months postoperatively there had been no recurrence of clinical signs.     

Acute tracheal obstruction associated with anticoagulant rodenticide intoxication in a dog

An adult female neutered crossbred dog was referred in respiratory distress. Thoracic radiographs revealed tracheal narrowing with a soft tissue opacity dorsal to the trachea, near the thoracic inlet, and a patchy interstitial pulmonary infiltrate. The tracheal narrowing was thought to be due to a combination of intraluminal haemorrhage and mediastinal haemorrhage resulting from a coagulopathy caused by anticoagulant rodenticide intoxication. Treatment included supportive care and administration of vitamin K1, and the dog showed a complete resolution of the clinical signs.     

A case of tracheal collapse in the dog.

An eight-year-old male Yorkshire terrier which had had a cough for two years was presented and a diagnosis of tracheal collapse was made after examination with a bronchoscope. It was decided to try to correct the tracheal defect by plication. Two weeks after the operation the dog was examined under general anaesthesia. Although traction had exposed a part of the thoracic trachea it was not sufficient in this case to achieve a complete repair. In view of a grave prognosis, the dog was destroyed.     

A Procedure for Permanent Tracheostomy and Its Effects on Tracheal Mucosa

Permanent tracheostomies were performed on six dogs which were evaluated clinically and histologically. One dog had abnormal tracheal cartilages and died following tracheal collapse three days postoperatively. Problems with coughing, swallowing, and infection were not noted in the remaining five dogs. The exposed tracheal epithelium temporarily underwent squamous metaplasia but returned to a relatively normal appearance within 16 weeks.     

Fracture of an endoluminal nitinol stent used in the treatment of tracheal collapse in a dog

A 5-year-old castrated male Pomeranian was evaluated because of severe dyspnea and coughing, and a diagnosis of complete, static collapse of the trachea at the thoracic inlet was made. After failure to improve with medical management alone, an endoluminal tracheal stent was placed, which resulted in resolution of signs. Ten weeks after stent placement, the dog underwent tracheal resection and anastomosis because the stent had fractured at the level of the thoracic inlet. One year after surgery, the dog was doing well and required treatment with hydrocodone infrequently. Compared with other surgical treatment options, placement of an endoluminal tracheal stent is a relatively noninvasive intervention that can provide effective relief from the clinical signs associated with tracheal collapse in dogs. Implantation of endoluminal tracheal stents may be associated with complications; therefore, the procedure may best be regarded as a salvage procedure for dogs with end-stage disease that are refractory to appropriate medical management, have extensive collapse of the intrathoracic portion of the trachea, or are poor candidates for surgery.     

Obstructive, granulomatous tracheitis caused by Onchocerca sp. in a dog

A 3-year-old spayed female dog was admitted with a history of episodes of dyspnoea and coughing. Severe tracheal stenosis was found on radiography. The dog died during an episode of refractory dyspnoea. Necropsy revealed an obstruction of the thoracic part of the trachea because of a chronic granulomatous inflammation protruding into the tracheal lumen. Histological examination revealed nematodes, which were identified as Onchocerca sp. according to their morphological characteristics. In contrast to the common ocular manifestation in dogs, obstructive tracheitis caused by Onchocerca infection has not been reported before.     

Surgical treatment of tracheal collapse using pliable total ring prostheses: results in one experimental and 4 clinical cases

Pliable total ring prostheses were created from the polyvinyl chloride drip chambers of intravenous administration sets. The total ring prostheses were placed in one clinically normal research dog and in 4 client-owned dogs diagnosed with tracheal collapse. The research dog was euthanized one month after placement of the prostheses. Histopathological analysis of the trachea adjacent to the prostheses revealed a mild inflammatory response. The follow-up period for the clinical cases was from 4 months to 11 years. Radiographs taken and fluoroscopy performed 1 day to 5 months after surgery revealed improvement or resolution of the tracheal collapse. One dog was asymptomatic 28 weeks following surgery. Two dogs died 7 and 9 years after surgery, with one requiring intermittent medical management for coughing. They were euthanized for nonrespiratory illness. One dog had a persistent nonproductive cough, due to collapse of the mainstem bronchi, when last evaluated 4 months postoperatively. Pliable total ring prostheses provided adequate stability to the trachea and had the advantage of conforming to the trachea and being easy to create, place, and suture.     

Surgical resection of a primary tracheal fibrosarcoma in a dog

A four-year-old, entire male Rottweiler was presented with a history of respiratory distress. A tracheal mass was diagnosed on thoracic radiographs and tracheoscopy. Surgical excision of three tracheal rings incorporating the tumour was performed. The mass was found to be a low-grade fibrosarcoma. Twenty-four months later, the owner reported that there was no recurrence of respiratory distress and the dog appeared to be doing well clinically. This case of primary tracheal fibrosarcoma suggests that this type of tumour should be listed in the differential diagnoses for tracheal neoplasia in dogs and that surgical treatment alone may be curative.     

Noninvasive correction of a fractured endoluminal nitinol tracheal stent in a dog

An 11-year-old, castrated male Pomeranian was presented for intractable cough and dyspnea secondary to severe tracheal collapse. An endoluminal nitinol tracheal stent was placed with good results. Five months following placement of the prosthesis, clinical signs acutely recurred and failure of the implant was noted. A second stent was superimposed over the fractured stent and resulted in resolution of all clinical signs. The dog died several months later from progression of the tracheal collapse to the carina and mainstem bronchi.     

Clinical Tolerance and Bronchoscopic Changes Associated With Transtracheal High-Frequency jet Ventilation in Dogs and Cats

Eleven awake dogs and two cats received high-frequency jet ventilation (HFJV) via a transtracheal catheter for 6 hours to evaluate their clinical tolerance to the technique. A bronchoscopic examination was performed in all animals prior to and the morning of the day after the procedure to determine the gross effects of the technique on the tracheal epithelium.
All animals tolerated the technique well, exhibiting no discomfort and only a minimal amount of coughing. Only one dog exhibited coughing on the day following the procedure. No bronchoscopic changes were noted after HFJV in one dog. In one dog and one cat, the only observed change was an increase in the prominence of the vascularity compared to that observed prior to HFJV. The remaining animals exhibited more severe tracheal changes that included: an accumulation of mucus (seven dogs, one cat), focal spots of hemorrhage (two dogs), linear stretches of epithelial denuding (two dogs), and diffuse reddening and epithelial denuding (four dogs).
High-frequency jet ventilation by a transtracheal intravenous catheter is well tolerated for short-term ventilatory support in dogs and cats, but the magnitude of the tracheal damage observed in the present report may preclude long-term ventilatory support by this tecnique.     

THORACIC RADIOGRAPHIC FEATURES OF ANTICOAGULANT RODENTICIDE TOXICITY IN FOURTEEN DOGS

Thoracic radiographs and clinical records from 14 dogs with confirmed anticoagulant rodenticide toxicity were reviewed. Twelve of the 14 dogs were presented with a chief complaint of respiratory distress, and 12 had elevated prothrombin and activated partial thromboplastin times consistent with a coagulopathy secondary to a clotting factor deficiency. Thoracic radiographs of the 14 dogs were reviewed and abnomalities included increased mediastinal soft tissue opacity with extra and intrathoracic tracheal narrowing (4/14), increased mediastinal soft tissue opacity without tracheal narrowing (8/14), variable degrees of pleural effusion (13/14) and generalized, patchy interstitial/alveolar pulmonary infiltrates (8/14). Radiographic evidence of cardiomegaly and pulmonary artery abnormalities consistent with concurrent heartworm infestation were detected in one dog. In four dogs, dramatic tracheal narrowing was identified on the lateral thoracic radiograph caused by either mediastinal hemorrhage compressing the trachea or submucosal hemorrhage within the tracheal lumen. The trachea was displaced in a ventral direction in two dogs, and extra and intrathoracic luminal diameter narrowing was evident cranially in all four dogs. Two of these four dogs had soft tissue opacity within the dorsal trachea that extended from the larynx to the intrathoracic trachea. Twelve of the 14 dogs survived with standard treatment protocols utilizing injectable and oral vitamin K₁. One dog died from pancreatitis and disseminated intravascular coagulopathy. The other dog died soon after presentation due to severe, disseminated hemorrhage. Follow-up thoracic radiographs were made in four dogs that survived and showed resolution of the mediastinal, pleural and pulmonary changes within one to five days after the initiation of vitamin K₁ therapy.     

Tracheal rupture in a dog

A two-year-old male Retriever-crossbred dog was presented with progressive subcutaneous emphysema and pronounced dyspnoea following a cervical impact injury sustained ten days previously. Radiography revealed an almost complete transection of the cervical trachea and an associated pneumomediastinum and unilateral pneumothorax. The damaged tracheal segment was resected and anastomosis performed following drainage of the pneumothorax. The dog made an uneventful recovery with no evidence of stenosis detectable at the site of the repair six months post-operatively.     

Long-term outcome of conventional endotracheal tube balloon dilation of tracheal stenosis in a dog

This report describes a successful dilation of tracheal stenosis in a 16-year-old dog using a conventional endotracheal tube balloon. This technique should be considered as palliative treatment when owners decline other therapeutic options.     

Haemophilia A in the cocker spaniel: a case report

A four-year-old entire male cocker spaniel was presented with a history of dyspnoea due to tracheal stenosis. As part of the clinical approach, a coagulation screening profile revealed moderately reduced levels of Factor VIII procoagulant activity (VIII: C), but elevated factor VHI-related antigen levels (VIIIR: Ag). A diagnosis of haemophilia A (classic haemophilia) was made and the tracheal stenosis attributed to a mediastinal haematoma. The dyspnoea was alleviated by the surgical insertion of a tracheostomy tube and the dog was treated with citrated whole blood and fresh-frozen canine plasma. Response to treatment was excellent and follow-up radiography three months later revealed resolution of the tracheal stenosis.     

Tracheal stenosis following endotracheal intubation in a dog

A 2-month-old intact female Rottweiler was presented for investigation of coughing and respiratory distress 9 d after an exploratory laparotomy for intestinal foreign body removal. Tracheal stenosis was suspected by radiography and confirmed with computed tomography (CT) and tracheoscopy. After 1 wk of medical management, clinical signs had resolved and the severity of the tracheal narrowing was markedly improved, as confirmed by radiography and tracheoscopy. Tracheal stenosis is a considerable complication of endotracheal intubation in veterinary medicine and may be medically managed, depending on the severity of the tracheal injury.Key clinical message:To our knowledge, this is the first clinical case report of tracheal stenosis resulting from endotracheal intubation in a dog and its resolution after medical management.     

Nodular immunocyte-derived (AL) amyloidosis in the trachea of a dog

A 7-year-old castrated male Miniature Schnauzer was examined because of labored breathing and episodes of respiratory distress that progressed to collapse. On cervical radiographs, a focal soft tissue mass in the caudal cervical portion of the trachea was observed, and during tracheoscopy, a 1 x 1 cm, pedunculated, multinodular, pink, intraluminal mass extending from the dorsal tracheal membrane and obstructing approximately 80% of the tracheal lumen was seen. Tracheal resection and anastomosis was performed to remove the mass, and the dog recovered without complications. On histologic examination, the mass consisted of a large accumulation of homogeneous, faintly fibrillar eosinophilic material admixed with a predominantly plasma cell infiltrate; examination of sections stained with thioflavin T and Congo red stain confirmed that the eosinophilic material was amyloid. A diagnosis of nodular, immunocyte-derived (AL) amyloidosis was made. Seventeen months after surgery, the dog had a relapse of respiratory distress because of an extramedullary plasmacytoma involving the trachea.     

Development of hypoparathyroidism after excision of laryngeal rhabdomyosarcoma in a dog

An uncommon neoplasm of the larynx, rhabdomyosarcoma, was diagnosed in a 6-year-old 14-kg neutered female Spitz. In addition to the progressive onset of expected clinical signs of the tumor (exercise intolerance, respiratory stridor, inability to bark), the dog experienced hyperthermic crisis. Laryngectomy was successful in eradicating the local neoplastic tissue; however, unusual postoperative complications developed and included acute complications of pharyngotracheal fistula and hypoparathyroidism, and long-term complications of periodic collapse of the tracheal stoma and intolerance to heat. Probable causes and successful management of these complications are described. At 22 months after laryngectomy, the dog was admitted for a solitary hepatic metastasis. While hospitalized, the dog died of apparent asphyxiation attributable to stoma collapse.     

Cytologic analysis of tracheal wash specimens and bronchoalveolar lavage fluid in the diagnosis of mycotic infections in dogs

Tracheal wash and bronchoalveolar lavage fluid analyses were performed in 9 dogs that had mycotic infections with pulmonary involvement. Characteristic organisms were identified in tracheal wash fluid in 3 of 7 dogs with blastomycosis. Organisms were identified in bronchoalveolar lavage fluid in 5 of 7 dogs with blastomycosis and in one dog with histoplasmosis. Organisms were not found in either fluid in one dog with coccidioidomycosis. These procedures should be considered for dogs with suspected mycotic infections that involve the lungs and that cannot be diagnosed by less invasive means.