Long-term follow-up of laryngeal Rhinosporidium seeberi diagnosed by PCR and treated with laser ablation and voriconazole nebulization in a retired thoroughbred polo horse.

A 21-year-old retired polo Argentinian thoroughbred horse from a teaching herd was presented for a routine bronchoalveolar lavage demonstration, during which an incidental finding of a granulomatous mass on the dorsal aspect of the epiglottis was made. Rhinosporidium seeberi was suspected from a histological section obtained from an initial biopsy, and the mass was removed via laser surgery for cytology and PCR. Sequencing of the PCR amplicons confirmed the diagnosis of R. seeberi. A treatment protocol of nebulized voriconazole for 10 d postoperatively was used. Long-term follow-up required 2 more laser surgeries plus oral fluconazole to resolve the remaining fungal spores. However, 2.5 y later, there was no evidence of remaining fungal spores. Key clinical message: Horses from endemic regions can potentially be exposed to R. seeberi. Based on its travel history, this horse may have contracted the infection in South America, California, or Alberta. Treatments administered, including diode laser resection, voriconazole antifungal nebulization, and oral fluconazole administration, were successful but required repeated interventions.

Suivi à long terme du Rhinosporidium seeberi laryngé diagnostiqué par PCR et traité par ablation au laser et nébulisation au voriconazole chez un cheval de polo thoroughbred pur-sang à la retraiteUn cheval thoroughbred argentin de polo retraité de 21 ans, issu d'un troupeau d'enseignement, a été présenté pour une démonstration de lavage broncho-alvéolaire de routine, au cours de laquelle une découverte fortuite d'une masse granulomateuse sur la face dorsale de l'épiglotte a été faite. Rhinosporidium seeberi a été suspecté à partir d'une coupe histologique obtenue à partir d'une biopsie initiale, et la masse a été retirée par chirurgie au laser pour cytologie et PCR. Le séquençage des amplicons PCR a confirmé le diagnostic de R. seeberi. Un protocole de traitement au voriconazole nébulisé pendant 10 jours après l'opération a été utilisé. Le suivi à long terme a nécessité 2 autres interventions chirurgicales au laser et du fluconazole oral pour éliminer les spores fongiques restantes. Cependant, 2,5 ans plus tard, il n'y avait aucune trace de spores fongiques restantes.Message clinique clé:Les chevaux des régions endémiques peuvent potentiellement être exposés à R. seeberi. D'après ses antécédents de voyage, ce cheval pourrait avoir contracté l'infection en Amérique du Sud, en Californie ou en Alberta. Les traitements administrés, notamment la résection au laser à diode, la nébulisation antifongique au voriconazole et l'administration orale de fluconazole, ont été efficaces mais ont nécessité des interventions répétées.(Traduit par Dr Serge Messier).

Dynamic laryngeal collapse associated with poll flexion as a complication of laryngeal tie-forward surgery in three harness racehorses.

OBJECTIVE: To report dynamic laryngeal collapse (DLC) associated with poll flexion as a potential complication of the laryngeal tie-forward procedure (LTFP) in harness racehorses. STUDY DESIGN: Short case series. ANIMALS: Three harness racehorses. METHODS: Preoperative and postoperative medical records of all harness racehorses that underwent the LTFP were reviewed, as were high-speed treadmill videoendoscopy recordings of 35 horses that returned for upper airway evaluation postoperatively. RESULTS: One standardbred and two Norwegian coldblooded trotters in which dorsal displacement of the soft palate had been initially diagnosed were found to have bilateral arytenoid cartilage and vocal fold collapse associated with poll flexion after the LTFP. These three horses were otherwise clinically normal when exercised in free head carriage. CONCLUSION: Dynamic laryngeal collapse associated with poll flexion can occur as a complication after the LTFP in harness racehorses and should be considered as a differential in horses with persistence of airway problems after surgery. CLINICAL SIGNIFICANCE: Postoperative DLC may be underdiagnosed in harness racehorses because this complication is obvious only when horses are driven with bit and reins during high speed treadmill or overground videoendoscopy.

Transendoscopic correction of epiglottic entrapment with a silicone-covered laser guide and diode laser in 29 horses.

OBJECTIVE: To describe the use of a silicone-covered laser guide and diode laser for surgical correction of epiglottic entrapment and report postoperative outcomes in horses with epiglottic entrapment. STUDY DESIGN: Retrospective case series. ANIMALS: Thoroughbred and standardbred racehorses (n = 29) with epiglottic entrapment. METHODS: A silicone-covered laser guide was placed endoscopically to direct the diode laser cutting action during transection of the entrapping subepiglottic membrane and to act as a physical barrier between the membrane and the epiglottic cartilage. Postoperative complications and trainer satisfaction were recorded via use of a follow-up questionnaire. Race records were reviewed to determine return to racing and detect differences in the number of starts, wins, or earnings before and after surgery. RESULTS: The entrapping membrane was successfully released in all horses. Mild postoperative complications such as swelling of the surgical site (12 horses) and coughing or mild nasal discharge (5 horses) were recorded during the first few days after surgery. Ninety-six percent of trainers were satisfied with the outcome of the procedure; 93% of horses returned to racing. CONCLUSION: Laser guide-assisted transection of the subepiglottic membrane corrected epiglottic entrapment in standing horses. CLINICAL SIGNIFICANCE: Ease of surgical technique, mild postoperative complications, and a good prognosis to return to racing make this a suitable alternative to the traditional laser procedure.

Upper Airway Obstruction Due to Primary Laryngeal Blastomycosis in a Dog.

A 9 yr old female spayed Labrador retriever presented for progressive dyspnea. Inspiratory stridor and inspiratory and expiratory dyspnea were present, consistent with an upper airway obstruction. A laryngeal exam revealed severe thickening of the arytenoid cartilages and masses associated with the arytenoids. A tracheostomy tube was placed, and the masses were biopsied. Histopathology showed pyogranulomatous inflammation secondary to Blastomyces dermatitidis. The dog was initially treated with amphotericin B and terbinafine in the hospital until the airway obstruction resolved and the tracheostomy tube could be removed. The dog experienced complete recovery after long-term treatment with itraconazole and terbinafine. This is the first report of laryngeal obstruction secondary to primary laryngeal blastomycosis in a dog. Blastomycosis should be considered for cases of obstructive laryngeal disease, and a good outcome can be achieved with antifungal treatment.

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.

Epiglottopexy for the treatment of epiglottic retroversion in 2 horses.

OBJECTIVE: To report an epiglottopexy technique for the treatment of epiglottic retroversion (ER) in 2 horses. STUDY DESIGN: Case report. ANIMALS: A 2-year-old thoroughbred gelding and a 6-year-old standardbred gelding, both with ER. METHODS: Epiglottic retroversion was diagnosed via exercising endoscopic examination in both horses. Epiglottopexy technique was performed in both cases. RESULTS: Both horses returned to previous racing class within 1 year after surgery. Repeat exercising endoscopy of 1 horse 6 months postoperatively revealed resolution of the ER. CONCLUSION: Epiglottopexy should be considered for treatment of ER in the equine athlete. CLINICAL SIGNIFICANCE: Previously reported surgical techniques for ER in the equine athlete have not resulted in horses returning to previous performance level. The technique reported here resulted in both horses achieving athletic status.

Using quarterly earnings to assess racing performance in 66 thoroughbreds after transendoscopic laser surgery for treatment of epiglottic entrapment.

OBJECTIVE: To assess the outcome of transendoscopic laser surgery for the treatment of epiglottic entrapment (EE) and determine the influence of preoperative morphological characteristics on outcomes. STUDY DESIGN: Retrospective cohort study. ANIMALS: Thoroughbred racehorses treated with transendoscopic laser surgery (n = 66) and untreated cohorts (n = 132). METHODS: Medical, surgical, and race records of 66 horses treated with transendoscopic laser surgery were compared with untreated cohorts randomly selected from their last race presurgery. Postsurgery data were collated as number of starts and race winnings for each quarter after the date of surgery. RESULTS: Treated horses performed worse (P = .002) than their untreated cohorts in their last race presurgery. Although treated horses raced fewer times (P < .001) and earned less money (P < .001) in the first quarter after surgery compared with untreated horses, quarterly earnings or starts did not differ between groups after the first quarter. Among variables tested, subepiglottic membrane resection was the only prognostic factor; horses requiring this resection raced fewer times (P = .001) but without a significant difference in earnings. CONCLUSION: Horses treated for EE via transendoscopic laser surgery returned to a performance standard comparable to their untreated cohorts by the second quarter postsurgery. Horses with entrapments requiring resection raced fewer times postoperatively than the untreated cohorts. CLINICAL SIGNIFICANCE: Treated horses can be expected to perform equivocally to that of untreated cohorts in all but the first quarter following surgery except in those cases where resection of the entrapping membranes is required.

Long-term outcome of permanent tracheostomy in 15 dogs with severe laryngeal collapse secondary to brachycephalic airway obstructive syndrome.

OBJECTIVE: To report the long-term outcome of permanent tracheostomy for the management of severe laryngeal collapse secondary to brachycephalic airway obstructive syndrome. STUDY DESIGN: Retrospective case series. ANIMALS: Fifteen brachycephalic dogs with severe laryngeal collapse treated with permanent tracheostomy. METHODS: Follow-up data were obtained from medical records or via telephone conversation with the owners. The Kaplan-Meier estimator was used to calculate median survival time. Death was classified as related or unrelated to tracheostomy surgery. Complications were classified as major when they were life-threatening or required revision surgery. Owners were asked to classify the postoperative quality of life as improved, unchanged, or worse and the management of the stoma as simple or demanding. RESULTS: The median survival time was 100 days. Major complications were diagnosed in 12 of 15 (80%) dogs, resulting in death in 8 (median survival time 15 days) and revision surgery in 4 dogs. Seven of 15 (47%) dogs died of unrelated causes or were alive at the end of the study (median survival time 1982 days). The postoperative quality of life of 9 dogs was judged as markedly improved. Stoma management was defined as simple in 8 dogs and demanding in 4. CONCLUSION: Permanent tracheostomy was associated with a high risk of complications and postoperative death in brachycephalic dogs. However, long-term survival (exceeding 5 years) with a good quality of life was documented in 5 of 15 dogs. CLINICAL SIGNIFICANCE: Permanent tracheostomy is a suitable salvage option in brachycephalic dogs with severe laryngeal collapse that did not improve following more conservative surgeries.

Laryngeal Neuropathy in Adult Goats With Copper Deficiency.

The aim of this study was to elucidate the cause of a neurological syndrome characterized by stridor in adult goats with clinical signs of copper deficiency. The main clinical signs consisted of apathy, emaciation, pale mucous membranes, mucous nasal discharge, dyspnea, severe achromotrichia, diffuse alopecia, torpor, ataxia, and stridor. When the goats were forced to move, the stridor increased. In a herd of 194 Toggenburg goats, 10 adult goats with clinical signs of copper deficiency were removed from the herd and divided into 2 groups: group 1, which consisted of 4 nannies and 1 buck with stridor, and group 2, which consisted of 4 nannies and 1 buck without stridor. Group 3, used as a control, consisted of 5 adult goats from another flock without any clinical signs of disease. The mean serum copper concentrations were 1.3 ± 0.3 µmol/L in group 1, 8.1 ± 1.1 µmol/L in group 2, and 11.3 ± 2.2 µmol/L in group 3. The mean serum iron concentrations were 42.3 ± 14.2 µmol/L in group 1, 39.1 ± 8.2 µmol/L in group 2, and 20.6 ± 6.1 µmol/L in group 3. The main histological lesions in goats from group 1 were axonal degeneration of the recurrent laryngeal nerves and atrophy of the muscles of vocal folds and of the dorsal cricoarytenoid and right and left cricothyroid muscles. Goats with ataxia had neuronal degeneration and necrosis of cerebellar Purkinje cells and of the cranial cervical ganglion. We concluded that the stridor was caused by axonal degeneration of the recurrent laryngeal nerves due to the severe copper deficiency.

Ex Vivo Mechanical Evaluation of a Sternal ZipFix(®) Implant for Prosthetic Laryngoplasty in Horses.

OBJECTIVE: To evaluate the properties of a ZipFix(®) (ZipFix) implant in equine laryngeal cartilages. STUDY DESIGN: Ex vivo biomechanical study. SAMPLE POPULATION: Equine arytenoid (n=36) and cricoid cartilages (n=18). METHODS: Suture bites were placed in arytenoid or cricoid cartilages using a ZipFix(®) implant or a single strand of USP 5 braided polyester (TiCron™), and arytenoid and cricoid cartilages were separately subjected to single load to failure (25 N preload) or cyclic loading for 1,000 cycles, followed by single load to failure. Load, distraction, and stiffness were recorded. RESULTS: Four arytenoid-ZipFix cartilages fractured on implant placement. Under single load, arytenoid-ZipFix (n=9) failed at a greater mean load (359.01 ± 57.98 N) than arytenoid-Ticron (159.11 ± 22.98 N; n=12; P<.001). Arytenoid-ZipFix stiffness (31.32 ± 4.26 N/mm) was significantly greater than arytenoid-Ticron (13.18 ± 2.60 N/mm; P<.001). Cricoid-ZipFix stiffness (20.83 ± 3.37 N/mm) was significantly greater than cricoid-Ticron (13.6 ± 3.82 N/mm; n=6; P=.006). Under cyclic load, arytenoid-ZipFix distraction (2.53 ± 0.63 mm; n=5) was significantly less than arytenoid-Ticron (5.06 ± 1.37 mm; n=6, P=.006). After cyclic load, arytenoid-ZipFix failure load (295.16 ± 54.95 N) was significantly greater than arytenoid-Ticron (127.69 ± 32.67 N; P=.002). Arytenoid-ZipFix stiffness (35.59 ± 1.58 N/mm) was significantly greater than arytenoid-Ticron (24.10 ± 6.85 N/mm; P=.019). CONCLUSION: In arytenoid cartilages, the sternal ZipFix(®) implant was significantly stronger and stiffer compared to a single strand of Ticron. During placement of the ZipFix(®) implant, frequent arytenoid cartilage failure occurred before testing, suggesting the implant is not suitable for clinical application.

Surgical Treatment of Iatrogenic Ventral Glottic Stenosis Using a Mucosal Flap Technique.

OBJECTIVE: To describe a novel surgical technique for correcting postoperative ventral glottic stenosis (cicatrix or web formation) and the outcome in 2 Thoroughbred racehorses. STUDY DESIGN: Retrospective case report. ANIMALS: Thoroughbreds diagnosed with ventral glottic stenosis (n=2). METHODS: Horses presenting with iatrogenic ventral glottic stenosis and resultant exercise intolerance and abnormal exercise-related noise were anesthetized and a midline sagittal skin incision was made over the ventral larynx and between the sternohyoideus muscles overlying the cricothyroid notch. The cricothyroid ligament, attached laryngeal cicatrix, and overlying mucosa were sagittally sectioned at the dorsal aspect of the cicatrix on the left side. The laryngeal mucosa, cicatrix, and underlying cricothyroid ligament immediately rostral and caudal to the cicatrix were sectioned in a medial (axial) direction as far as the right side of the cricothyroid notch. After resection of the majority of the attached cicatrix tissue, the residual mucosal flap (attached to the right side of the larynx) was reflected ventrally and sutured to the attachment of the cricothyroid ligament on the right side of the cricothyroid notch, creating an intact mucosal layer on the right side of the ventral larynx. RESULTS: Both horses had good intralaryngeal wound healing with minimal redevelopment of ventral glottic stenosis at 5 and 9 months postoperatively and were successfully returned to racing with complete absence of abnormal respiratory noise. CONCLUSION: The unique laryngeal anatomy of horses, with a cartilage-free ventral laryngeal area (cricothyroid notch), allowed the use of this novel surgical technique to successfully treat ventral glottic stenosis.

Mechanical comparison of 3 anchoring techniques in the muscular process for laryngoplasty in the equine larynx.

OBJECTIVE: To compare mechanical properties of 2 techniques with a conventional technique for anchoring the muscular process in a laryngoplasty procedure. STUDY DESIGN: Experimental ex vivo study. SAMPLE POPULATION: Equine larynges (n = 60). METHODS: A single loop (SL), a screw (SC), and a double loop technique (DL) were compared. Constructs were subjected to cyclic loading, oscillating from 5 to 50 N for 3000 cycles, followed by a single cycle to failure test. Mean distraction, load at failure, stiffness, and failure mode were compared between groups. RESULTS: Mean ± SD distraction in cyclic loading was greater for DL (2.1 ± 0.7 mm) than for SL (1.9 ± 1.3 mm) and SC (1.539 ± 0.9 mm); however, there was no significant difference between SL and SC or between SL and DL. Mean ultimate failure load was greater for DL (240 ± 44.56 N) than for SC (189.59 ± 46.16 N) and SL (150.93 ± 44.43 N) and greater for SC compared with SL. Failure occurred by cartilage tearing for DL and SL, and by screw pull out (n = 13) or knot slippage (4) for SC. CONCLUSION: In cyclic loading, SC is more stable than DL and at least as stable as SL. In single cycle to failure, DL is the strongest construct and SC is stronger than SL.

In vitro mechanical testing of braided polyurethane elastic fiber and braided polyester for equine laryngoplasty.

OBJECTIVES: In vitro comparison of the mechanical properties of braided polyurethane elastomer (Lycra®) and braided polyester (Ethibond™) (1) when inserted into the muscular process of the arytenoid cartilage and (2) as suture loops. STUDY DESIGN: Experimental. ANIMALS: Equine cadaver larynges (n = 15). METHODS: The muscular processes (n = 30) of the arytenoid cartilages were dissected from each larynx and embedded in a resin base. Lycra® and Ethibond™ prostheses were randomly allocated to the left or right muscular process and each underwent cyclic fatigue (25-50 N) followed by load-to-failure testing. Isolated suture loops of Lycra® (n = 25) and Ethibond™ (n = 25) also underwent the same cyclic fatigue followed by load-to-failure testing (n = 20) or a creep testing protocol (25 N for 10 min; n = 5). RESULTS: Lycra® prostheses pulled through the cartilage in a significantly greater proportion of cyclic tests (P = .015) and at lower mean (±SD) loads, (95.9 ± 23.4 N) during load-to-failure testing than Ethibond™ prostheses (155.2 ± 24.4 N; P = .0041). Lycra® had a significantly greater displacement with and without a cartilage interface when compared to Ethibond™ (P < .001, P < .002). The Lycra® isolated suture loops failed at significantly greater loads (233.0 ± 38.7 N) during load-to-failure testing than Ethibond™ loops (201.6 ± 47.4 N; P = .042). CONCLUSIONS: Lycra® prostheses embedded in laryngeal cartilage pulled through the cartilage at lower loads than Ethibond™ prostheses. Lycra® suture loops were stronger than Ethibond™ suture loops. Lycra® had greater displacement than Ethibond™ in all tests as suture loops or when embedded in cartilage.

Endoscopic, transoral, reduction of epiglottic entrapment via wire snare technique.

OBJECTIVE: To describe the use of a wire snare technique for epiglottic entrapment. STUDY DESIGN: Case series. ANIMALS: Eight adult horses. METHODS: Under general anesthesia, a modified mouth gag was placed in the oropharynx. An endoscope was passed through the gag until there was adequate visualization of the entrapped epiglottis. The entrapping mucosa was grasped with bronchoesophageal forceps and pulled rostrally, releasing the epiglottis. A custom snare was passed down the bronchoesophageal forceps to encircle the redundant subepiglottic mucosa. Tension was applied to the entrapping mucosa via the forceps as the obstetric wire was tightened at the base and the redundant mucosa (aryepiglottic fold) was excised. RESULTS: The procedure was performed on 8 adult thoroughbred horses. Re-evaluation by endoscopy did not show entrapment in any horse and no horse developed complications or has had problems with performance. CONCLUSIONS: This technique is a minimally invasive, competitively priced and straightforward method for resection of entrapping subepiglottic mucosa in adult horses.

Changes in rima glottidis area and lack of laryngeal epiglottic-glottic seal after unilateral cricoarytenoid lateralization ex vivo.

OBJECTIVE: To evaluate variation in rima glottidis (RG) area and lack of epiglottic-glottic seal (LEGS) of the canine larynx associated with different suture anchor points in the arytenoid and cricoid cartilages, dissection of the cricoarytenoid joint capsule, section of the interarytenoid band, and disarticulation of the cricothyroid joint. STUDY DESIGN: Experimental study. ANIMALS: Cadaveric canine larynges (n = 18). METHODS: Larynges were assigned to 2 groups: group 1 = intact cricothyroid articulation and group 2 = cricothyroid articulation sharply sectioned. In each group, the arytenoid cartilage was lateralized successively as follows: (a) intact cricoarytenoid articulation, (b) cricoarytenoid articulation sharply sectioned, and (c) division of the interarytenoid band. Each variation was performed initially with the suture passed dorsally into the cricoid cartilage then with the suture passed laterally. Each time, the increase of rima glottis area (%) and the LEGS (mm(2) ) were measured. RESULTS: Rima glottis area (RGA): when the suture was placed dorsally, division of the interarytenoid band resulted in a significant increase in RGA compared with groups with an intact band. Laryngeal distortion: when the suture through the cricoid cartilage was dorsal, LEGS increased with section of the cricothyroid articulation, dissection of cricoarytenoid articulation, and division of the interarytenoid band. CONCLUSION: Unilateral arytenoid lateralization results in some degree of LEGS with a misalignment of the epiglottis over the RG. Our results revealed that the optimal RGA associated with the minimal LEGS was obtained with dorsal placement of a cricoarytenoid suture when the cricothyroid joint and the interarytenoid band were intact.

Update on laryngeal disorders and treatment.

Laryngeal disorders are relatively common in the horse, and thorough diagnostic evaluation is essential to make an accurate definitive diagnosis and selection of appropriate treatment. The value of exercising endoscopy must not be overlooked, and the recent development of dynamic (overground) endoscopy is providing new insights into dynamic laryngeal lesions. The focus of this article will be on recently described disorders and treatments or modifications to existing treatments. It summarizes the numerous investigations attempting to perfect the laryngoplasty procedure for treatment of laryngeal hemiplegia. The newly described conditions, bilateral dynamic laryngeal collapse, and dynamically flaccid epiglottis will also be discussed.

Transoral snare removal of subepiglottic cysts.

OBJECTIVE: The objective of this demonstration was to describe and simulate a surgical technique for removing subepiglottic cysts in horses via an oral approach under endoscopic guidance using a cadaver model for simulation and clinical data. The technique aims to provide a minimally invasive method for the removal of these cysts. ANIMALS: 2 clinical case images from the Washington State University Teaching Hospital were used in the video. In a third horse euthanized for reasons unrelated to the study, the procedure was simulated after the head was frozen and transected transversally. METHODS: Files from 2 horses were reviewed, and the relevant parts were selected. The horse head was set on a stand, and a simulated cyst was implanted under the mucosa, made of the fingertip from a glove filled with carboxymethyl cellulose gel, and sutured. The procedure was performed by one of the authors (CAR) and recorded. A bronchoesophageal grasping forceps and cautery snare were used to simulate a clinical situation in dorsal recumbency. RESULTS: The cyst was successfully removed as in the real procedure, and the demonstration was recorded for educational use. The review of the videos shows that the simulated procedure is also achievable in a real clinical environment. CLINICAL RELEVANCE: This technique provides a minimally invasive method for the removal of subepiglottic cysts in horses. The demonstration of this procedure is crucial for the training of surgeons, as it allows the visualization of the procedure in a controlled setting, free from the complications of real clinical situations.

Computed tomography of nonanesthetized cats with upper airway obstruction.

Upper airway obstruction is a potentially life-threatening problem in cats and for which a noninvasive, sensitive method rapid diagnosis is needed. The purposes of this prospective study were to describe a computed tomography (CT) technique for nonanesthetized cats with upper airway obstruction, CT characteristics of obstructive diseases, and comparisons between CT findings and findings from other diagnostic tests. Ten cats with clinical signs of upper airway obstruction were recruited for the study. Four cats with no clinical signs of upper airway obstruction were recruited as controls. All cats underwent computed tomography imaging without sedation or anesthesia, using a 16-slice helical CT scanner and a previously described transparent positional device. Three-dimensional (3D) internal volume rendering was performed on all CT image sets and 3D external volume rendering was also performed on cats with evidence of mass lesions. Confirmation of upper airway obstruction was based on visual laryngeal examination, endoscopy, fine-needle aspirate, biopsy, or necropsy. Seven cats were diagnosed with intramural upper airway masses, two with laryngotracheitis, and one with laryngeal paralysis. The CT and 3D volume-rendered images identified lesions consistent with upper airway disease in all cats. In cats with mass lesions, CT accurately identified the mass and location. Findings from this study supported the use of CT imaging as an effective technique for diagnosing upper airway obstruction in nonanesthetized cats.

Retrospective study of 1050 dogs with respiratory symptoms in Japan (2005-2020).

BACKGROUND: Few studies have investigated the incidence of respiratory diseases based on anatomical sites or the relationship between breed and these diseases. OBJECTIVE: The objective of this study was to investigate the prevalence of canine respiratory diseases among dogs in Japan, with relationship to the breed. METHODS: We retrospectively reviewed the medical records of dogs with respiratory symptoms and calculated the odds ratio (OR) to evaluate the relationship between breed and disease. RESULTS: A total of 1050 dogs with respiratory symptoms were included in this study. Miniature dachshunds were the most common breed affected by respiratory diseases. Among tracheobronchial diseases, there was a significant association between some small breeds and tracheobronchial collapse, miniature dachshunds (OR: 4.44, 8.43, 95% confidence interval [CI]: 3.17-6.22, 4.33-16.0) and chronic bronchitis and bronchiectasis. Among nasal diseases, miniature dachshunds (OR: 27.2, 95% CI: 16.8-44.8) and golden retrievers (OR: 21.0, 95% CI: 6.43-69.3) were the most affected by non-infectious rhinitis and nasal aspergillosis, respectively. Brachycephalic obstructive airway syndrome was the most common disease among pharyngeal and laryngeal diseases, with a relationship with breed being found in some brachycephalic breeds, and Pomeranians (OR: 2.7, 95% CI: 1.42-5.17). CONCLUSIONS: Respiratory diseases in dogs are strongly correlated with popular breeds in Japan. Miniature dachshunds, in particular, are associated with many respiratory diseases, which may differ from international reports. Thus, this result may help in the early detection, prevention, treatment, and elucidation of the pathophysiology of canine respiratory diseases.

A case of epiglottic entrapment in a cat.

OBJECTIVE: The objective of this study was to describe a case of epiglottic entrapment in a cat. CASE SUMMARY: A 5-month-old male neutered Russian Blue cat was evaluated for progressive stertorous upper airway sounds, acute onset vestibulopathy and abnormal laryngeal anatomy. Endotracheal intubation was only able to be achieved using videoscopic guidance and identified concern for severe nasopharyngeal stenosis. A computerized tomography scan revealed otitis interna, narrowed nasopharynx and no definitive cause for the stertorous breathing. The cat recovered very slowly from anaesthesia due to concern for airway obstruction following extubation. It was discharged the following day and then passed away at home 2 weeks later. Necropsy revealed that the epiglottis was obscured by 2 cm of redundant mucosal tissue extending from the base of the tongue to the larynx resulting in epiglottic entrapment. Also noted was chronic, severe otitis interna and externa. Upper airway obstruction is suspected to be the cause of sudden death. NEW OR UNIQUE INFORMATION: To the authors' knowledge, this is the first report of these oropharyngeal anatomic abnormalities in a cat.