Brachycephalic Syndrome is a respiratory condition affecting short-faced dog breeds like Bulldogs and Pugs. It is caused by anatomical abnormalities including a shortened skull, narrowed nasal passages, thickened soft palate, everted laryngeal saccules, and in severe cases, laryngeal collapse. Affected dogs experience heat and exercise intolerance, snoring, difficulty breathing, and sometimes fainting. Diagnosis involves owner reports, physical exam noting stenotic nares, and diagnostic imaging like CT scans and endoscopy to evaluate the severity of airway obstruction at multiple levels from nose to lungs.
Angels presenting chronic patellar luxation in cattle.by pavulPavulraj Selvaraj
Patellar luxation is a non-inflammatory disorder of the femoropatellar articulation in cattle and dogs where the patella is displaced from its normal position. In cattle, it causes jerky limb movements and an extended limb stance. Surgical treatment involves cutting the medial patellar ligament to allow the patella to move freely. In dogs, it causes intermittent lameness and abnormal gaits. Surgical options aim to deepen the trochlear groove or reinforce the lateral soft tissues to stabilize the patella.
www.petsgroomingtips.com is one of the front-runners in providing complete digital information to the pet owners, which would guide theme through various process of grooming their beloved kids. A shabby puppy or kitten not only appears dirty but soon infested with disease if not treated properly. Our various tutorials and free PDF guides cover every aspect of the grooming process.
This document provides information on seizures in animals. It begins by defining a seizure as excessive discharge of excitable neurons in the brain. There are two main types of seizures - generalized seizures which involve the whole brain and cause loss of consciousness, and focal or partial seizures which start in one area of the brain. Epilepsy is defined as recurrent seizures regardless of cause. Seizures occur due to an imbalance between inhibitory and excitatory neurotransmitters in the brain. The document outlines the classification, causes, diagnosis and treatment of seizures including anti-seizure medications.
Mange is among the common illnesses that many dog owners are concerned about. People usually get tensed and do not know how to handle such situations. I present you this Presentation that speaks about Mange, a skin disease caused by tiny parasite mites on dogs. You can refer to this to know what Mange is all about, the types of Mange, the causes, the symptoms and a few easy ways to deal with it. Mange, if left untreated can be fatal. Therefore, timely knowledge and treatment about this disease is important. You can also add your views in the comments below.
For more information about Mange, you can refer to the following links:
http://www.vet-organics.com/types-of-mange-in-dogs/
http://pets.webmd.com/dogs/mange-dogs-canine-scabies
The document discusses horn anatomy and affections in cattle. It notes that horns are formed by the frontal bones and become hollow. The base is thin and the horn thickens towards the apex. Blood and nerve supply are described. Major horn affections include avulsion, fracture, and horn cancer. Treatment for fractures may include amputation. Dehorning involves removing the horn at the base through elliptical incision and sawing. Disbudding young calves removes small horn buds using a caustic compound or hot iron. Procedures are done with local anesthesia and analgesia.
Epidural anesthesia can be effectively performed in cattle, horses, sheep, and goats. The injection site is between the coccygeal vertebrae. For cattle, 5-10 ml of 2% lidocaine provides adequate caudal anesthesia for minor procedures while 100-150 ml provides anterior anesthesia, though the animal may become recumbent. For horses, a mixture of xylazine and mepivacaine at the sacrococcygeal junction provides effective caudal epidural anesthesia. Sheep and goats can receive lumbosacral epidural injections of lignocaine for abdominal surgery or c-sections. Correct needle placement in the epidural space is important to avoid complications.
This document discusses ear conditions in pets. It covers otitis externa (inflammation of the outer ear), including common signs like head shaking and discharge. Otoscopic examination of the ear canal is described. Treatment for otitis externa involves cleaning and applying medications to the ear canal. Other conditions covered include auricular hematoma, otitis media (middle ear inflammation), and otitis interna (inner ear). Surgical techniques like lateral ear canal resection are discussed. Diagnosis and treatment of otitis media and interna involve cytology, antibiotics, and anti-fungals based on culture results from the infected areas.
This document discusses fetal mummification and maceration in animals. Fetal mummification is the shriveling of the fetus caused by the absorption of fluids from the fetus and uterus, leading to the death of the fetus. It can be caused by genetic abnormalities, hormonal issues, or problems with the placenta or umbilical cord. Maceration occurs when the fetus dies but is not aborted, causing it to become putrefied inside the uterus. Both conditions require veterinary intervention such as medications to induce abortion or surgical removal of the remains if abortion does not occur naturally.
Angels presenting chronic patellar luxation in cattle.by pavulPavulraj Selvaraj
Patellar luxation is a non-inflammatory disorder of the femoropatellar articulation in cattle and dogs where the patella is displaced from its normal position. In cattle, it causes jerky limb movements and an extended limb stance. Surgical treatment involves cutting the medial patellar ligament to allow the patella to move freely. In dogs, it causes intermittent lameness and abnormal gaits. Surgical options aim to deepen the trochlear groove or reinforce the lateral soft tissues to stabilize the patella.
www.petsgroomingtips.com is one of the front-runners in providing complete digital information to the pet owners, which would guide theme through various process of grooming their beloved kids. A shabby puppy or kitten not only appears dirty but soon infested with disease if not treated properly. Our various tutorials and free PDF guides cover every aspect of the grooming process.
This document provides information on seizures in animals. It begins by defining a seizure as excessive discharge of excitable neurons in the brain. There are two main types of seizures - generalized seizures which involve the whole brain and cause loss of consciousness, and focal or partial seizures which start in one area of the brain. Epilepsy is defined as recurrent seizures regardless of cause. Seizures occur due to an imbalance between inhibitory and excitatory neurotransmitters in the brain. The document outlines the classification, causes, diagnosis and treatment of seizures including anti-seizure medications.
Mange is among the common illnesses that many dog owners are concerned about. People usually get tensed and do not know how to handle such situations. I present you this Presentation that speaks about Mange, a skin disease caused by tiny parasite mites on dogs. You can refer to this to know what Mange is all about, the types of Mange, the causes, the symptoms and a few easy ways to deal with it. Mange, if left untreated can be fatal. Therefore, timely knowledge and treatment about this disease is important. You can also add your views in the comments below.
For more information about Mange, you can refer to the following links:
http://www.vet-organics.com/types-of-mange-in-dogs/
http://pets.webmd.com/dogs/mange-dogs-canine-scabies
The document discusses horn anatomy and affections in cattle. It notes that horns are formed by the frontal bones and become hollow. The base is thin and the horn thickens towards the apex. Blood and nerve supply are described. Major horn affections include avulsion, fracture, and horn cancer. Treatment for fractures may include amputation. Dehorning involves removing the horn at the base through elliptical incision and sawing. Disbudding young calves removes small horn buds using a caustic compound or hot iron. Procedures are done with local anesthesia and analgesia.
Epidural anesthesia can be effectively performed in cattle, horses, sheep, and goats. The injection site is between the coccygeal vertebrae. For cattle, 5-10 ml of 2% lidocaine provides adequate caudal anesthesia for minor procedures while 100-150 ml provides anterior anesthesia, though the animal may become recumbent. For horses, a mixture of xylazine and mepivacaine at the sacrococcygeal junction provides effective caudal epidural anesthesia. Sheep and goats can receive lumbosacral epidural injections of lignocaine for abdominal surgery or c-sections. Correct needle placement in the epidural space is important to avoid complications.
This document discusses ear conditions in pets. It covers otitis externa (inflammation of the outer ear), including common signs like head shaking and discharge. Otoscopic examination of the ear canal is described. Treatment for otitis externa involves cleaning and applying medications to the ear canal. Other conditions covered include auricular hematoma, otitis media (middle ear inflammation), and otitis interna (inner ear). Surgical techniques like lateral ear canal resection are discussed. Diagnosis and treatment of otitis media and interna involve cytology, antibiotics, and anti-fungals based on culture results from the infected areas.
This document discusses fetal mummification and maceration in animals. Fetal mummification is the shriveling of the fetus caused by the absorption of fluids from the fetus and uterus, leading to the death of the fetus. It can be caused by genetic abnormalities, hormonal issues, or problems with the placenta or umbilical cord. Maceration occurs when the fetus dies but is not aborted, causing it to become putrefied inside the uterus. Both conditions require veterinary intervention such as medications to induce abortion or surgical removal of the remains if abortion does not occur naturally.
This document discusses the anatomy, diagnosis, and treatment of guttural pouch diseases in horses. It describes the guttural pouch as a mucous sac located in the cranial cavity that connects the pharynx to the eustachian tube. Common guttural pouch diseases include empyema (accumulation of exudate), emphysema (abnormal filling with air), and impactions. Diagnosis involves endoscopy, radiography, or ultrasound imaging of the pouch. Treatment involves systemic antibiotics, flushing the pouch, or surgical drainage and removal of debris through approaches like Viborg's triangle or hyovertebrotomy. Post-operative care includes antibiotics, analgesics
1) Cystic ovarian degeneration is a condition in dairy cows where ovarian follicles fail to ovulate, continuing to grow into cysts. It commonly occurs 30-60 days after calving and can impair fertility.
2) Ovarian cysts are diagnosed using history, palpation, ultrasound to detect enlarged follicles over 17mm in the absence of a corpus luteum, and progesterone assays.
3) Common treatments include a single injection of GnRH or hCG to induce luteinization and ovulation, followed by a prostaglandin injection 9 days later if needed to induce estrus. This summary effectively captures the key details about cystic ovarian degeneration in cattle.
A 3.5 year old murrah buffalo was brought to a free animal health camp with swelling in the vulvar region. Upon examination, maggots were discovered in the wound. The buffalo had a history of parturition 3 months prior and poor sanitation. Maggots were removed from the wound using turpentine oil and the buffalo was treated with oxytetracycline and ivermectin. The owner was advised on wound care and improving sanitation to prevent further infestation.
This document discusses various conditions affecting the neck region in working cattle and buffaloes, including yoke gall, abscesses, tumors, and torticollis. Yoke gall is an inflammation of the skin on the neck caused by friction from the yoke. Abscesses in the neck should be incised and drained once mature to release pus. Tumors can be removed through enucleation. Torticollis involves twisting of the neck due to injury. Fistula wither is an inflammation of bursae in the withers of horses that can lead to draining sinuses.
1. Hernia is defined as a protrusion of an organ or tissue through an abnormal opening in the wall of the cavity that normally contains it.
2. Hernias are classified based on location, contents, cause, and degree of complications. Common types include ventral, inguinal, diaphragmatic, and umbilical hernias.
3. Clinical signs include swelling at the hernia site. Treatment options range from conservative bandaging to radical surgery to repair the defect and prevent recurrence, sometimes using prosthetic mesh.
This document discusses vaginal and uterine prolapse in cattle. It defines prolapse as the downward displacement of an organ from its normal position. It describes the types and signs of simple, moderate, and severe vaginal prolapse and provides their causes, clinical signs, and treatments. Uterine prolapse is defined as the falling of the uterus from its normal position, often occurring after difficult calving. Its causes, signs, and treatments involving reduction and replacement or amputation are summarized. Surgical techniques for correcting vaginal prolapse like trusses, sutures, and Caslick's operation are also briefly outlined.
This document discusses tail amputation procedures in various animal species. It describes the anatomy of the tail and indications for amputation such as trauma, infection, or cosmetic purposes. The procedure typically involves clipping and preparing the tail, retracting the skin, identifying the desired transection site, ligating vessels, disarticulating the tail between vertebrae, and suturing skin edges. Considerations for puppies, adults, and different animal species are provided. Complications can include tetanus or vertebral necrosis.
1. Anaplasmosis is a tick-borne disease of cattle caused by the bacteria Anaplasma marginale. It is characterized by fever, weakness, anemia, emaciation, and jaundice.
2. The disease is transmitted by ticks of several genera and can also be spread mechanically by flies or contaminated surgical instruments.
3. Anaplasmosis causes major losses to cattle industries in tropical and subtropical regions. It infects red blood cells and clinical signs vary from mild to severe depending on factors like age and previous exposure.
This document provides an overview of colic in horses. It begins by defining colic as acute abdominal pain in horses. Colic can be classified as spasmodic, tympanitic, obstructive, or impactive. Spasmodic colic involves hypermotility of the intestines. Tympanitic colic is caused by gas accumulation in the intestines. Obstructive colic blocks intestinal passages, while impactive colic specifically involves food or other material blocking the stomach or intestines. The document discusses causes, signs, diagnosis, and treatment for each type of colic. Common signs of colic include pawing, looking at the flank, lip curling, rolling, and abdominal distension
This document discusses glanders, a disease caused by the bacterium Burkholderia mallei that affects solipeds like horses and donkeys. It presents in three main forms - nasal, cutaneous, and pulmonary. Symptoms include nasal discharge, skin nodules and ulcers, and pneumonia. Diagnosis involves isolating the bacterium or using tests like the mallein test. There is no vaccine and infected animals should be slaughtered to prevent spread, as the disease can also infect humans. Antibiotics may treat the infection but are not usually recommended due to risk of transmission and carrier status.
Canine distemper is a highly contagious viral disease that affects multiple carnivore species. It is characterized by fever, respiratory and gastrointestinal issues, and neurological complications. While vaccination has reduced cases, it remains a major disease. The virus is transmitted through respiratory droplets and infected bodily fluids. Puppies and unvaccinated dogs are most at risk. Treatment focuses on supportive care, though the virus can cause lasting issues in survivors. Widespread vaccination is important to control the disease.
local names, definition, etiology,epidemiology lifecycle, pathogenesis, clinical findings, necropsy finding, diagnosis,treatment, control and prevention
Diagnosis and Treatment of Canine Pyodermaupstatevet
Ed Jazic, DVM, DACVD
The prevalence of Canine Pyoderma is increasing very quickly and the clinical condition can present in a variety of ways. It is a common secondary manifestation of a variety of clinical conditions like allergic skin diseases, endocrinopathies, autoimmune skin diseases, and keratinization disorders. An efficient and correct diagnosis is essential as is proper therapy in the face of ever-increasing development of Canine Methicillin-Resistant Staphylococcal Pyoderma.
Congenital anomalies/Pathology of oral cavity in animalsishtiaquaf
This document describes various congenital anomalies and developmental abnormalities that can affect the oral cavity and teeth in animals. It discusses conditions such as cleft lip and palate, brachygnathia, and agnathia. It also covers anomalies in tooth development including anodontia, oligodontia, and polyodontia. Finally, it summarizes common degenerative conditions and infectious diseases that impact teeth, such as dental caries, pulpitis, periodontitis, and discoloration from factors like fluorosis.
Pregnancy toxemia in sheep is a metabolic disease that occurs late in pregnancy. It is caused by a negative energy balance where the ewe's energy demands for her growing fetuses exceeds her energy intake. Affected ewes experience hypoglycemia, ketonemia, and low liver glycogen levels. Treatment involves parenteral glucose and electrolytes supplementation, corticosteroids, and in some cases caesarean section to remove the fetal glucose demand if the ewe is very advanced in disease. Prevention focuses on proper nutrition and avoiding overfat or underweight body condition in pregnant ewes.
ICAWC 2013 - Sarcoptic and Demodectic Mange - David GrantDogs Trust
Demodectic and sarcoptic mange are parasitic skin diseases caused by mites. Canine demodicosis is caused by Demodex canis mites and generally presents in young dogs, though some cases occur in older dogs. It is not contagious between dogs. Canine scabies is caused by Sarcoptes scabiei mites and is highly contagious between dogs. It causes severe itching that escalates over time. Both diseases can be diagnosed via skin scrapings and treated with licensed products. Canine demodicosis can be difficult to cure and require multiple treatments, while canine scabies usually responds well to treatment with high cure rates.
This document discusses various methods for preparing teaser bulls to identify cows in heat for artificial insemination. Key considerations for choosing a teaser bull include mild temperament, good libido, and moderate size. Common surgical preparation techniques include vasectomy, caudal epididymectomy, penile deflection, and preputial obstruction. Non-surgical methods involve testosterone administration. Advantages and disadvantages of different techniques are provided, such as vasectomized bulls maintaining libido but risk of spreading venereal disease, and penile deviated bulls better detecting cows in heat with no disadvantages noted.
Peste des Petits Ruminants (PPR) in India Epidemiology and ControlBhoj Raj Singh
PPR is endemic in India in sheep & goats. Mainly young stocks are more affected. Disease occurs throughout the year but more common in October & March. Though vaccination is the only method for control & eradication, even the institutes those developed the effective vaccine in India to control the disease fear to use it because many a time outbreaks ensue on vaccination. The other important reason for persistence of disease is undeclared Policy of suppressed reporting of PPR outbreaks.
Hypothyroidism and hyperthyroidism in dogs are endocrine diseases caused by impaired or excessive thyroid hormone production respectively. Hypothyroidism is more common and seen as lethargy, weight gain, hair loss, and other metabolic signs. It is diagnosed via low thyroid hormone levels and treated with levothyroxine supplementation. Hyperthyroidism is rare in dogs and caused by functional thyroid tumors, seen as weight loss and other hypermetabolic signs.
The document discusses laryngeal disease in dogs and cats, focusing on laryngeal paralysis in dogs. The most common cause of laryngeal disease is laryngeal paralysis, which is more common in dogs than cats and large and giant breed dogs over 9 years old. Laryngeal paralysis results in varying degrees of upper airway obstruction and clinical signs include noisy breathing, coughing, and exercise intolerance. Diagnosis involves laryngeal examination under anesthesia to check for lack of arytenoid abduction during inspiration. Treatment options for severe cases include temporary tracheostomy, steroids, or surgery such as unilateral arytenoid lateralization to improve breathing and quality of life.
Presentation1, radiological imaging of hypertrophic pyloric stenosis.Abdellah Nazeer
Ultrasonography is the preferred imaging method for diagnosing hypertrophic pyloric stenosis. Key findings on ultrasound include thickening of the pyloric muscle greater than 3mm and elongation of the pyloric channel greater than 17mm. Doppler ultrasound can also detect increased blood flow to the hypertrophied pyloric muscle and mucosa. While upper gastrointestinal studies with barium can identify signs like double tracking, ultrasonography has greater sensitivity and specificity for diagnosing hypertrophic pyloric stenosis.
This document discusses the anatomy, diagnosis, and treatment of guttural pouch diseases in horses. It describes the guttural pouch as a mucous sac located in the cranial cavity that connects the pharynx to the eustachian tube. Common guttural pouch diseases include empyema (accumulation of exudate), emphysema (abnormal filling with air), and impactions. Diagnosis involves endoscopy, radiography, or ultrasound imaging of the pouch. Treatment involves systemic antibiotics, flushing the pouch, or surgical drainage and removal of debris through approaches like Viborg's triangle or hyovertebrotomy. Post-operative care includes antibiotics, analgesics
1) Cystic ovarian degeneration is a condition in dairy cows where ovarian follicles fail to ovulate, continuing to grow into cysts. It commonly occurs 30-60 days after calving and can impair fertility.
2) Ovarian cysts are diagnosed using history, palpation, ultrasound to detect enlarged follicles over 17mm in the absence of a corpus luteum, and progesterone assays.
3) Common treatments include a single injection of GnRH or hCG to induce luteinization and ovulation, followed by a prostaglandin injection 9 days later if needed to induce estrus. This summary effectively captures the key details about cystic ovarian degeneration in cattle.
A 3.5 year old murrah buffalo was brought to a free animal health camp with swelling in the vulvar region. Upon examination, maggots were discovered in the wound. The buffalo had a history of parturition 3 months prior and poor sanitation. Maggots were removed from the wound using turpentine oil and the buffalo was treated with oxytetracycline and ivermectin. The owner was advised on wound care and improving sanitation to prevent further infestation.
This document discusses various conditions affecting the neck region in working cattle and buffaloes, including yoke gall, abscesses, tumors, and torticollis. Yoke gall is an inflammation of the skin on the neck caused by friction from the yoke. Abscesses in the neck should be incised and drained once mature to release pus. Tumors can be removed through enucleation. Torticollis involves twisting of the neck due to injury. Fistula wither is an inflammation of bursae in the withers of horses that can lead to draining sinuses.
1. Hernia is defined as a protrusion of an organ or tissue through an abnormal opening in the wall of the cavity that normally contains it.
2. Hernias are classified based on location, contents, cause, and degree of complications. Common types include ventral, inguinal, diaphragmatic, and umbilical hernias.
3. Clinical signs include swelling at the hernia site. Treatment options range from conservative bandaging to radical surgery to repair the defect and prevent recurrence, sometimes using prosthetic mesh.
This document discusses vaginal and uterine prolapse in cattle. It defines prolapse as the downward displacement of an organ from its normal position. It describes the types and signs of simple, moderate, and severe vaginal prolapse and provides their causes, clinical signs, and treatments. Uterine prolapse is defined as the falling of the uterus from its normal position, often occurring after difficult calving. Its causes, signs, and treatments involving reduction and replacement or amputation are summarized. Surgical techniques for correcting vaginal prolapse like trusses, sutures, and Caslick's operation are also briefly outlined.
This document discusses tail amputation procedures in various animal species. It describes the anatomy of the tail and indications for amputation such as trauma, infection, or cosmetic purposes. The procedure typically involves clipping and preparing the tail, retracting the skin, identifying the desired transection site, ligating vessels, disarticulating the tail between vertebrae, and suturing skin edges. Considerations for puppies, adults, and different animal species are provided. Complications can include tetanus or vertebral necrosis.
1. Anaplasmosis is a tick-borne disease of cattle caused by the bacteria Anaplasma marginale. It is characterized by fever, weakness, anemia, emaciation, and jaundice.
2. The disease is transmitted by ticks of several genera and can also be spread mechanically by flies or contaminated surgical instruments.
3. Anaplasmosis causes major losses to cattle industries in tropical and subtropical regions. It infects red blood cells and clinical signs vary from mild to severe depending on factors like age and previous exposure.
This document provides an overview of colic in horses. It begins by defining colic as acute abdominal pain in horses. Colic can be classified as spasmodic, tympanitic, obstructive, or impactive. Spasmodic colic involves hypermotility of the intestines. Tympanitic colic is caused by gas accumulation in the intestines. Obstructive colic blocks intestinal passages, while impactive colic specifically involves food or other material blocking the stomach or intestines. The document discusses causes, signs, diagnosis, and treatment for each type of colic. Common signs of colic include pawing, looking at the flank, lip curling, rolling, and abdominal distension
This document discusses glanders, a disease caused by the bacterium Burkholderia mallei that affects solipeds like horses and donkeys. It presents in three main forms - nasal, cutaneous, and pulmonary. Symptoms include nasal discharge, skin nodules and ulcers, and pneumonia. Diagnosis involves isolating the bacterium or using tests like the mallein test. There is no vaccine and infected animals should be slaughtered to prevent spread, as the disease can also infect humans. Antibiotics may treat the infection but are not usually recommended due to risk of transmission and carrier status.
Canine distemper is a highly contagious viral disease that affects multiple carnivore species. It is characterized by fever, respiratory and gastrointestinal issues, and neurological complications. While vaccination has reduced cases, it remains a major disease. The virus is transmitted through respiratory droplets and infected bodily fluids. Puppies and unvaccinated dogs are most at risk. Treatment focuses on supportive care, though the virus can cause lasting issues in survivors. Widespread vaccination is important to control the disease.
local names, definition, etiology,epidemiology lifecycle, pathogenesis, clinical findings, necropsy finding, diagnosis,treatment, control and prevention
Diagnosis and Treatment of Canine Pyodermaupstatevet
Ed Jazic, DVM, DACVD
The prevalence of Canine Pyoderma is increasing very quickly and the clinical condition can present in a variety of ways. It is a common secondary manifestation of a variety of clinical conditions like allergic skin diseases, endocrinopathies, autoimmune skin diseases, and keratinization disorders. An efficient and correct diagnosis is essential as is proper therapy in the face of ever-increasing development of Canine Methicillin-Resistant Staphylococcal Pyoderma.
Congenital anomalies/Pathology of oral cavity in animalsishtiaquaf
This document describes various congenital anomalies and developmental abnormalities that can affect the oral cavity and teeth in animals. It discusses conditions such as cleft lip and palate, brachygnathia, and agnathia. It also covers anomalies in tooth development including anodontia, oligodontia, and polyodontia. Finally, it summarizes common degenerative conditions and infectious diseases that impact teeth, such as dental caries, pulpitis, periodontitis, and discoloration from factors like fluorosis.
Pregnancy toxemia in sheep is a metabolic disease that occurs late in pregnancy. It is caused by a negative energy balance where the ewe's energy demands for her growing fetuses exceeds her energy intake. Affected ewes experience hypoglycemia, ketonemia, and low liver glycogen levels. Treatment involves parenteral glucose and electrolytes supplementation, corticosteroids, and in some cases caesarean section to remove the fetal glucose demand if the ewe is very advanced in disease. Prevention focuses on proper nutrition and avoiding overfat or underweight body condition in pregnant ewes.
ICAWC 2013 - Sarcoptic and Demodectic Mange - David GrantDogs Trust
Demodectic and sarcoptic mange are parasitic skin diseases caused by mites. Canine demodicosis is caused by Demodex canis mites and generally presents in young dogs, though some cases occur in older dogs. It is not contagious between dogs. Canine scabies is caused by Sarcoptes scabiei mites and is highly contagious between dogs. It causes severe itching that escalates over time. Both diseases can be diagnosed via skin scrapings and treated with licensed products. Canine demodicosis can be difficult to cure and require multiple treatments, while canine scabies usually responds well to treatment with high cure rates.
This document discusses various methods for preparing teaser bulls to identify cows in heat for artificial insemination. Key considerations for choosing a teaser bull include mild temperament, good libido, and moderate size. Common surgical preparation techniques include vasectomy, caudal epididymectomy, penile deflection, and preputial obstruction. Non-surgical methods involve testosterone administration. Advantages and disadvantages of different techniques are provided, such as vasectomized bulls maintaining libido but risk of spreading venereal disease, and penile deviated bulls better detecting cows in heat with no disadvantages noted.
Peste des Petits Ruminants (PPR) in India Epidemiology and ControlBhoj Raj Singh
PPR is endemic in India in sheep & goats. Mainly young stocks are more affected. Disease occurs throughout the year but more common in October & March. Though vaccination is the only method for control & eradication, even the institutes those developed the effective vaccine in India to control the disease fear to use it because many a time outbreaks ensue on vaccination. The other important reason for persistence of disease is undeclared Policy of suppressed reporting of PPR outbreaks.
Hypothyroidism and hyperthyroidism in dogs are endocrine diseases caused by impaired or excessive thyroid hormone production respectively. Hypothyroidism is more common and seen as lethargy, weight gain, hair loss, and other metabolic signs. It is diagnosed via low thyroid hormone levels and treated with levothyroxine supplementation. Hyperthyroidism is rare in dogs and caused by functional thyroid tumors, seen as weight loss and other hypermetabolic signs.
The document discusses laryngeal disease in dogs and cats, focusing on laryngeal paralysis in dogs. The most common cause of laryngeal disease is laryngeal paralysis, which is more common in dogs than cats and large and giant breed dogs over 9 years old. Laryngeal paralysis results in varying degrees of upper airway obstruction and clinical signs include noisy breathing, coughing, and exercise intolerance. Diagnosis involves laryngeal examination under anesthesia to check for lack of arytenoid abduction during inspiration. Treatment options for severe cases include temporary tracheostomy, steroids, or surgery such as unilateral arytenoid lateralization to improve breathing and quality of life.
Presentation1, radiological imaging of hypertrophic pyloric stenosis.Abdellah Nazeer
Ultrasonography is the preferred imaging method for diagnosing hypertrophic pyloric stenosis. Key findings on ultrasound include thickening of the pyloric muscle greater than 3mm and elongation of the pyloric channel greater than 17mm. Doppler ultrasound can also detect increased blood flow to the hypertrophied pyloric muscle and mucosa. While upper gastrointestinal studies with barium can identify signs like double tracking, ultrasonography has greater sensitivity and specificity for diagnosing hypertrophic pyloric stenosis.
Imaging acute airway in both infants and children Pankaj Kaira
This document discusses the differences between pediatric and adult airways and provides imaging recommendations and features for various causes of respiratory distress in children. Key points include:
- The pediatric larynx is higher and narrower than the adult larynx. The cricoid cartilage is the narrowest part of the pediatric airway.
- Upright radiographs of the neck and chest are recommended for evaluating acute airway obstruction. CT may help delineate anatomy but is often not required.
- Common causes of respiratory distress in children include croup, epiglottitis, retropharyngeal infections, foreign body aspiration/ingestion, and neoplasms. Imaging can identify features to diagnose these conditions and assess airway
Ménière's disease it’s definition ,etiopathogenesis and managementsritama1988
Meniere's disease is characterized by spontaneous attacks of vertigo accompanied by fluctuating hearing loss, tinnitus, and aural fullness. It is caused by endolymphatic hydrops, or a buildup of fluid in the inner ear. Attacks typically involve severe vertigo that lasts hours and progresses through irritative, paretic, and recovery phases with associated nystagmus. Hearing loss is usually low frequency and fluctuating at first but becomes progressively worse over time. The pathophysiology is thought to involve ruptures in the inner ear membranes allowing toxic endolymph to leak out and cause sustained neuron activation during attacks.
This clinical case conference document discusses a 95-year-old male patient presenting with progressive shortness of breath. It provides details on the patient's medical history including prior treatment for Mycobacterium avium complex and tracheomalacia. The document summarizes examination findings and test results. It also includes an in-depth discussion of tracheomalacia including classification, causes, symptoms, diagnostic methods such as bronchoscopy, imaging with CT and MRI, and treatment challenges for this condition.
Pharyngeal pouch, also known as Zenker's diverticulum, is a pulsion diverticulum that arises between the thyropharyngeus and cricopharyngeus muscles in an area of weakness. It is the most common type of posterior pharyngeal pouch. Zenker's diverticulum usually presents in older adults, affecting men more often than women. Symptoms include dysphagia, regurgitation of food, and halitosis. Treatment involves surgical excision of the diverticulum. While the exact cause is unknown, it is hypothesized to be related to the large size and oblique orientation of the pharyngeal muscles in humans, creating regions of weakness where the divert
This document describes a study of 6 patients with acquired aural cholesteatoma that extended into the intracranial region. The most common pathway for intracranial extension was through the supratubal recess into the middle cranial fossa. Less frequently, extension occurred via the retrofacial air cells into the posterior cranial fossa. Surgical removal of the intracranial cholesteatoma was accomplished through various approaches including translabyrinthine, transcochlear, retrolabyrinthine, and middle cranial fossa. One patient was found to have residual cholesteatoma during reoperation.
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Laryngomalacia is a congenital abnormality where the laryngeal cartilage collapses inward during inspiration, obstructing the airway. It is the most common cause of stridor in infants. Symptoms typically begin around 4-6 weeks of age and peak at 6-8 months before resolving by age 2. Diagnosis is made by laryngoscopy, which shows an omega-shaped epiglottis prolapsing inward during breathing. Treatment involves positioning infants in a way to open the airway or supraglottoplasty for severe cases. Prognosis is excellent as infants generally outgrow the condition by their second birthday.
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Brachycephalic Syndrome.pdf
1. Brachycephalic Syndrome
Gilles Dupré, Univ Prof Dr Med Vet*,
Dorothee Heidenreich, Dr Med Vet
Video content accompanies this article at http://www.vetsmall.theclinics.com
Brachycephalic syndrome (BS) is an established cause of respiratory distress
in brachycephalic breeds.1–3
Breeds most commonly affected are English and French
bulldogs, pugs, and Boston terriers; however, Pekingese, Shih tzu, Cavalier King
Charles Spaniels, Boxers, Dogue de Bordeaux, and Bullmastiffs are also categorized
as brachycephalic dogs.4
Most owners report heat, stress and exercise intolerance,
snoring, inspiratory dyspnea, and in severe cases, cyanosis and even syncopal epi-
sodes. Sleep apneas can be observed,5
and occasionally gastrointestinal signs
such as vomiting and regurgitation.
ANATOMIC AND PATHOPHYSIOLOGIC CHANGES OBSERVED IN BRACHYCEPHALIC
BREEDS
Skull Conformation Anomalies
Brachycephalic breeds have a shorter and wider skull compared with mesaticephalic
and dolichicephalic breeds,6,7
which leads to a compressed nasal passage8
and
Disclosure Statement: The authors have nothing to disclose.
Department for Small Animal and Equine, Vetmeduni Vienna, Veterinary Medicine University,
Veterinärplatz 1, A-1210 Vienna, Austria
* Corresponding author.
E-mail address: Gilles.dupre@vetmeduni.ac.at
KEYWORDS
Brachycephalic airway obstructive syndrome Soft palate Laryngeal collapse
Surgery
KEY POINTS
Skull conformation anomalies in brachycephalic breeds lead to compression of nasal
passages.
Additional mucosal hyperplasia and secondary collapse of the upper airway contribute to
a multilevel obstruction and the genesis of the so-called brachycephalic syndrome.
Surgical treatments usually include widening of stenotic nares as well as various palato-
plasty techniques to improve airflow through the rima glottidis.
The overall prognosis for a significant improvement is excellent.
Vet Clin Small Anim 46 (2016) 691–707
http://dx.doi.org/10.1016/j.cvsm.2016.02.002 vetsmall.theclinics.com
0195-5616/16/$ – see front matter Ó 2016 Elsevier Inc. All rights reserved.
2. altered pharyngeal anatomy.9–11
In addition, pugs are reported to have a dorsal rota-
tion of the maxillary bone, miniscule or absent frontal sinuses,12,13
a ventral orientation
of the olfactorial bulb,14
and altogether, a shorter craniofacial skull measurement than
French and English bulldogs.12,14–17
This dorsal rotation has been discussed as a potential cause for aberrant naso-
pharyngeal turbinates, which are also more commonly reported in pugs (Figs. 1
and 2).3,12,18–20
Soft Tissues Changes
Stenotic nares
One typical and easily recognized primary anatomic component of brachycephalic
syndrome.
BS-affected dogs have stenotic nares, which reduce each nostril to a vertical slit
(Fig. 3).
Soft palate hyperplasia
Although the literature used to emphasize an elongated soft palate,2,18,21
fluttering,
and obstructing the rima glottidis as a primary component of BS, recent radiographic,
computed tomography (CT), and histologic examinations demonstrated an additional
pathologic thickening of the soft palate, which might play a major role in the nasopha-
ryngeal obstruction.3,13,22–27
One study22
demonstrated a positive correlation be-
tween the thickness of the soft palate and the severity of the clinical signs. A recent
study using CT evaluation of airway dimension showed a significantly thicker soft pal-
ate in French bulldogs compared with pugs but no free airway space dorsal to the soft
palate in 81% of pugs.13
In addition to soft palate hyperplasia, CT and endoscopic
studies reported hyperplasia of the nasopharyngeal mucosa,28,29
hypertrophy and
eversion of the tonsils,30
and an overlong and thickened tongue (macroglossia), which
further displaces the soft palate dorsally.31
Laryngeal, Tracheal, and Bronchial Anomalies
Laryngeal diseases
Laryngeal diseases associated with BS are thought to be mainly secondary to the tur-
bulent airflow and chronic high negative pressures in the pharynx.2,21,23,32,33
They
include
Mucosal edema
Everted laryngeal saccules (ELS)
Laryngeal collapse
Fig. 1. Dorsal rotation maxillary bone. Midsagittal CT image of a 4-year-old pug depicting
dorsal rotation (arrow) of the maxillary bone.
Dupré Heidenreich
692
3. In one early classification, ELS were considered the first stage of laryngeal collapse34
(Fig. 4). Stage 2 was characterized by a medial displacement of the cuneiform pro-
cesses of the arytenoid cartilages, and stage 3 by a collapse of the corniculate pro-
cesses with loss of the dorsal arch of the rima glottidis. Altogether, the incidence of
laryngeal collapse varies from 50%35,36
to as many as 95%37
in BS-affected dogs.
Studies report that the size of the rima glottidis is smaller in pugs38
and that they are
also significantly more often affected by severe laryngeal collapse than French bull-
dogs.39
In this breed, the arytenoid cartilages can even invert into the laryngeal lumen
as a consequence of lack of rigidity (chondromalacia), which makes the larynx inca-
pable to withstand high negative pharyngeal pressures23
(Video 1).
Tracheal and bronchial anomalies
Tracheal hypoplasia,2,18,40
as defined as a tracheal diameter (TD) to the thoracic inlet
(TI) ratio (TD:TI) less than 0.2 in nonbrachycephliac and less than 0.16 in
Fig. 2. Aberrant turbinates. Transverse CT image of a French bulldog depicting aberrant
nasopharyngeal turbinates (arrow).
Fig. 3. Stenotic nares. Stenotic nares in a 2-year-old French bulldog.
Brachycephalic Syndrome 693
4. brachycephalic dogs,41
has been described in 13% of BS-affected dogs.10,42
The En-
glish bulldog has the highest incidence of tracheal hypoplasia among brachycephalic
breeds, and tracheal hypoplasia in this breed has been defined as a TD:TI ratio of less
than 0.12. Although tracheal hypoplasia increases airway resistance, its contribution
to the syndrome is likely minimal.3
Bronchial collapse was found to be significantly correlated to the severity of the
laryngeal collapse (P 5 .45), and pugs were found to be most severely affected.
Left-side bronchi were generally more affected by bronchial collapse (52.1%) than
the right, with the cranial left bronchus most commonly collapsed.37
Whether the eti-
ology is loss of rigidity (chondromalacia), increased negative pressure or compression
within the chest remains to be investigated (Video 2).
Gastroesophageal Diseases Associated with Brachycephalic Syndrome
Dysphagia, vomiting, and regurgitation are common clinical signs in brachycephalic
breeds,32
and investigation of dogs affected by BS showed concurrent esophageal,
gastric, or duodenal anomalies.43
The negative intrathoracic pressures generated by
increased inspiratory effort44–47
is believed to be a major cause of gastroesophageal
reflux. The associated regurgitation and vomiting can contribute to upper esophageal,
pharyngeal, and laryngeal inflammation.48
French bulldogs exhibit significantly more
often and more severe digestive signs than pugs.39,49
DIAGNOSIS
Diagnosis is usually based on owners’ reports, clinical examination, and diagnostic
imaging.
Clinical Diagnosis
Snoring, inspiratory dyspnea, cyanosis, and in the most severe cases, syncopal epi-
sodes are most often reported by owners. On inspection, stenotic nares and inspira-
tory efforts with even abdominal breathing can be observed. A particular attention
shall be paid to respiratory sounds.
Whereas snoring is most likely caused by air turbulences in the oro-pharyngeal re-
gion, the high-pitch sound associated with extreme inspiratory effort is related to more
Fig. 4. Everted laryngeal saccules. Laryngoscopic view of the rima glottides of a dog a
French bulldog with stage 1 laryngeal collapse with everted laryngeal saccules.
Dupré Heidenreich
694
5. severe airway compromise when turbulent air is passing through the collapsed larynx
or nasopharynx.
Diagnostic Imaging
Radiographic, fluoroscopic, CT, and endoscopic studies all contribute to the evalua-
tion of the static and dynamic obstruction of the respiratory tract.8,12,13,22,23,50
In a clin-
ical practice setting, a proper evaluation of BS patients should include at least neck
and thoracic radiographs, and endoscopic examination of the upper airways.
Thoracic radiographs are performed to document secondary heart or lung dis-
eases and to rule out aspiration pneumonia. Also, on occasion a sliding hiatal
hernia can incidentally be found on a lateral radiograph.
Lateral radiographs of the neck (when CT is not available) can help to assess the
soft palate thickness as defined by the soft tissue density present between the
nasopharynx and oropharynx.1
CT evaluation of the head and neck allows a detailed assessment of the nostrils,
vestibule, nasal cavity, and nasopharynx and oropharynx (Fig. 5).12,13,22
Endoscopic examination provides more information on the dynamic changes
within the upper airways:
With the dog intubated, retrograde rhinoscopy performed with a 120
rigid
scope or a flexible endoscope allows for good evaluation of nasopharyngeal
tissue hyperplasia and collapse as well as for the presence of aberrant turbi-
nates (Fig. 6, Videos 3 and 4).
With the dog extubated, a laryngoscopic examination can expose ELS and also
help evaluate laryngeal dynamics. With laryngeal collapse, lack of abduction
during inspiration or even paradoxic movements of the arytenoid cartilages
can occur. In pugs and other dogs affected by laryngeal chondromalacia, the
dorsal border of the cuneiform process of the arytenoid cartilages can even
invert into the laryngeal lumen (Video 5).
Fig. 5. Soft palate thickening. Midsagittal CT image of 2-year-old French bulldog with thick-
ening of the soft palate (arrow).
Brachycephalic Syndrome 695
6. CONTROVERSY REGARDING THE GENESIS OF BRACHYCEPHALIC SYNDROME
The genesis of BS is thought to be due to anatomic changes which lead to increased
inspiratory resistance.32,42,51,52
With significant negative pressure, the soft tissues are
drawn into the lumen resulting in collapse of the upper airway.23,32
Eversion of the
laryngeal saccules, nasopharyngeal collapse, and laryngeal collapse, are suspected
to contribute to clinical signs and further deterioration of BS, which might ultimately
cause syncopal episodes and death from suffocation.42,52
Although, in the past, an overlong soft palate fluttering in the rima glottidis has been
considered as the main cause of BS, it remains difficult to estimate the greatest
contributor to the clinical signs. The nose is known to be the greatest source of flow
resistance in the total airway system,53,54
and rhinomanometric studies confirm that
intranasal resistance is significantly higher in brachycephalic dogs compared with
normal dogs.55,56
The major upper airway obstruction was postulated to be intranasal
secondary to aberrant turbinates12
or located in the compressed nasopharynx.22
But
late CT studies comparing pugs and French bulldogs found that the smallest airway
space is located dorsal to the soft palate even in dogs with aberrant nasopharyngeal
turbinates.13
Additionally, aberrant turbinates were also described in clinically normal
English bulldogs,57
which means that the contribution of the aberrant turbinates to BS
needs to be more thoroughly evaluated.
Although laryngeal collapse has usually been considered to be associated with pro-
gression of the disease, a significant correlation between age and severity of laryngeal
collapse was demonstrated only recently.39
In another study including pugs and En-
glish and French bulldogs with stage 1 laryngeal collapse, no correlation between
Glottic index and age or weight could be demonstrated.38
Finally, the overall postop-
erative prognosis of BS was not affected by the grade of laryngeal collapse in 2 recent
studies.21,39
Overall, although it is clear that air cannot flow through the nose as long as the nos-
trils are obstructed, it remains uncertain which part of the obstructed airway—nasal
cavity, nasopharynx or rima glottis—is most responsible for the clinical signs associ-
ated with BS. In that regard, the effect of soft palate resection might be due to the
opening of the nasopharyngeal space and not to the relief of the rima glottidis
obstruction.
Fig. 6. Nasopharyngeal turbinates. Images of a retrograde rhinoscopy displaying aberrant
nasopharyngeal turbinates.
Dupré Heidenreich
696
7. TREATMENT OF BRACHYCEPHALIC SYNDROME
Medical Therapy
Patients presented with acute signs of respiratory distress should be treated accord-
ingly with cooling, tranquilizers, oxygen therapy, and anti-inflammatory drugs. When-
ever digestive signs are observed in dogs with BS, medical treatment including
inhibition of hydrogen ion secretion and gastric prokinetic drugs is recommended
before and immediately after surgery.
Surgical Therapy
Timing
According to the pathophysiology of the syndrome, relief of the proximally located
obstruction should be attempted early to prevent deterioration or possibly reverse tis-
sue collapse,10,42,58
but the optimal time to correct upper airway obstruction has not
been determined and was recommended to be performed after the age of 6 months.
Recent studies suggest that improvement in clinical signs is still obtained when sur-
gery is performed on mature and middle-aged dogs.39
Stenotic Nares
Several surgical options have been described for correction of stenotic nares: ampu-
tation of the ala nasi,59,60
various alaplasty techniques, alapexy,61
and vestibuloplasty.
Alaplasty is the most used procedure and consists of the excision of a wedge of the
ala nasi with primary closure of the defect. This wedge excision can be made verti-
cally, horizontally,58,62
or laterally.10,42,63
Incisions are made with a No. 11 or 15 scalpel
blade or alternatively with a punch.64
Two to 4 simple interrupted sutures, using
absorbable monofilament material, are placed to appose the wedge margins. Hemor-
rhage resolves quickly when the wound is sutured (Video 6).
Vestibuloplasty has been advocated instead of alaplasty to further improve
airflow.65
It involves the dorsomedial and caudal portion of the ala and results in a
wide and open vestibule.
Turbinectomy
Turbinectomy66
and its laser-assisted variation (LATE)67
are aimed at removal of mal-
formed obstructive parts of the ventral and medial nasal turbinates. The LATE, com-
bined with vestibuloplasty and staphylectomy, resulted in a decrease of 55% of
intranasal resistance 3 to 6 months after surgery compared with preoperative
values.55
Studies show partial regrowth of the removed turbinates but with less
mucosal contact points.68
The long-term positive effects of turbinectomy on intranasal
resistance and adverse effects on thermoregulation require further investigation.
Elongated–Hyperplastic Soft Palate
Common surgical techniques for correction of elongated soft palate are aimed at
shortening the soft palate by simple resection of its caudal portion (staphylectomy),
to prevent it from obstructing the rima glottidis on inspiration. Different landmarks
have been recommended, varying from the tip of epiglottis,32,62,69–71
or the middle
to caudal aspect of the palatine tonsils.10,33,69,71,72
During staphylectomy, the caudal border of the soft palate is grasped and held with
Allis forceps or stay sutures,70,73
and resection of excessive length of soft palate can
be performed with a scalpel blade,5,58,70
scissors,32,42,62,74
monopolar electrocoagu-
lation,58,69,75
carbon dioxide laser,2,71,75–77
diode laser,75
or bipolar sealing device
(Ligasure, Valleylab, Covidien, Boulder, Colorado).73,77
Brachycephalic Syndrome 697
8. As these palate-trimming techniques may not address the soft palate hyperplasia,
techniques designed to more extensively shorten and thin the soft palate have been
described.24,73,75,78,79
The folded flap palatoplasty (FFP) has been developed to cor-
rect both the excessive length and excessive thickness of the soft palate, therefore
relieving also nasopharyngeal obstruction.24,78,79
In this technique, the soft palate is
made thinner by excision of a portion of its oropharyngeal mucosa and underlying
soft tissues. In addition, the palate is made shorter by being folded onto itself until
the caudal nasopharyngeal opening is readily visible transorally (Box 1, Figs. 7–9,
Video 7).
Postoperative adverse effects or pharyngo-nasal regurgitation have not been
observed with the folded flap palatoplasty.73,75,79
Whatever technique is chosen, a
telescope and high-definition camera system for magnification and illumination of
the surgical field (VITOM TM, Karl Storz Endoscopy, Tuttlingen, Germany) are helpful
(Fig. 10).
Surgical Treatments for Laryngeal Diseases
Everted laryngeal saccules
Excision of ELS has been described using electrocautery, scissors, tonsil snares
or laryngeal biopsy cup forceps.1,10,21,32,42,62,69,72
In 1 study reevaluating ELS after
single side resection, no regression of the nonremoved site despite treatment of nares
and soft palate was found.80
Altogether, whether resection of the ELS is needed re-
mains questionable. In several recent BS outcome studies, in which nares and palates
were corrected but ELS were either not or rarely addressed, outcomes appeared to
be similar to studies in which ELS were excised.29,75,79
Also, complications such as
laryngeal webbing and regrowth can occur.81,82
With this in mind, the authors only
recommend removal of ELS when the eversion contributes significantly to the
obstruction.
Laryngeal collapse
As laryngeal collapse is suspected to be secondary to proximal airway obstruction,
first address the proximal obstruction areas (ie, nares and soft palate), as this may
obviate the need to treat the collapse.2,3,21,23,33,83
In the author’s experience, surgical
Box 1
The folded flap palatoplasty: surgical technique
The head is restrained and the mouth kept open. The tongue is pulled rostrally and
maintained with a malleable retractor connected to an articulated arm.
The caudal edge of the soft palate is grasped with forceps and retracted rostrally and dorsally
into the oropharynx, until the caudal opening of the nasopharynx can be visualized.
The contact point on the ventral mucosa of the soft palate is marked, as this represents the
proximal cut of the soft palate.
The ventral mucosa of the soft palate is then incised in a trapezoidal shape from this mark
rostrally to the free edge of the soft palate caudally.
Laterally, the sides of the trapeze passed just medially to the tonsils.
The soft tissues under the cut portion of the soft palate are excised together with part of the
levator veli palatini muscle.
The caudal edge of the soft palate is retracted rostrally and is sutured folded on itself with
simple interrupted monofilament absorbable sutures.
Dupré Heidenreich
698
9. treatment of laryngeal collapse is considered only when clinical signs do not improve
after appropriate treatment of the nares and soft palate. Partial laryngectomy as
described earlier69
has been found to be associated with unacceptably high (50%)
mortality rates, and is no longer recommended.72
Laser-assisted partial arytenoidec-
tomy as recommended for treatment of laryngeal paralysis might provide some relief84
but needs to be further investigated. Alternatively, arytenoid lateralization is a valid op-
tion for dogs with sufficient mineralization of the laryngeal cartilages.33,44,85
On the
contrary, its efficacy is questionable in pugs and dogs suffering from chrondromalacia
when arytenoid cartilages have a tendency to inwardly rotate during inspiration
(pugs).21,23
If there is inefficient relief of airway obstruction after the previously
mentioned procedures, a permanent tracheostomy can be attempted as a palliative
option.1,10,32,42,58,86
Removal of other hyperplastic tissues
Excision of the palatine tonsils has been recommended when they seem to contribute
to pharyngeal obstruction.42,69,74
However, the advantage of tonsillectomy warrants
further investigation.30,32,62
Similarly, excision of redundant soft tissues located in
the pharynx, especially in its dorsal aspect, has been suggested,62
but more data
are needed to evaluate which of the pharyngeal tissues are involved in the obstruction
process and the optimal surgical method to remove the hyperplastic tissue.
Fig. 7. Folded flap palatoplasty: incision lines in the oral mucosa for the thinning process of
soft palate hyperplasia.
Brachycephalic Syndrome 699
10. Tracheostomy
Although it has been advocated in the past, a preoperative temporary tracheos-
tomy1,69,87
is not necessary. Postoperative temporary tracheostomy has been re-
ported in the past in 5% to 28% of cases.21,29,58,79,88
As the complication rate of
temporary tracheostomy in brachycephalic dogs is very high (86% in 1 study)89
it
should therefore be reserved for cases not responding to routine postoperative care.
Postoperative Care
The challenge during the postoperative period is to enable adequate airflow in a not
yet fully awake patient with potentially swollen airway mucosa. It is critical that BS
dogs are monitored constantly after extubation to determine if ventilation is
inadequate.
Several methods can be combined or used independently to help relieve upper
airway obstruction or improve ventilation after surgical repair:
The dog can be recovered with the upper jaw hung up, which allows the lower
jaw to drop, further opening the airway (Fig. 11).
Increasing the oxygen delivery—placement of a small nasotracheal tube imme-
diately after surgery but before the dog is awake is a very simple technique of in-
sufflating oxygen, allowing oxygen delivery beyond the rima glottis.3,90
Fig. 8. Folded flap palatoplasty: end of dissection of the soft palate. The yellow area depicts
the removed oral part of the soft palate.
Dupré Heidenreich
700
11. Fig. 9. Folded flap palatoplasty: schematic view showing folding of thinned soft palate
upon itself.
Fig. 10. Surgery set-up with telescope. For folded flap palatoplasty, the mouth of the dog is
kept open, and the tongue is pushed down using a malleable retractor. Magnification is pro-
vided with the Exoscope (VITOM TM, Karl Storz Endoscopy, Tuttlingen, Germany).
Brachycephalic Syndrome 701
12. PROGNOSIS
It is difficult to gain an accurate perspective of the prognosis for individual dogs
afflicted with BS.2,21,33,58,64,71,76,91
Most studies evaluating outcome after BS surgery
are retrospective in nature, and compare results in different breeds with various com-
binations of treatments and reconstructive techniques. In addition, these studies
compare outcomes with surgical treatments performed at variable patient ages and
by different surgeons, using different grading systems,24,60,73,75
Furthermore, it is diffi-
cult to compare the postoperative outcome in these various studies, because there is
often a mismatch between the owners’ perception of their pets clinical disability and
the severity of the clinical signs.92
A recent study compared preoperative and postop-
erative treatments in different breeds that underwent the same diagnostic work-up,
treatment, and evaluation methods.39
Despite inherent study limitations, late studies
report that around 90% of BS dogs are significantly improved with surgery.2,24,29,39,75
This is better than earlier reports. Similarly, perioperative mortality rates have
improved from around 15% in earlier reports58,91
to less than 4% in more recent
studies.2,24,29,73,75
Postoperative improvement is most often observed immediately
after surgery.24,29
Some studies report long-term recurrence of clinical signs in up
to 100% of cases, although 89% of dogs still remain improved compared with their
preoperative status.21
In other studies, clinical grades improved in the first 2 weeks af-
ter folded flap palatoplasty24,39
and remained the same over the following period
(mean 12–22 months).
Fig. 11. Patient recovery after BS surgery. Bulldog recovering from anesthesia with the up-
per jaw hung to help open the mouth to improve oxygenation.
Dupré Heidenreich
702
13. SUMMARY
Animals presenting with BS suffer of multilevel obstruction of the airways and second-
ary soft tissue collapse. Despite progresses achieved through advanced diagnostic
modalities such as CT and endoscopy, the main contributor to the increased inspira-
tory efforts remains to be found. Recent studies suggest that postoperative prognosis
is good even in middle-aged dogs.
SUPPLEMENTARY DATA
Supplementary data related to this article can be found at http://dx.doi.org/10.1016/j.
cvsm.2016.02.002.
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