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Objectives: To observe the occurrence of postanaesthetic respiratory complications and to determine their prevalence and risk factors in dogs undergoing brachycephalic obstructive airway syndrome surgery., Materials and Methods: Data from 199 clinical records were retrospectively analysed. Univariable logistic regression followed by multivariable logistic regression was used to identify associations between the dependent variables (set as the postoperative respiratory complications observed in the study dogs) and various independent covariates. The quality of model-fit was assessed using the likelihood ratio test. P≤0.05 was considered statistically significant., Results: Four postoperative respiratory complications were observed: hypoxaemia (n=10/199; 5%), dyspnoea requiring tracheal re-intubation (n=13/199, 7%), dyspnoea requiring tracheostomy (n=10/199, 5%) and aspiration pneumonia (n=12/199, 6%). Univariable logistic regression showed an association between postoperative aspiration pneumonia and increasing body condition score and American Society of Anaesthesiology classification; however, when these covariates were evaluated in the multivariable model significance was not maintained. Risk factors for tracheostomy were preoperative and postoperative aspiration pneumonia (odds ratio: 9.52, 95% confidence interval: 1.56 to 57.93) and increasing brachycephalic obstructive airway syndrome grade (odds ratio: 4.65, 95% confidence interval: 0.79 to 27.50)., Clinical Significance: High brachycephalic obstructive airway syndrome grade and aspiration pneumonia, either developing peri-operatively or as pre-existing condition, may represent risk factors for postoperative tracheostomy. Preoperative diagnosis of aspiration pneumonia may further increase the risk of postoperative complications., (© 2024 The Authors. Journal of Small Animal Practice published by John Wiley & Sons Ltd on behalf of British Small Animal Veterinary Association.)

Objectives: This study aims to describe a perioperative protocol for dogs recovered from anaesthesia with the owners and discharged from the hospital on the same day after surgical management of brachycephalic obstructive airway syndrome and to determine whether implementation of this protocol was associated with reduced incidence of complications compared with standard anaesthesia recovery and 24 hours hospitalisation., Materials and Methods: Medical records of dogs that underwent brachycephalic obstructive airway surgery over two consecutive years (June 2017 to May 2019) were reviewed retrospectively. Signalment, clinical signs, diagnostic findings, surgical procedures and postoperative respiratory complications were recorded. Data were compared using the chi-squared or Fisher's exact tests., Results: Sixty-three dogs met the inclusion criteria for the study. Forty-two dogs underwent owner-assisted recovery and 21 dogs standard recovery. No statistical difference was found between groups in age, breed, gender, severity of respiratory or gastrointestinal clinical signs and surgical techniques employed. The incidence of postoperative complications was higher in dogs that received standard recovery (28%) compared to dogs recovered with the owners (2%). None of the dogs recovered with the owners and discharged the same day required veterinary assistance after discharge from the hospital., Clinical Significance: Corrective surgery for brachycephalic obstructive airway syndrome was associated with lower postoperative respiratory complications when dogs were discharged on the same day after recovery with the owners. Owner-assisted recovery and early discharge are possible and safe and may decrease the incidence of postoperative complications. However, other unmeasured factors may have contributed to the lower complication rate in dogs recovered with the owners during the course of this study., (© 2023 British Small Animal Veterinary Association.)

Objectives: The objective was to compare sharp staphylectomy and staphylectomy using harmonic focus shears, assess surgical time, intraoperative haemorrhage and outcome. Our hypothesis was that harmonic staphylectomy would result in reduced surgical time, decreased intraoperative haemorrhage and greater relative improvement., Materials and Methods: Dogs that were presented to Highcroft Veterinary Referrals between July 2020 and September 2021 with brachycephalic obstructive airway syndrome and underwent surgical correction were prospectively enrolled. Surgical technique was randomised, and surgical time, staphylectomy time, intraoperative haemorrhage, hospitalisation and change in patients' Cambridge BOAS Grade at a 14-day recheck were recorded., Results: Fifteen dogs were enrolled: seven dogs underwent sharp and eight underwent harmonic staphylectomy. Nine patients returned for follow-up, four of seven and five of eight, respectively. Harmonic staphylectomy was associated with less haemorrhage (0 versus 9 cotton buds) and a shorter average staphylectomy time (3 minutes 36 seconds versus 14 minutes 50 seconds). No statistically significant differences were observed in total surgery time, number of nights hospitalised, or change in Cambridge BOAS Grade. An average of 0.68 mm of thermal necrosis was seen at the cut edges of soft palates removed by harmonic staphylectomy., Clinical Significance: Harmonic staphylectomy can result in a reduction in staphylectomy time and degree of intraoperative haemorrhage compared to sharp staphylectomy, with no deleterious impact on postoperative recovery or the long-term outcome of patients., (© 2022 British Small Animal Veterinary Association.)

Objectives: Describe the split staphylectomy procedure to address soft palate thickness and assess the complications and long-term outcome of this procedure as a part of multi-level surgery for brachycephalic obstructive airway syndrome. To consider whether same-day discharge following this surgery can be recommended., Materials and Methods: Medical records of dogs treated for brachycephalic obstructive airway syndrome using the split staphylectomy were reviewed. Owners were contacted to complete a questionnaire assessing initial postoperative concerns, the long-term outcome and the effect of surgery on their dog's quality of life., Results: Seventy-five dogs underwent split staphylectomy during the study period. The overall complication rate was 8.3%, of which 2.7% were considered major. No life-threatening complications occurred, and no complications were related to the staphylectomy. The questionnaire was completed by 66.7% of owners (median follow-up 459 days), of which 88% felt that surgery had improved the quality of life for their dog. The majority (88%) of dogs were discharged from hospital on the day of surgery. Of the surveyed owners, 14% sought veterinary attention between their dog leaving the hospital and the scheduled postoperative reassessment 2 weeks after surgery. Four dogs were presented for veterinary intervention during this time period, but no intervention was related to the staphylectomy or for a life-threatening condition., Clinical Significance: The split staphylectomy offers a safe, straightforward method of addressing both excess thickness and length of soft palate in dogs with brachycephalic obstructive airway syndrome. Dogs can be discharged on the same day as brachycephalic obstructive airway syndrome surgery including split staphylectomy without an increased risk of complications., (© 2022 British Small Animal Veterinary Association.)

Objective: To describe the use of temporary palatopexy procedure as a treatment for brachycephalic dogs in severe respiratory distress., Materials and Methods: In this prospective pilot study, seven client-owned brachycephalic dogs in severe respiratory distress, requiring emergent intubation or failing extubation, had a temporary palatopexy placed using a novel suture pattern., Results: Six out of seven dogs were successfully extubated less than 2 hours post palatopexy and survived to discharge. One dog failed extubation secondary to worsening lower airway disease and laryngeal collapse. That patient was euthanased. The only noted complication was regurgitation in two dogs; however, one had pre-existing gastrointestinal signs., Clinical Significance: Temporary palatopexy is a relatively simple procedure that may be a useful method for managing brachycephalic dogs in an upper airway crisis. This could avoid the need for prolonged intubation, emergency tracheostomy, re-intubation or euthanasia in dogs where costs, access to specialists and availability of referral centres are limited., (© 2021 British Small Animal Veterinary Association.)

Objectives: To determine whether there is a benefit of using pre- and postoperative antacid treatment in dogs undergoing surgery for brachycephalic syndrome. To assess the use of an obstruction manoeuvre during endoscopy for the detection of dynamic gastro-oesophageal junction abnormalities., Materials and Methods: Thirty-six client-owned brachycephalic dogs were prospectively included in a randomised trial. Antacid treatment was randomly prescribed in 18 dogs before and after surgery while the other 18 dogs did not receive any gastrointestinal medical treatment. At presentation, at the time of surgery and at recheck, digestive clinical signs and gastro-oesophageal junction abnormalities were assessed using specific scores. Gastro-oesophageal junction abnormalities were assessed during endoscopy in standard conditions as well as during endotracheal tube obstruction. This manoeuvre was also applied in an unrelated control group., Results: The results suggest a beneficial effect of antacid treatment on the improvement of digestive clinical signs and lesions in dogs with brachycephalic syndrome undergoing surgery. At postsurgical control 83% of dogs had a digestive clinical score ≤1 in the treated group in contrast to 44% in the non-treated group and 39% of dogs had a gastro-oesophageal abnormalities score (during obstruction manoeuvre) ≤1 in the treated group in contrast to 16.7% in the non-treated group. The use of the obstruction manoeuvre during endoscopic assessment in a control group revealed that gastro-oesophageal junction movements are negligible in healthy animals., Clinical Significance: The addition of antacid treatment during the pre- and postoperative period for brachycephalic dogs undergoing surgery may result in a faster and greater improvement in treated dogs. The obstruction manoeuvre is an interesting technique to improve detection of gastro-oesophageal junction abnormalities., (© 2020 British Small Animal Veterinary Association.)

Objectives: To describe the use, complications and outcome of temporary tracheostomy tube placement as part of the management of acute upper airway obstruction in the postoperative period following multi-level airway surgery in patients with brachycephalic obstructive airway syndrome., Materials and Methods: Retrospective review of records of dogs surgically treated for brachycephalic obstructive airway syndrome that had a temporary tracheostomy tube placed in the postoperative period., Results: Forty-two dogs were included. Median duration of temporary tracheostomy tube placement was 2 days (range 1 to 7). The major complication rate was 83.3%, minor complication rate was 71.4%, resulting in an overall postoperative complication rate of 95.2%. The most common postoperative complications were tracheostomy tube obstruction (32/42), cough (25/42) and tracheostomy tube dislodgement (16/42). Temporary tracheostomy tube management was classified as successful in 97.6%. Dyspnoea was the most common clinical sign in the short-term postoperative follow-up period, while dyspnoea and increased upper respiratory tract noise were the most common clinical sign in the long term. The median duration of follow-up was 251 days., Clinical Significance: In an appropriate clinical setting, placement of temporary tracheostomy tubes following multi-level airway surgery for brachycephalic obstructive airway syndrome is a useful strategy to manage postoperative airway obstruction, carrying a low mortality rate, and with a complication rate similar to that found in previous reports., (© 2020 British Small Animal Veterinary Association.)

Brachycephalic breeds of dog have grown in popularity in the UK and so form an increasing proportion of cases requiring anaesthesia. These breeds are predisposed to several conditions, notably brachycephalic obstructive airway syndrome and gastro-oesophageal reflux, that have important implications for anaesthetic management and carry high risk for complications. This review incorporates peer-reviewed veterinary literature with clinical experience in a discussion on perioperative management of brachycephalic dogs. We focus on preoperative identification of common concurrent conditions, practical strategies for reducing anaesthetic risk and improving postoperative management. Comparisons of brachycephalic obstructive airway syndrome with the human condition of obstructive sleep apnoea are included where appropriate., (© 2018 British Small Animal Veterinary Association.)

Objectives: To assess the breed-specific prevalence of, and effects of corrective airway surgery on, gastrointestinal signs in French bulldogs, English bulldogs and pugs presenting with brachycephalic airway syndrome to a referral teaching hospital., Materials and Methods: In this retrospective study, ptyalism, regurgitation and vomiting were graded at presentation using a previously established scoring system. Staphylectomy and nares resection were performed on all dogs. Gastrointestinal signs were re-assessed via telephone follow-up at least 6 weeks after surgery., Results: Ninety-eight dogs were included: French bulldogs (n=43), English bulldogs (n=12) and pugs (n=43). Overall population prevalence of all gastrointestinal signs was 56%. Breed-specific prevalence for French bulldogs was 93%, English bulldogs 58% and pugs 16%. There was post-surgical clinical improvement in gastrointestinal signs for the whole study population, especially in French bulldogs., Clinical Significance: The prevalence of gastrointestinal signs in dogs presenting with brachycephalic airway syndrome and improvement in these clinical signs following corrective surgery may vary between breeds., (© 2018 British Small Animal Veterinary Association.)

Objectives: To evaluate the effect of sacculectomy on the immediate postoperative complication rate in dogs affected with brachycephalic obstructive airway syndrome., Materials and Methods: Retrospective review of clinical records of brachycephalic dogs with everted saccules that underwent surgery for brachycephalic obstructive airway syndrome between 2009 and 2014. Dogs were grouped as those having nares resection and staphylectomy only and those having nares resection, staphylectomy and laryngeal sacculectomy. Complications were scored as mild, moderate or severe., Results: In total, 37 dogs were included in the sacculectomy group and 44 in the comparator group. Dogs that had undergone sacculectomy were more likely to develop postoperative complications, with 18 of 37 developing complications, nine of which were moderate to severe. In the group without sacculectomy, nine of 44 dogs developed complications, of which one was severe. Different breed distribution between groups might also impact this outcome., Clinical Significance: The results suggest that sacculectomy might increase morbidity following brachycephalic airway surgery, but repeat studies are required to confirm this result. Further information is also required to determine whether the short-term risks of sacculectomy are outweighed by superior long-term functional outcome., (© 2017 British Small Animal Veterinary Association.)

Objectives: To report the prevalence of abnormal fluoroscopic findings in brachycephalic dogs that were presented to a referral hospital for obstructive airway syndrome., Methods: Hospital records between May 2013 and November 2015 identified 36 brachycephalic dogs investigated for obstructive airway disease: 21 French bulldogs, six bulldogs, four Boston terriers, two pugs, two boxers and one shih-tzu. The presence or absence of hiatal hernia, delayed oesophageal transit, gastro-oesophageal reflux and redundant oesophagus were recorded., Results: Of the 36 dogs, 16 had hiatal hernia, all of which were French bulldogs; 31 dogs had delayed oesophageal transit time, 27 had gastro-oesophageal reflux, and four had redundant oesophagus., Clinical Significance: Clinical Significance: The prevalence of hiatal hernia is higher than expected in the French bulldog, and there was a high prevalence of oesophageal disease in this group in general. These results suggest a need to investigate similar cases for evidence of gastrointestinal disease that may also require attention., (© 2017 British Small Animal Veterinary Association.)

Three cats showing chronic, intermittent respiratory distress associated with increased noise on inspiration were examined. Head, neck and thoracic radiographs were unremarkable and laboratory findings were within normal ranges. In all three cats direct laryngoscopy revealed bilateral redundant arytenoid mucosa, which collapsed into the supraglottic and glottis airways during inspiration. Temporary tracheostomy and endoscopic diode laser excision of the excessive mucosa resolved symptoms in all three cats. Redundant arytenoid mucosa is a rare condition that may cause signs similar to laryngeal paralysis or laryngeal mass in cats. According to our results, diode laser surgery in association with temporary tracheostomy appears an appropriate mode of therapy., (© 2015 British Small Animal Veterinary Association.)

Objective: To compare clinical features of brachycephalic airway syndrome and long-term surgical outcomes between pugs and French bulldogs and evaluate the influence of laryngeal collapse., Methods: This retrospective study included 72 dogs that underwent wedge rhinoplasty and folded flap palatoplasty for brachycephalic airway syndrome. Epidemiological data, clinical signs, postoperative complications and owners' responses to a questionnaire at least six months after surgery were compared between pugs and French bulldogs. Spearman's rank correlation tests were used for associating laryngeal collapse with age and respiratory signs before and after surgery., Results: On the basis of the results of the owners' questionnaires (available in 52/72 dogs), French bulldogs presented with lower activity levels and more severe digestive signs than pugs. Owners perceived clinical improvement in 88 · 5% of all dogs. The grades of respiratory and digestive signs were not different between the breeds in the long-term follow-up, and the grade of laryngeal collapse did not influence the grade of respiratory signs or surgical outcome., Clinical Significance: Surgical treatment resulted in improved clinical signs in pugs and French bulldogs with brachycephalic airway syndrome, with a high owner satisfaction rate. There were no correlations between the severity of laryngeal collapse and overall respiratory signs or prognosis., (© 2015 British Small Animal Veterinary Association.)

Objectives: To report the use of silicone tracheal stoma stents for temporary tracheostomy in dogs with upper airway obstruction., Methods: Retrospective review of medical records for dogs in which silicone tracheal stoma stents were placed., Results: Eighteen dogs had a silicone tracheal stoma stent placed for maintenance of a tracheostomy stoma for periods ranging from three hours to eight months. No intra-operative or immediate postoperative complications were recorded. In 11 dogs the stent was removed by simple traction after a period ranging from 36 hours to 6 weeks, and the tracheal stoma was left to heal by second intention. Five of the 18 dogs were determined as being tracheostomy dependent and underwent conversion to permanent tracheostomy after a period ranging from five days to eight months following stent placement. One dog was euthanased after three months, with the stent still in place, because of poor respiratory function, and one dog died of unrelated reasons. In 6 of 10 dogs (60%) where the stent was in place for five days or more, granulation tissue formation caused dislodgement of the stent., Clinical Significance: Silicone tracheal stoma stents may be used as an alternative to conventional tracheostomy tubes in selected dogs with upper airway obstruction. Long-term use of the stent beyond five days is not recommended because of granulation tissue formation. The long-term consequences of partial tracheal ring resection are unknown., (© 2014 British Small Animal Veterinary Association.)

A brachycephalic dog was presented with an acute onset of retching and abdominal discomfort. The dog had a chronic history of stertor and exercise intolerance suggestive of brachycephalic airway obstructive syndrome. Radiographs were consistent with a Type II hiatal hernia. The dog was referred and within hours of admission became acutely painful and developed tympanic abdominal distension. A right lateral abdominal radiograph confirmed gastric dilatation and volvulus with herniation of the pylorus through the hiatus. An emergency exploratory coeliotomy was performed, during which the stomach was derotated, and an incisional gastropexy, herniorrhaphy and splenectomy were performed. A staphylectomy was performed immediately following the exploratory coeliotomy. The dog recovered uneventfully. Gastric dilatation and volvulus is a potentially life-threatening complication that can occur in dogs with Type II hiatal hernia and should be considered a surgical emergency., (© 2014 British Small Animal Veterinary Association.)

Objective: To describe the use of cricoarytenoid lateralisation combined with thyroarytenoid caudo- lateralisation (arytenoid laryngoplasty) for the management of stage II and III laryngeal collapse in dogs., Methods: A retrospective study of a consecutive series of 12 dogs suffering from life-threatening stage II or III laryngeal collapse associated with brachycephalic airway obstruction syndrome., Results: Pre-operatively, either stage II collapse (2/12) or stage III collapse (10/12) was confirmed on visual examination. In all cases, a left-sided arytenoid laryngoplasty was performed. Two dogs were euthanased postoperatively as a result of persistent life-threatening respiratory compromise. The procedure resulted in subjective enlargement of the rima glottidis and an associated improvement in respiratory function in the remaining 10 dogs. Follow-up, long-term outcome (median, 3·5 years) in these dogs indicated that all owners considered that the surgery had resulted in marked improvements in their dog's respiratory function, tolerance to exercise, and quality of life., Clinical Significance: Combined cricoarytenoid and thyroarytenoid caudo-lateralisation may be a useful procedure for treatment of stage II and III laryngeal collapse in the dog., (© 2011 British Small Animal Veterinary Association.)

Objectives: The goal of this study was to compare the dimensions of the soft palate and cross-sectional area of the meatus nasopharyngeus in non-brachycephalic dogs and brachycephalic dogs with different degrees of severity of brachycephalic airway syndrome using computed tomography., Methods: A total of 26 brachycephalic dogs that had at least one of four major symptoms of snoring, inspiratory effort, stress or exercise intolerance, and syncope were included in this prospective study. The dogs were grouped by the frequency of different clinical signs into absent/minimal brachycephalic airway syndrome and severe brachycephalic airway syndrome groups. Five non-brachycephalic dogs were studied as control animals. All dogs underwent pharyngeal area computed tomography. Seven measurements were made on the transverse and midsagittal reconstructions. All parameters were compared between controls, absent/minimal and severe brachycephalic airway syndrome groups., Results: The dogs with severe brachycephalic airway syndrome had significantly thicker soft palates compared to absent/minimal brachycephalic airway syndrome (P<0·05) and control (P<0·05) dogs. There were no significant differences among groups with regard to the length of the soft palate or the cross-sectional area of the airway at the level of the meatus nasopharyngeus., Clinical Relevance: These results support the thickening of the soft palate as a component of severe brachycephalic airway syndrome. Further studies are required to confirm the association between this anatomical characteristic and functional impairment., (© 2011 British Small Animal Veterinary Association.)

Trimetoquinol (TMQ) is a very potent and fast acting bronchodilator in horses with heaves. This study assessed the plasma and urinary concentrations of TMQ in horses with heaves following administration via the intravenous (IV, 0.2 microg/kg) and intra-tracheal (IT, 2 microg/kg) routes. TMQ was administered to six horses affected with heaves (RAO - Recurrent Airway Obstruction, used interchangeably) by the above routes and plasma and urine samples collected and stored at -20 degrees C until analyzed. Solid Phase Extraction (SPE) of TMQ was followed by highly sensitive ESI(+)-LC-MS-MS (ElectroSpray Ionization, positive mode - Liquid Chromatography - Mass Spectrometry - Mass Spectrometry); with a Limit of Detection (LOD) estimated at 1 pg/mL. Following IV administration, TMQ plasma levels peaked at 1 min at 707 pg/mL, and at 9 min at 306 pg/mL following IT administration. Our results show that TMQ plasma concentrations decline rapidly following IV administration, which is consistent with the fast onset and short duration of TMQ effect that was observed in our previous studies. On the other hand, IT administration showed a very unique plasma concentration pattern. From a regulatory standpoint, the current available TMQ ELISA kit was also used in an attempt to detect TMQ from the plasma and urine samples. We report that the ELISA kit was unable to detect TMQ from any of the samples generated in these studies.

In recurrent airway obstruction (RAO) or heaves, bronchospasm has been attributed to enhanced cholinergic activity. However, the expression and function of muscarinic acetylcholine receptors (mAChR) and their signaling components are not yet known. Thus, we examined the expression, subtype distribution and postreceptor signaling pathways of mAChR in the peripheral lung, bronchial and tracheal epithelia with the underlying smooth muscle from nine horses with RAO and 11 healthy control horses. In RAO horses, no significant segment-dependent alteration in mAChR density and subtype distribution (assessed by [N-methyl-3H]-scopolamine binding; ([3H]-NMS)), was found, except a trend in receptor down-regulation in some peripheral parts of the lung. The total number of high mAChR binding sites (assessed by carbachol-displacement experiments in the presence or absence of guanosine 5'-triphosphate) was not changed in RAO, suggesting that the functional coupling of mAChR to the corresponding G-proteins is intact. The M2-mediated inhibition of adenylate cyclase (AC) as well as the M3-receptor-G(q/11)-phospholipase C (PLC) activity was not different between RAO and control airway tissues. In conclusion, in equine RAO airways, mAChR expression and function were not altered, and thus appear not to account for the enhanced cholinergic activity in RAO.

Objectives: To describe clinical features of brachycephalic airway obstructive disease in dogs, the incidence of laryngeal collapse in dogs presenting for surgery and the outcome after surgery in dogs with laryngeal collapse., Methods: Basic clinical details were reviewed retrospectively in 73 dogs. Presence of laryngeal collapse and short-term outcomes after surgery were determined for 64 dogs with complete medical records. Long-term outcomes were reviewed for 46 dogs by telephone survey between 19 and 77 months following surgery., Results: Stenotic nares were present in 31 dogs (42.5 per cent), elongated soft palate in 63 (86.3 per cent) and everted laryngeal saccules in 43 (58.9 per cent). The most common breeds were the pug (19 dogs, 26 per cent), Cavalier King Charles spaniel (15 dogs, 20.5 per cent), British bulldog (14 dogs, 19.2 per cent) and Staffordshire bull terrier (4 dogs, 5.5 per cent). Laryngeal collapse was present in 34 of 64 (53 per cent) dogs. No dogs died perioperatively and only one dog was euthanased as a result of its respiratory disease three years after surgery. Telephone interviews indicated that 26 dogs (56.5 per cent) were much improved after surgery, 15 (32.6 per cent) had some improvement and 5 (10.9 per cent) showed no improvement. Signs that persisted after surgery were snoring during sleep (34 dogs, 73.9 per cent), stertor/stridor while conscious (23 dogs, 50 per cent), excessive panting (13 dogs, 28.3 per cent) and dyspnoea (10 dogs, 21.7 per cent). Long-term outcome was considered good, even in dogs with laryngeal collapse., Clinical Significance: Laryngeal collapse is relatively common in dogs presented for surgical correction of brachycephalic airway obstructive disease. Dogs with severe laryngeal collapse often respond well to surgery. Clinical signs rarely resolve completely following surgery.

Objectives: After a first clinical study showing a high prevalence of gastrointestinal tract diseases in brachycephalic dogs presented for upper respiratory syndrome, a prospective study was performed to determine the influence of medical treatment for gastrointestinal tract disorders associated with upper respiratory syndrome surgery., Methods: The gastrointestinal tract and respiratory disorders of 61 brachycephalic dogs presented for upper respiratory syndrome were evaluated. Together with surgery of the upper respiratory tract, a specific gastrointestinal medical treatment was administered. A minimal follow-up of six months was required for inclusion., Results: Palatoplasty with rhinoplasty was the most common surgical correction (88.5 per cent). The mortality rate in the perioperative period was 3.3 per cent. Minor complications accounted for 26.2 per cent of cases. No aspiration pneumonia was encountered. A sufficient follow-up was obtained in 51 dogs. The improvement was judged by the owners as excellent or good in 88.3 per cent of the respiratory disorders and in 91.4 per cent of the gastrointestinal disorders. Clinically, a statistically significant improvement was obtained for both respiratory and gastrointestinal disorders., Clinical Significance: In comparison with other studies, digestive tract medical treatment combined with upper respiratory surgery seems to decrease the complication rate and improve the prognosis of dogs presented for upper respiratory syndrome.

Respiratory obstruction resulting from a discrete haematoma within the dorsal tracheal membrane was seen in an 11-year-old neutered female greyhound that had been involved in a fight two days earlier. There was no history or evidence of rodenticide toxicity or other coagulopathy, and it is suggested that the tracheal haematoma resulted from trauma. A right third intercostal thoracotomy was performed and this allowed resection of the haematoma from within the dorsal membrane of the cranial thoracic trachea, relieving the obstruction with no subsequent signs of dyspnoea. Intramural haematoma should be considered as a rare differential diagnosis for dogs presenting with acute respiratory obstruction.

Objectives: To document the histories, clinical findings, and management of seven puppies with laryngeal collapse occurring secondarily to brachycephalic airway syndrome., Methods: Seven brachycephalic puppies aged between 4.5 and six months underwent surgery for management of brachycephalic airway syndrome following presentation for exercise intolerance and increased respiratory noise and effort., Results: Stenotic nares of varying severity and an elongated soft palate were common to all dogs. All dogs had tracheal hypoplasia and this was severe in four dogs. Laryngeal collapse was present in all dogs. Two dogs had stage I, four dogs stage II, and one dog stage III laryngeal collapse. The dog with stage III laryngeal collapse and one dog with stage II laryngeal collapse died. There was no apparent association between the changes evident on thoracic radiographs or the degree of tracheal hypoplasia and postoperative outcome., Clinical Significance: The development of severe secondary laryngeal changes in dogs aged six months or less supports the suggestion that immature brachycephalic dogs should undergo assessment and, if indicated, surgery as soon as any clinical signs of BAS are apparent.

Objectives: To determine the prevalence of gastrointestinal tract lesions in brachycephalic dogs with upper respiratory tract disease., Methods: The gastrointestinal tract and respiratory disorders of 73 brachycephalic dogs presented with upper respiratory signs were evaluated. Clinical signs and endoscopic and histological anomalies of the upper digestive tract were analysed., Results: A very high prevalence of gastrointestinal tract problems in brachycephalic dogs presented with upper respiratory problems was observed clinically, endoscopically and histologically. Endoscopic anomalies of the upper digestive tract were present even in dogs without digestive clinical signs. Furthermore, histological evaluation of the digestive tract sometimes showed inflammatory lesions not macroscopically visible at endoscopy. Statistical analysis showed a relationship between the severity of the respiratory and digestive signs. This was significant in French bulldogs, males and heavy brachycephalic dogs., Clinical Significance: These observations show a correlation between upper respiratory and gastrointestinal tract problems in brachycephalic breeds with upper respiratory disease. Surgical treatment of respiratory disease could improve the digestive clinical signs, and/or gastro-oesophageal medical treatment could improve the outcome for surgically treated brachycephalic dogs.

Endotracheal tubes manufactured from red rubber and polyvinyl chloride (PVC) were compared, using radiographic techniques, in dog cadavers, under in vitro conditions and in anaesthetised dogs (in vivo study). All endotracheal tubes were radiographed in 'neutral' and flexed positions and the percentage reduction in the ventrodorsal radiographical diameter of the tube was calculated. The red rubber tubes kinked completely in 40 per cent of the cadavers, 75 per cent of the in vitro study and 40 per cent of anaesthetised dogs. The PVC tubes kinked completely in only one case (in vivo study). However, these tubes had a mean reduction in diameter of 15 per cent in the dog cadaver study, 19 per cent in the in vitro study and 26 per cent in the in vivo study. During procedures in which the trachea is intubated and the atlanto-occipital joint of the patient must be flexed, PVC endotracheal tubes may be less prone to kinking than red rubber tubes.

An adult female neutered crossbred dog was referred in respiratory distress. Thoracic radiographs revealed tracheal narrowing with a soft tissue opacity dorsal to the trachea, near the thoracic inlet, and a patchy interstitial pulmonary infiltrate. The tracheal narrowing was thought to be due to a combination of intraluminal haemorrhage and mediastinal haemorrhage resulting from a coagulopathy caused by anticoagulant rodenticide intoxication. Treatment included supportive care and administration of vitamin K1, and the dog showed a complete resolution of the clinical signs.

An eight-year-old bull mastiff presented with respiratory obstruction caused by a tumour dorsolateral to the larynx. Removal of the tumour was attempted but the dog died. A novel noninvasive measurement of heart rate variability and cardiac parasympathetic activity, recorded real-time from an electrocardiograph signal, was used to investigate cardiac rhythm in the dog. A simultaneous record of heart rate and cardiac parasympathetic activity showed severe sinus arrhythmia caused by the parasympathetic tone, in which the inspiratory heart rate exceeded 140 beats per minute (bpm) and the expiratory heart rate fell to below 60 bpm. The extent of respiratory modulation of the cardiac parasympathetic activity (vagal tone) has not been reported before using this technique on-line in a conscious, freely-behaving and spontaneously breathing animal. Non-invasive measurements of cardiac parasympathetic tone show great potential for the assessment of animals with systemic and cardiac disease including cardiac failure.

Antigen-induced airway hyperresponsiveness in allergic horses has previously been demonstrated when clinical signs of acute airway obstruction were apparent, as a consequence of exposure of animals to hay and straw for variable periods of time, and repeat measurements of hyperresponsiveness have been made no earlier than 1 week after challenge. In the present study airway responsiveness to methacholine has been measured in normal horses and allergic horses in clinical remission before and 24, 48 and 72 h after a hay and straw challenge of fixed, short, duration (7 h). Correlations between early increases in interpleural pressure and hyperresponsiveness have also been investigated. As in other studies, the mean airway responsiveness of groups of normal and allergic horses in clinical remission was not significantly different. The responsiveness to methacholine of allergic, but not normal, horses was increased after antigen challenge and was significantly greater than that of normal horses at 48 and 72 h after challenge (log PD8 cm: -0.77 +/- 0.28 vs. 0.27 +/- 0.14 at 48 h and -0.6 +/- 0.25 vs. 044 +/- 01 at 72 h; P < 0.05). There was also a significant correlation between interpleural pressure at the end of the 7-h challenge in allergic horses and the increase in responsiveness to methacholine at 24, 48 and 72 h. These results demonstrate that antigen induces an increase in airway responsiveness in allergic horses that persists for up to 3 days and which may be linked to the initial increase in interpleural pressure.