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- Author or Editor: Erik Tozier x
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Abstract
OBJECTIVE
To compare short-, intermediate-, and long-term results between dogs with tracheal collapse (TC) that received multimodal medical management only and those that underwent tracheal endoluminal stent placement.
ANIMALS
159 dogs with TC that underwent medical management only (MM group; n = 84) or were surgically managed by stent placement (SM group; 75).
PROCEDURES
Medical records of dogs with TC that underwent medical management only or stent placement at a referral hospital between September 1, 2009, and August 1, 2018, were reviewed. Data regarding signalment, information relevant to TC, and outcome were extracted from the records and aggregated into short-, intermediate-, and long-term follow-up periods for analysis. Descriptive data and median survival times (MSTs) were compared between the MM and SM groups.
RESULTS
Clinical signs of dogs in the MM group generally improved during the short term but regressed and worsened over time. The proportion of dogs with malformation-type TC that underwent stent placement (38/43 [88%]) was significantly greater than the proportion of dogs with traditional-type TC that underwent stent placement (37/107 [35%]). The MST from TC diagnosis was 3.7 years for the MM group and 5.2 years for the SM group. For dogs with severe disease, the MST was 12 days for medically managed dogs and 1,338 days for dogs that underwent stent placement.
CONCLUSIONS AND CLINICAL RELEVANCE
Multimodal medical management alleviated clinical signs for months to years in dogs with mild to moderate TC disease, but stent placement should be considered for dogs with severe disease.
Abstract
OBJECTIVE
To better understand spatial relationships between principal bronchi and other intrathoracic structures by use of CT images of dogs of various somatotypes.
ANIMALS
93 dogs that underwent thoracic CT.
PROCEDURES
Information was collected from medical records regarding signalment and physical examination and echocardiographic findings. Two investigators recorded multiple measurements on a thoracic axial CT image from each dog.
RESULTS
Thoracic height-to-width ratio (H:W) was associated with left principal bronchus (LPB) and right principal bronchus (RPB) H:W, aortic-LPB separation, focal LPB narrowing, and aortic-vertebral overlap. Thoracic H:W was not associated with dog age, weight, sex, or brachycephalic breed. Twenty-five (27%) dogs had focal LPB narrowing, compared with 5 (5%) dogs with focal RPB narrowing (P < 0.001). Ten of 25 dogs had overlap or contact between vertebrae, aorta, LPB, and heart, suggesting a cumulative compressive effect on the LPB, while 15 had LPB-aorta contact and lack of contact between the aorta and thoracic vertebrae, suggesting an aortic constrictive effect on the LPB. None had LPB narrowing without contact from surrounding structures. Inter-rater agreement was high.
CLINICAL RELEVANCE
In dogs that underwent CT and were not selected for clinical suspicion of bronchial disease, principal bronchial morphology was associated with thoracic conformation. Focal LPB narrowing occurred more often than RPB narrowing. Focal LPB narrowing occurred with evidence of extraluminal compression, with or without contact between aorta and vertebrae. Brachycephalic breed could not be used for predicting thoracic H:W.
Abstract
OBJECTIVE To determine outcome for dogs and cats with benign nasopharyngeal stenosis or an imperforate nasopharynx that underwent balloon dilatation or metallic stent placement.
DESIGN Retrospective case series.
ANIMALS 15 dogs and 31 cats.
PROCEDURES Medical records were retrospectively reviewed, and data on signalment, history, clinical signs, lesion location, treatment, and outcome were obtained. Patients were excluded if < 6 months of follow-up information was available.
RESULTS 5 dogs and 22 cats underwent balloon dilatation, and results were successful in 11 (0 dogs and 11 cats) of the 27 (41%). Stents were placed in 34 patients (including 15 in which balloon dilatation had been unsuccessful). Uncovered stents were placed in 30 patients, and results were successful in 20 (67%). Covered stents were placed in 11 patients (including 7 in which uncovered stent placement was unsuccessful), and results were successful in all 11. Twenty-three of the 34 (68%) patients in which stents were placed developed complications. The most common complications were tissue ingrowth (n = 10), chronic infection (7), and stent fracture (5) for the 30 patients with uncovered stents and chronic infection (8) and oronasal fistula (3) for the 11 patients with covered stents. Overall, outcome was successful in 36 of the 46 (78%) patients (median follow-up time, 24 months; range, 2 to 109 months).
CONCLUSIONS AND CLINICAL RELEVANCE Results suggested that in dogs and cats, nasopharyngeal stenosis and imperforate nasopharynx can be successfully treated with balloon dilatation or stent placement, but that there was a high risk of failure with balloon dilatation alone and a high risk of complications regardless of procedure.
