resp Flashcards
- reck, JSAP 2021. Melanocytic tumours of the nasal planum in cats: 10 cases (2004–2019)
predisposing factor? most common tx? benign of malignant more common?
o Pigmentation of the nasal planum = predisposing factor
o RT most common tx
70% malig
- liu, VS 2019. Objective effectiveness of and indications for laser‐assisted turbinectomy in brachycephalic obstructive airway syndrome
which dogs were candidates for LATE?
o Dogs with BOAS index >50% and BOAS functional grades II‐III after boas sx were considered candidates for LATE
- Dickerson, VS 2018. Outcome following cosmetic rostral nasal reconstruction after planectomy in 26 dogs
complications? revision? MST
o Complications = 73% dogs
revision surgery = 35%
o MST = 1542d (4yr)
- filipas, JSAP 2024. A retrospective observational cohort study on the postoperative respiratory complications and their risk factors in brachycephalic dogs undergoing BOAS surgery: 199 cases (2019‐2021)
Complications %? Risk factor for trach?
o postop complications = 15%
o Risk factors for tracheostomy: preop/ postop aspiration pneumonia (9.5x) and inc BOAS grade (4.6x)
- Araos, VS 2024. Effect of continuous positive airway pressure helmet on respiratory function following surgical procedures in brachycephalic dogs: A randomized controlled trial
effect of CPAP?
o CPAP had no effect on SpO2 but improved the PaO2/FiO2 ratio in brachycephalic dogs postoperatively
o valuable solution to improve gas exchange efficiency
- fracka, VS 2024. Risk factors for complicated perioperative recovery in dogs undergoing staphylectomy or folded flap palatoplasty: Seventy‐six cases (2018–2022)
factors associated with complicated recovery
o factors assoc w/ complicated recovery: staphylectomy, inc age, laryngeal collapse grade >2 and inc length of GA
- Jones. Vet surg 2023. Comparison of mortality of brachycephalic dogs undergoing partial staphylectomy using conventional incisional, carbon dioxide laser, or bipolar sealing device
mortality rate? what was associated with w/ death?
o mortality rate = 4.0%
o BVSD technique was assoc with mortality prior to discharge
o use of BVSD and grade of laryngeal collapse were associated with a higher risk of perioperative mortality
- Camarasa. JSAP 2023. Owner assisted recovery and early discharge after surgical treatment in dogs with brachycephalic obstructive airway syndrome.
complications bw owner assisted vs std recovery?
o incidence of postoperative complications was higher in dogs that received standard recovery (28%) compared to dogs recovered with the owners (2%)
o Owner-assisted recovery and early discharge are possible and safe
- Pavletic, JAVMA 2023. Surgical closure of cleft palate defects in dogs using a modification of the traditional von Langenbeck technique: 12 cases (2015–2022)
reccs for modifications?
o Modifications: complete flap elevation, vertical mattress sutures, sutures at rugal folds, fine interrupted sutures in between vertical mattress
- Carbalona. Vet surg 2022. Complications, prognostic factors, and long term outcomes for dogs with brachycephalic obstructive airway syndrome that underwent H pharyngoplasty and ala-vestibuloplasty: 423 cases (2011-2017)
mortality rate? what was associated with risk of death?
o mortality rate = 2.6%.
o clinical improvement: respiratory 72%, GI 34%
o Risk of death increased by 30% for every 1-year increase in age
- Clarke, VS 2022. Severity of nasopharyngeal collapse before and after corrective upper airway surgery in brachycephalic dogs
effect of surgery ?
o Surgery did not improve the reduction in dorsoventral diameter of the nasopharynx during respiration i
- Franklin. Vet surg 2021. Nebulization of epinephrine to reduce the severity of brachycephalic obstructive airway syndrome in dogs
ADE? clinical recc?
o Nausea =ADE
o Nebulized epinephrine reduced the BOAS index of dogs – clinically significant in preop dogs with a BOAS index >70%
o provides evidence to support the use of nebulized epinephrine
- Doyle. Vet surg 2020. Anesthetic risk during subsequent anesthetic events in brachycephalic dogs that have undergone corrective airway surgery: 45 cases (2007-2019)
effect of prev BOAS sx? what was associated with w/ inc oddsss of postop complication?
o Prev BOAS sx dec odds of postop complications w/ subsequent GA by 79%
o Every 15-minute increase in anesthetic duration 12% inc odds of having a postGA complication
- Costa. JAVMA 2020. Postoperative regurgitation and respiratory complications in brachycephalic dogs undergoing airway surgery before and after implementation of a standardized perianesthetic protocol.
what wass the protocol? regurg post protocol? what was associated with w/ dlvpt of postop regurg
o Protocol: preoperative metoclopramide & famotidine, restrictive use of opioids, and recovery of patients in ICU
o Regurg: protocol = 9% vs pre-protocol = 35%
o Hx of preop regurgitation was assoc w development of postop regurgitation
- Fenner. Vet Surg 2020. Postoperative regurgitation in dogs after upper airway surgery to treat brachycephalic obstructive airway syndrome: 258 cases (2013-2017)
postop regurg?? what factors associated with postop regrug
o Regurg: preop =11% vs postop = 35% rate of regurg higher than other studies
o For every 1-year increase in age odds of postop regurg dec by 29%
o Factors assoc w postop regurg: young age, hx of regurg
- Tarricone. Vet surg 2019. Development and validation of a brachycephalic risk (Brisk) score to predict the risk of complications in dogs presenting for surgical treatment of brachycephalic obstructive airway syndrome.
score cutoff for inc risk? what were components of score?
o Dogs with scores >3 were 9.1x more likely to have a negative outcome
o Factors: breed, hx of prev airway sx, # of procedures planned, BCS, level of compromise @ admission, admission rectal temp (dec temp was worse)
- Liu, VS 2017. Outcomes and prognostic factors of surgical treatments for brachycephalic obstructive airway syndrome in 3 breeds
neg prognostic factors
o Negative prognostic factors: Young age, normal BCS, presence of laryngeal collapse, and tx with traditional sx
- Rodriquez, JFMS 2023. Clinical presentation, treatment and outcome in 23 cats with laryngeal or tracheal lymphoma
most common phenotype (B or T cell, low or high)? MST?
o Laryngeal/Tracheal lymphoma =mostly B-cell phenotype, low-to-medium grade, and may respond to sx/med mgmt with a longer survival time
o OS = 909d (2.5yr)
pretx w/ steroids inc survival time other studies have survival ~100-250d
- Druid, VS 2022. Comparison of immediate and short‐term outcomes of cricoarytenoid and thyroarytenoid lateralization in dogs with idiopathic laryngeal paralysis
diff in tech? what happened at recheck?
o Cricoarytenoid lateralization and TAL were both effective
dec in rima glottidis area occurred in the TAL group at recheck w/o associated CS
- Moser, JFMS 2022. Partial laryngectomy for the management of laryngeal masses in six cats
temp trach? MST?
o 66% had resp distress, 20% had temp trach postop
o MST = 252d (8mo)
- Rishiniw, JVIM 2021. Effect of doxepin on quality of life in Labradors with laryngeal paralysis: A double‐blinded, randomized, placebo‐controlled trial
main findings?
o Doxepin did not appear to improve any measures of owner‐assessed QOL made them more ataxic
- Sakai, VS 2021. Influence of doxapram and intermittent 10% carbon dioxide inspiration on cardiovascular and laryngeal functions in anesthetized dogs
effect of CO2 vs doxapam?
o doxapram = hypertension and tachycardia
o CO2 inhalation might improve arytenoid motion w/o CV effects
- Mullins, VS 2019. Intraoperative and major postoperative complications and survival of dogs undergoing surgical management of epiglottic retroversion: 50 dogs (2003‐2017)
sx options? (4), most common complication?
o Sx options for epiglottic retroversion: Temporary epiglottopexy (nonincisional), permanent epiglottopexy (incisional), partial epiglottectomy, subtotal epiglottectomy
o complications: epiglottopexy 54% vs epiglottectomy 25% Epiglottopexy failure = most common major complication (41%)
o MST >716d
- Wilson, JAVMA 2016. Risk factors for the development of aspiration pneumonia after unilateral arytenoid lateralization in dogs with laryngeal paralysis: 232 cases (1987–2012)
imp risk factor for asp pneumonia?
o aspiration pneumonia = most common complication preexisting asp pneu not assoc w/ inc risk for postop
o Megaesophagus = important risk factor dvlpt of aspiration pneumonia
- Macphail, JAVMA 2001. Outcome of and postoperative complications in dogs undergoing surgical treatment of laryngeal paralysis: 140 cases (1985–1998)
factors associated with inc complications?
o bilateral arytenoid lateralization were significantly more likely to develop complications
o Factors assoc w/ complications: Age, temp trach, concurrent resp tract abN, esophageal dz, postop ME, concurrent neoplasia or neuro dz
- kanemoto, JFMS 2023. Retrospective study of feline tracheal mass lesions
most common location and tumor? MST for lymphoma?
o cervical tracheal involvement =most common
o Lymphoma was most common (83%)»
MST: lymphoma = 214d (7mo)
lymphoma had good resp to chemotx
- stordalen, JSAP 2020. Outcome of temporary tracheostomy tube‐placement following surgery for brachycephalic obstructive airway syndrome in 42 dogs
comp rate? common compS?
o complications =95% (major = 83%) tube obstruction (76%), cough (59%) and tracheostomy tube dislodgement (38%)
o successful tube mgmt = 97%
- grimes, JAVMA 2019. Long-term outcome and risk factors associated with death or the need for revision surgery in dogs with permanent tracheostomies
comp rate? common comps? revision rate?
o Major complications = 61% – aspiration pneumonia (19%), skinfold occlusion (19%), and stoma stenosis (17%)
o Revision surgery =35% dogs—d/t stoma stenosis (38%) or skinfold occlusion (38%)
o Brachys 3.5x as likely to require revision surgery
- Weisse, JAVMA 2019. Short-, intermediate-, and long-term results for endoluminal stent placement in dogs with tracheal collapse
complication rate?
o Major complications = 47% of dogs
stent fracture and tissue ingrowth were the most common
- Mather. Vet surg 2023. Anatomical considerations for the surgical approach to the canine accessory lung lobe
recc ICS space? /side
o Accessory LL best @ RIGHT 6th ICS
- Ichimata. JVIM 2023. Prognosis of primary pulmonary adenocarcinoma after surgical resection in small breed dogs: 52 cases (2005-2021)
tumor size > ?? associated with survival time? OST?
o tumor size >7 cm associated with OST
o OST = 716 days (2yr)
- Park, JAVMA 2023. Thoracoscopic resection of lung masses is associated with excellent survival to discharge and good long-term outcomes.
what was associated w conversion? MST for carcinomas?
o Conversion in 26% dogs– Larger tumor diameter(≥ 5 cm) and lymphadenopathy assoc w/ inc risk of conversion
o 81% carcinomas – MST 311d
- Mcphetridge. JAVMA 2022. Distribution of histopathologic types of primary pulmonary neoplasia in dogs and outcome of affected dogs: 340 cases (2010–2019)
most common tumor? MST for the most common type?
o Most common = Pulmonary carcinoma 87%»_space; sarcoma (7.6%), adenoma (3.2%), and pulmonary neuroendocrine tumor (1.5%)
o MST: pulmonary carcinomas =399d (13mo), histiocytic sarcomas =300d (10mo), neuroendocrine =498d (16mo)
- Tindale. JFMS 2021. Clinical characteristics and long-term outcome of lung lobe torsions in cats: a review of 10 cases (2000–2021)
% w chylothorax? mortality rate?
o Chylothorax = 30% cats
o Mortality rate = 70%
- Howes, JSAP 2020. Long‐term clinical outcomes following surgery for spontaneous pneumothorax caused by pulmonary blebs and bullae in dogs – a multicentre (AVSTS Research Cooperative) retrospective study
recur rate?
o recurrence in 14.1% 50% euth if recurr
- Rossanese. Vet surg 2020. Long‐term survival after treatment of idiopathic lung lobe torsion in 80 cases
common breeds? most common cause? survival?
o Breeds: pugs (47.5%) and sighthounds (16.2%)
o Causes of LLT: primary =77% and secondary = 21%
o Survival = 95%
What imaging technique is ideal for evaluating nasopharyngeal collapse? Noh, VRU 2024.
Dynamic CT
It provides detailed information about the nasopharyngeal structure and collapsibility.
What is the significance of ΔL in fluoroscopic examinations? Vodnarek. Vet surg 2023.
ΔL may offer higher repeatability and reproducibility than the grade of NP collapse.
This is particularly relevant in assessing nasopharyngeal conditions in pugs and French bulldogs.
What surgical techniques were used for correcting stenotic nares in brachycephalic cats? * pavlectic, JAVMA 2023.
Combined Alar Fold Lift-Up and Sulcus Pull-Down Techniques
These techniques focus on improving airflow without altering the external appearance of the nose.
What was the primary treatment for hemangiosarcoma of the nasal planum in cats? McGrath. JFMS 2022.
Surgery
Only narrow or incomplete surgical margins are possible, and radiotherapy may be utilized to decrease the risk of recurrence.
What did the study on computed tomography sinography reveal? Lopez, JSAP 2022.
CT sinography provides limited additional information and did not increase the number of foreign bodies identified.
This was assessed in a study involving 27 dogs and one cat.
What influence do skull biometrics have on cosmetic reconstruction after nasal planectomy and incisivectomy dogs? Goldschmidt, Vet surg 2021 (what 2 things were related to tension on the closure?)
wider facial
features / thicker lips
Factors include philtrum placement and tension during reconstruction.
What was the common treatment for melanocytic tumors of the nasal planum in cats? and most common predisposing factors? reck, JSAP 2021.
Radiotherapy
Pigmentation of the nasal planum
Melanocytic tumors include malignant melanomas and benign melanocytomas.
What is the median survival time for dogs with stage 3 nasal carcinomas treated with toceranib phosphate? what was assoc w/ longer MST? Merino, JSAP 2021.
140 days (4mo)
dogs with epistaxis achieved a longer median survival (166 d/ 5mo) vs without epistaxis (83 days/ 2.5mo)
For stage 4 nasal carcinomas, the median survival time is 120 days.
What is a significant predictor for candidacy for laser-assisted turbinectomy in dogs on CT? liu, VS 2019.
Soft tissue proportion at the rostral entrance of choanae
This is particularly relevant for dogs with brachycephalic obstructive airway syndrome.
What is the percentage of postoperative complications in brachycephalic dogs undergoing BOAS surgery? filipas, JSAP 2024.
15%
Complications include hypoxemia, reintubation, tracheostomy, and aspiration pneumonia.
What effect does continuous positive airway pressure (CPAP) have on brachycephalic dogs postoperatively? Araos, VS 2024.
Improves the PaO2/FiO2 ratio
However, it had no effect on SpO2.
What are the primary airway abnormalities in brachycephalic obstructive airway syndrome (BOAS)? Wallace, VS 2024.
Elongated soft palate, stenotic nares, hypoplastic trachea, aberrant nasal turbinates, and macroglossia
These contribute to respiratory difficulties in affected dogs.
Which was the mortality rate for staphylectomy in brachycephalic dogs? Jones 2023 what was assoc w Inc mortality
4% (use of BVSD and lar collapse)
The mortality rate is influenced by use of BVSD
What is the outcome of modified multilevel surgery in dogs with BOAS? Liu et al
More positive outcomes compared to standard surgery.
This includes procedures like ala-vestibuloplasty, FFP, and tonsillectomy.
What did studies find about gastrointestinal improvement (SHH / GERD) after BOAS surgery? Mayhew. Vet surg 2023.
Owners perceived improvement in regurgitation and activity; however, objective improvement in GERD or SHH was not confirmed.
This highlights the discrepancy between subjective and objective assessments.
What is the effect of adding adrenaline in a bilateral maxillary nerve block during sharp staphylectomy in dogs? Williams, VS 2023
Lower intraoperative hemorrhage, improved visualization, prevention of blood loss, and reduction in risk of blood aspiration.
What risks are associated with brachycephalic cats compared to non-brachycephalic cats? Gleason. Vet surg 2022.
Respiratory, gastrointestinal, and activity-related symptoms.
What were the postoperative complications rates in standard recovery vs owner-assisted recovery after surgery for brachycephalic obstructive airway syndrome? Camarasa. JSAP 2023.
Standard recovery: 28%; Owner-assisted recovery: 2%.
What modifications were made in the surgical closure of cleft palate defects in dogs? pavletic, JAVMA 2023.
- Complete flap elevation
- Vertical mattress sutures
- Sutures at rugal folds
- Fine interrupted sutures in between vertical mattress.
At what age is surgical treatment for cleft palate in dogs recommended? Castejon, JAVMA 2023.
4 months.
What is the most frequent complication of cleft palate surgery in dogs? Castejon, JAVMA 2023.
Oronasal fistula (ONF) formation.
What percentage of dogs may experience ONF after initial cleft palate repair? Castejon, JAVMA 2023.
50% to 100%.
What was the mortality rate for dogs undergoing H pharyngoplasty and ala-vestibuloplasty for brachycephalic obstructive airway syndrome? Carbalona. Vet surg 2022.
2.6%.
What is the purpose of temporary palatopexy in dogs with respiratory distress due to brachycephalic obstructive airway syndrome? Sun, JSAP 2022.
Avoids the need for prolonged intubation, emergency tracheostomy, re-intubation, or euthanasia.
What did the study find regarding the prevalence of bronchial wall thickening in brachycephalic dogs? Guillem. JAVMA 2022.
93% in the BOAS group.
True or False: Surgery improved the reduction in dorsoventral diameter of the nasopharynx during respiration in brachycephalic dogs postoperatively. Clarke, VS 2022.
False.
What was the complication rate of split staphylectomy in brachycephalic dogs? Holloway. JSAP 2022.
8%.
What effect did nebulization of epinephrine have on dogs with brachycephalic obstructive airway syndrome? Franklin. Vet surg 2021
Reduced the BOAS index significantly in preoperative dogs with a BOAS index >70%.
What was the rate of postoperative regurgitation in brachycephalic dogs after airway surgery before and after implementing a standardized perianesthetic protocol? Costa. JAVMA 2020
Pre-protocol: 35%; Protocol: 9%.
What factors were associated with postoperative regurgitation in dogs undergoing airway surgery? Costa. JAVMA 2020
- Young age
- History of regurgitation.
What is the Brachycephalic Risk (Brisk) score used for? Tarricone. Vet surg 2019.
To predict the risk of complications in dogs presenting for surgical treatment of brachycephalic obstructive airway syndrome.
What surgical options exist for managing epiglottic retroversion in dogs? Mullins, VS 2019.
- Temporary epiglottopexy (nonincisional)
- Permanent epiglottopexy (incisional)
- Partial epiglottectomy
- Subtotal epiglottectomy.
What is the most common complication following unilateral arytenoid lateralization in dogs? Wilson, JAVMA 2016.
Aspiration pneumonia.
What was the effect of doxapram on laryngeal function in dogs with laryngeal paralysis? Tobias, VAA 2004.
Developed paradoxical arytenoid motion.
What is a suitable salvage option for brachycephalic dogs with severe laryngeal collapse? Gobbetti, VS 2018.
Permanent tracheostomy.
What was the outcome of the comparison between CAL and TAL in dogs with laryngeal paralysis? Druid, VS 2022.
Inc rima glotta for CAL > TAL – no difference in clinical outcome
CAL refers to cricothyroid approximation, while TAL refers to tie-back technique.
What factors were associated with complications in dogs undergoing surgical treatment of laryngeal paralysis? Macphail, JAVMA 2001.
- Age
- Temp trach
- Concurrent respiratory tract abnormalities
- Esophageal disease
- Postoperative medication
- Concurrent neoplasia or neurological disease
These factors were identified in a study by Macphail, JAVMA 2001.
What is the most common site for feline tracheal mass lesions? kanemoto, JFMS 2023
Cervical trachea
This information is based on a retrospective study by Kanemoto, JFMS 2023.
What types of tumors were found in feline tracheal mass lesions and their respective prevalence? kanemoto, JFMS 2023
- Lymphoma (83%)
- Adenocarcinoma (11%)
- SCC (5%)
SCC refers to squamous cell carcinoma.
What was the median survival time (MST) for lymphoma and other tumors in feline tracheal mass lesions? kanemoto, JFMS 2023
- Lymphoma = 214 days /6mo
- Other tumors = 21 days
Lymphoma had a good response to chemotherapy.
In the study by Brisimi, what did immature dogs exhibit compared to adult dogs after tracheal anastomoses?
Immature dogs required less force to create failure and exhibited longer elongation to failure
This suggests that reinforcement is recommended due to weaker tracheal tissue in immature dogs.
What is the recommended resection limit for tracheal length in adult and immature dogs? maeda/grillo et al
- Adult dogs: 60%
- Immature dogs: 25%
This recommendation comes from Maeda/Grillo et al.
What was the median survival time (MST) for dogs with tracheal collapse receiving multimodal medical management compared to those with stent placement? congiusta, JAVMA 2021.
- Medical management: 3.7 years
- Stent placement: 5.2 years
This comparison was made in a study by Congiusta, JAVMA 2021.
What are the two types of tracheal collapse identified? congiusta, JAVMA 2021.
- Traditional-type TC
- Malformation-type TC
Traditional-type is due to chondromalacia and muscle laxity, while malformation-type is caused by static obstruction.
What was the major complication rate for temporary tracheostomy tube placement in dogs? stordalen, JSAP 2020.
95% (major complications = 83%)
Complications included tube obstruction, cough, and tube dislodgement.
What percentage of dogs required revision surgery after permanent tracheostomy according to Grimes, JAVMA 2019?
35%
Revision surgery was primarily due to stoma stenosis or skinfold occlusion.
What was the major complication rate for endoluminal stent placement in dogs with tracheal collapse? Weisse, JAVMA 2019.
47%
Major complications included stent fracture and tissue ingrowth.
What was the MST for dogs undergoing thoracoscopic resection of lung masses? Park, JAVMA 2023.
311 days
This finding was reported by Park, JAVMA 2023.
What is the most common histopathologic type of primary pulmonary neoplasia in dogs? Mcphetridge. JAVMA 2022.
Pulmonary carcinoma (87%)
This was found in a study by Mcphetridge, JAVMA 2022.
What were the common complications associated with lung lobe torsion in cats according to Tindale, JFMS 2021?
- Chylothorax (30%)
- Secondary lung lobe torsion more common
The mortality rate was reported as 70%.
What are the computed tomographic features of lung lobe torsion? Seiler. VRU 2008.
- Pleural effusion
- Abruptly ending bronchus
- Enlargement / consolidation
- Emphysema
- Mediastinal shift to contralateral side
These findings were noted by Seiler, VRU 2008.
What breed was overrepresented in cases of lung lobe torsion according to Neath, JAVMA 2000?
Afghan hounds (23%)
The survival rate was reported as 55%.
What was the survival rate for dogs with lung lobe torsion according to the study by Park 2018?
92%
Park. Vet surg 2018.
What was the survival rate for dogs with concurrent torsion of the right cranial and right middle lobes vs L Cr only? Park 2018
50% for R cr/mid and 100% for L cr
Park. Vet surg 2018.
What was the survival rate after treatment of idiopathic lung lobe torsion according to Rossanese’s study?
95%
Rossanese. Vet surg 2020.
What were the causes of lung lobe torsion as identified in Rossanese’s study?
- Primary = 77%
- Secondary = 21%
Rossanese. Vet surg 2020.
Where is the accessory lung lobe best accessed surgically in canines? Mather 2023
RIGHT 6th ICS
ICS stands for intercostal space.
What percentage of dogs experienced major complications after permanent tracheostomies? grimes, JAVMA 2019.
61%
Major complications included aspiration pneumonia, skinfold occlusion, and stoma stenosis.
What percentage of dogs required revision surgery after permanent tracheostomies? grimes, JAVMA 2019.
35%
Revision surgery was primarily due to stoma stenosis or skinfold occlusion.
What are the two main causes for revision surgery in dogs with permanent tracheostomies? grimes, JAVMA 2019.
- Stoma stenosis (38%)
- Skinfold occlusion (38%)
These conditions were significant contributors to the need for surgical revision.
