Cover Journal of the American Veterinary Medical Association
Journal of the American Veterinary Medical Association
ISSN:
0003-1488
Publication Date:
01 Oct 2019

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Comparison of complications and outcome following unilateral, staged bilateral, and single-stage bilateral ventral bulla osteotomy in cats

Shannon H. Wainberg DVM1, Laura E. Selmic BVetMeD, MPH2, Annika N. Haagsman DVM3, Stan Veytsman DVM4, Karl C. Maritato DVM4, Brian J. Trumpatori DVM5, Allison B. Putterman VMD5, Michelle L. Oblak DVM6, Joshua S. Montel DVM7, Larie Allen DVM7, Antoine Dunié-Mérigot DMV8, Michael B. Mison DVM9, Julia P. Sumner BVSc10, Ronan A. Mullins MVB11, Sarah Malek DVM12, Malgorzata M. J. Bielecki Mag med vet13, Leslie E. Fox DVM, MS14, Claire Legallet DVM1, and Julius M. Liptak BVSc, MVetClinStud1
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  • 1 1VCA Canada Alta Vista Animal Hospital, 2616 Bank St, Ottawa, ON K1T 1M9, Canada.
  • | 2 2Department of Veterinary Clinical Medicine, College of Veterinary Medicine, University of Illinois, Urbana, IL 61802.
  • | 3 3Department of Clinical Sciences of Companion Animals, Faculty of Veterinary Medicine, Utrecht University, 3584 CL Utrecht, The Netherlands.
  • | 4 4MedVet Medical & Cancer Centers for Pets, 3964 Red Bank Rd, Fairfax, OH 45227.
  • | 5 5Veterinary Specialty Hospital of the Carolinas, 4640 Paragon Park Rd, Raleigh, NC 27616.
  • | 6 6Department of Clinical Studies, Ontario Veterinary College, University of Guelph, Guelph, ON N1G 2W1, Canada.
  • | 7 7Wheat Ridge Veterinary Specialists, 10140 West 44th Ave, Wheat Ridge, CO 80033.
  • | 8 8Clinique Vétérinaire Languedocia, 395 rue Maurice Béjart–Parc 2000, 34080 Montpellier, France.
  • | 9 9Department of Clinical Studies-Philadelphia, School of Veterinary Medicine, University of Pennsylvania, Philadelphia, PA 19104.
  • | 10 10Department of Clinical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, NY 14853.
  • | 11 11Section of Veterinary Clinical Sciences, UCD School of Veterinary Medicine, University College Dublin, Belfield, Dublin 4, Ireland.
  • | 12 12Department of Clinical Sciences, College of Veterinary Medicine, Purdue University, West Lafayette, IN 47907.
  • | 13 13Tierklinik Haar, Keferloher Strasse 25, D-85540, Haar, Germany.
  • | 14 14Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Iowa State University, Ames, IA 50011.
DOI:
https://doi.org/10.2460/javma.255.7.828
Volume/Issue:
Volume 255: Issue 7
Online Publication Date:
01 Oct 2019
Restricted access
Reprints and Permissions Purchase Article

Abstract

OBJECTIVE

To compare complications and outcome following unilateral, staged bilateral, and single-stage bilateral ventral bulla osteotomy (VBO) in cats.

ANIMALS

282 client-owned cats treated by VBO at 25 veterinary referral and academic hospitals from 2005 through 2016.

PROCEDURES

Medical records of cats were reviewed to collect information on signalment, clinical signs, diagnostic test results, surgical and postoperative management details, complications (anesthetic, surgical, and postoperative), and outcome. Associations were evaluated among selected variables.

RESULTS

Unilateral, staged bilateral, and single-stage bilateral VBO was performed in 211, 7, and 64 cats, respectively, representing 289 separate procedures. Eighteen (9%), 2 (29%), and 30 (47%) of these cats, respectively, had postoperative respiratory complications. Cats treated with single-stage bilateral VBO were significantly more likely to have severe respiratory complications and surgery-related death than cats treated with other VBO procedures. Overall, 68.2% (n = 197) of the 289 procedures were associated with Horner syndrome (19.4% permanently), 30.1% (87) with head tilt (22.1% permanently), 13.5% (39) with facial nerve paralysis (8.0% permanently), and 6.2% (18) with local disease recurrence. Cats with (vs without) Horner syndrome, head tilt, and facial nerve paralysis before VBO had 2.6, 3.3, and 5.6 times the odds, respectively, of having these conditions permanently.

CONCLUSIONS AND CLINICAL RELEVANCE

Findings suggested that staged bilateral VBO should be recommended over single-stage bilateral VBO for cats with bilateral middle ear disease. Cats with Horner syndrome, head tilt, and facial nerve paralysis before surgery were more likely to have these conditions permanently following surgery than were cats without these conditions.

Contributor Notes

Dr. Wainberg's present address is Department of Clinical Studies, Ontario Veterinary College, University of Guelph, Guelph, ON N1G 2W1, Canada.

Dr. Selmic's present address is Department of Veterinary Clinical Sciences, College of Veterinary Medicine, The Ohio State University, Columbus, OH 43210.

Dr. Veytsman's present address is Veterinary Medical Center, College of Veterinary Medicine, University of Minnesota, Saint Paul, MN 55108.

Dr. Putterman's present address is Department of Veterinary Clinical Medicine, College of Veterinary Medicine, University of Illinois, Urbana, IL 61802.

Address correspondence to Dr. Liptak (animalcancersurgeon@icloud.com).