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Unilateral laryngeal paralysis subsequent to surgical ligation of a patent ductus arteriosus in an 8-week-old domestic shorthair cat

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  • 1 Veterinary Medical Teaching Hospital, School of Veterinary Medicine, University of California-Davis, Davis, CA 95616.
  • | 2 Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California-Davis, Davis, CA 95616.
  • | 3 Veterinary Medical Teaching Hospital, School of Veterinary Medicine, University of California-Davis, Davis, CA 95616.
  • | 4 Department of Medicine and Epidemiology, School of Veterinary Medicine, University of California-Davis, Davis, CA 95616.

Abstract

Case Description—An 8-week-old female domestic shorthair cat was treated for patent ductus arteriosus (PDA) with surgical ligation. Seven weeks postoperatively, the cat was evaluated because of increased upper respiratory noise, inspiratory stridor, wheezing, and episodes of intermittent open-mouth breathing that had developed 1 week following the surgical ligation.

Clinical Findings—The cat was sedated, and examination of the larynx revealed left-sided laryngeal paralysis.

Treatment and Outcome—At the time left-sided laryngeal paralysis was diagnosed, the clinical signs of laryngeal dysfunction were not considered severe enough to warrant surgical intervention. No treatment was administered, and the owner monitored the cat for respiratory distress and worsening of clinical signs for an additional 5 months. During those 5 months, the clinical signs improved but persisted. Seven months after PDA ligation, the cat was again sedated and the larynx examined. The examination revealed persistent left arytenoid dysfunction, which was believed to be the result of permanent damage to the recurrent laryngeal nerve that was sustained during the surgical ligation of the PDA. The owner was counseled about surgical and medical treatment options for laryngeal paralysis but elected to forego treatment at that time.

Clinical Relevance—Unilateral laryngeal paralysis caused by iatrogenic damage to the recurrent laryngeal nerve is a potential complication subsequent to surgical ligation of a PDA. The frequency of iatrogenically induced laryngeal paralysis is likely underestimated in small animal patients. Laryngoscopy should be performed in any small animal with a history of PDA attenuation and clinical signs of respiratory tract disease.

Contributor Notes

Address correspondence to Dr. Steffey (masteffey@ucdavis.edu).