Dumon silicone stents can improve respiratory function in dogs with grade IV tracheal collapse: 12 cases (2019-2023).

OBJECTIVE: To evaluate the efficacy, complications, and outcome of Dumon silicone stent placement for dogs with grade IV tracheal collapse. ANIMALS: 12 client-owned dogs. CLINICAL PRESENTATION: Each dog was diagnosed with grade IV TC unresponsive to medical therapy and had severe obstructive respiratory failure. RESULTS: 12 dogs were included in the study. By the end of the study, 5 of 12 (41.7%) remained alive, while 7 of 12 (58.3%) dogs died. Survival times after stent placement ranged from 97 to 1,310 days (mean, 822.43 days; median, 810 days). Three of the 12 (25%) dogs died spontaneously, while 4 of 12 (33.3%) were euthanized. The cause of death was determined for 6 of 7 (85.7%) dogs and was TC related for 3 of 7 (50%). Causes of death related to TC were progressive airway collapse (2/3 [66.6%]) and incoercible cough (1/3 [33.4%]). Complications occurred in 9 of 12 (75%) cases and included granulation tissue growth (3/12 [25%]), incoercible cough (2/12 [16.7%]), stent migration (1/12 [8.3%]), and stent deformation (1/12 [8.3%]). Reduction of obstructive dyspnea and episodes of asphyxiation was achieved after Dumon silicone stent placement. CLINICAL RELEVANCE: The placement of an intraluminal Dumon silicone stent was a successful salvage treatment for TC in dogs that did not respond to medical management. Disease progression is inevitable, but substantial improvement of respiratory function may be achieved for months to years.

Nasopharyngeal sialoceles in 11 brachycephalic dogs.

OBJECTIVE: To report clinical features, diagnosis, surgical treatment, and outcomes of brachycephalic dogs with nasopharyngeal sialoceles (NPS). STUDY DESIGN: Retrospective case series. ANIMALS: Eleven brachycephalic dogs with NPS. METHODS: Diagnosis of NPS was based on identification of cystic nasopharyngeal masses containing saliva-like mucoid material on retroflexed endoscopy. Biopsies were obtained to support the diagnosis. Surgical deroofing was performed under endoscopic guidance, and endoscopic examination was repeated at least 3 months after surgery. The owners rated the outcome of surgery via a follow-up telephone inquiry. RESULTS: Pugs (n = 8), French bulldogs (n = 2), and English bulldogs (n = 1) were included in this study. Eight of the NPS were ventral, 6 were obstructive, and 2 were multiple; both the obstructive and the multiple sialoceles were ventral. Surgical deroofing of the sialoceles was performed under endoscopic guidance with biopsy forceps in 5 cases and by diode laser in 6 cases. No recurrence was diagnosed. Ten of 11 owners reported that they were satisfied with the outcome. CONCLUSIONS AND CLINICAL SIGNIFICANCE: NPS may be an uncommon consequence of chronic nonphysiologic mechanical stress causing changes in minor nasopharyngeal salivary glands. Direct visualization by nasopharyngoscopy is the best technique for detection of NPS, and we advise routine examination of the nasopharynx by endoscope in all brachycephalic dogs before performing surgery. Either endoscopic guided biopsy forceps or diode laser surgery can be used for noninvasive, rapid, and effective resolution of NPS in all of the dogs.

Treatment of acquired nasopharyngeal stenosis using a removable silicone stent.

The aim of this prospective study was to characterise patient characteristics and the histories of cats with acquired nasopharyngeal stenosis (ANS), and to describe the use of a removable silicone stent for treatment. ANS was diagnosed in 15 cats with clinical signs present for a median of 4 months. Clinical signs included stertor and inspiratory difficulty, nasal discharge, sneezing, dysphagia, regurgitation, vomiting and anorexia. Radiographs revealed a dorsal deviation or deformation of the caudal part of the soft palate in 10 of the cats, a soft tissue density across the cranial nasopharynx in four and no abnormality in one. The stenosis was initially dilated with a Kelly forceps in 10 of the cats and by balloon dilatation in five. A segment of a 24 Fr silicone thoracic catheter was used for the stent in five cats; in the other 10 cats a segment of a 28 Fr catheter was used. The stent was removed after 3 weeks in 12 cats and after 4 weeks in the other three. Endoscopy revealed an adequate nasopharyngeal diameter in all of the cats. At both 3 and 10 months after surgery the response was considered to be satisfactory, with complete resolution of clinical signs in 14 cats and improvement in the remaining cat. The treatment of ANS by stenosis dilatation followed by temporary stenting with a silicone stent is a rapid, safe, economical and effective procedure.

Bronchial abnormalities found in a consecutive series of 40 brachycephalic dogs.

OBJECTIVE: To detect abnormalities of the lower respiratory tract (trachea, principal bronchi, and lobar bronchi) in brachycephalic dogs by use of endoscopy, evaluate the correlation between laryngeal collapse and bronchial abnormalities, and determine whether dogs with bronchial abnormalities have a less favorable postsurgical long-term outcome following correction of brachycephalic syndrome. DESIGN: Prospective case series study. ANIMALS: 40 client-owned brachycephalic dogs with stertorous breathing and clinical signs of respiratory distress. PROCEDURES: Brachycephalic dogs anesthetized for pharyngoscopy and laryngoscopy between January 2007 and June 2008 underwent flexible bronchoscopy for systematic evaluation of the principal and lobar bronchi. For dogs that underwent surgical correction of any component of brachycephalic syndrome, owners rated surgical outcome during a follow-up telephone survey. Correlation between laryngeal collapse and bronchial abnormalities and association between bronchial abnormalities and long-term outcome were assessed. RESULTS: Pugs (n = 20), English Bulldogs (13), and French Bulldogs (7) were affected. A fixed bronchial collapse was recognized in 35 of 40 dogs with a total of 94 bronchial stenoses. Abnormalities were irregularly distributed between hemithoraces; 15 of 94 bronchial abnormalities were detected in the right bronchial system, and 79 of 94 were detected in the left. The left cranial bronchus was the most commonly affected structure, and Pugs were the most severely affected breed. Laryngeal collapse was significantly correlated with severe bronchial collapse; no significant correlation was found between severity of bronchial abnormalities and postsurgical outcome. CONCLUSIONS AND CLINICAL RELEVANCE: Bronchial collapse was a common finding in brachycephalic dogs, and long-term postsurgical outcome was not affected by bronchial stenosis.

Differential cell counts in canine cytocentrifuged bronchoalveolar lavage fluid: a study on reliable enumeration of each cell type.

BACKGROUND: Bronchoalveolar lavage (BAL) allows cell recovery from the lower respiratory tract; differential cell counts of BAL fluid gives important information in the assessment of various bronchial and pulmonary diseases. To the best of our knowledge no study has investigated the relation between the number of cells counted and the reproducibility of BAL fluid differential cell counts. OBJECTIVE: The purpose of this study was to investigate using statistical methods how many cells should be counted in cytocentrifuged BAL fluid preparations in order to obtain a reliable enumeration of each cell type. METHODS: BAL fluid samples from dogs with suspected bronchopulmonary disease were obtained during fiberoptic bronchoscopy with a standardized protocol. Differential cell counts were performed on May-Grünwald-Giemsa-stained cytocentrifuged preparations by 2 independent observers. Reproducibility for the enumeration of each cell type was expressed as the intraclass correlation coefficient. We considered a threshold level of >or=0.90 to be high and a threshold level of >or=0.85 to be adequate. RESULTS: Forty BAL fluid samples were included in the study. For neutrophils, alveolar macrophages, and eosinophils high reproducibility was reached by counting 200 cells; adequate reproducibility was reached for lymphocytes and bronchial epithelial cells by counting 500 cells. CONCLUSIONS: A 500-cell differential count is required for all types of cells to be quantified with adequate reproducibility in canine cytocentrifuged BAL fluid samples.

Squash-preparation cytology from nasopharyngeal masses in the cat: cytological results and histological correlations in 30 cases.

Upper airway obstruction in cats can be a life-threatening condition. Early recognition of clinical signs and an appropriate diagnostic approach increases the possibility of appropriate therapeutic choices. The purpose of this study was to assess the efficacy and diagnostic value of squash-preparation cytology in providing an accurate diagnosis of masses growing in the nasopharynx of cats. Cytological specimens prepared by a squash technique from nasopharyngeal masses in 30 cats were collected under direct endoscopic guidance and classified into four groups: benign inflammatory/hyperplastic mass, lymphoma, carcinoma and sarcoma. The cytopathological diagnosis was compared with the final histopathological diagnosis and indices of diagnostic test accuracy were calculated. The results showed good agreement between the cytological and histological diagnosis with a sensitivity of 0.94, a specificity of 0.81, a positive likelihood ratio of 0.9, a negative likelihood ratio of 0.9 and an overall accuracy of 0.9. Squash-preparation cytology is considered an accurate diagnostic tool for distinguishing benign from malignant nasopharyngeal masses in cats. For differentiation of lymphoma and lymphoid reactions histopathological confirmation is recommended.