Risk factors for the development of aspiration pneumonia after unilateral arytenoid lateralization in dogs with laryngeal paralysis: 232 cases (1987–2012)

Wilson, David Henry; Monnet, Eric

doi:10.2460/javma.248.2.188

Cited by 41 publications

(40 citation statements)

References 19 publications

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“…), but other studies do not support this (Hammel et al . , Wilson & Monnet ). Plain radiography is less sensitive for oesophageal pathology than an oesophagram via fluoroscopy, but the latter is less commonly performed, which may account for the inability of our study to detect an association.…”

Section: Discussionmentioning

confidence: 98%

“…Meanwhile, other investigations have not demonstrated a difference in gastroesophageal reflux or aspiration pneumonia rates when a metoclopramide constant‐rate infusion (CRI) was utilised (Milovancev et al . , Wilson & Monnet ), suggesting that the relationship between gastroesophageal reflux and aspiration pneumonia is neither direct nor consistent. Cisapride was previously used commonly in human gastroenterology, but has been removed from the market in the USA after being associated with cardiac arrhythmias and sudden death (Wysowski et al .…”

Section: Introductionmentioning

confidence: 99%

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Effects of preoperative cisapride on postoperative aspiration pneumonia in dogs with laryngeal paralysis

Ogden¹,

Ovbey²,

Saile³

2018

J of Small Animal Practice

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Objectives: Retrospective evaluation of a preoperative prokinetic protocol using a constant-rate infusion of a serotonin 5-HT4 receptor agonist, cisapride, and its association with frequency of postoperative aspiration pneumonia in dogs undergoing unilateral arytenoid lateralisation as compared to a historical population at the same institution.Materials and MethOds: Medical records of dogs undergoing unilateral arytenoid lateralisation for laryngeal paralysis were reviewed for historical findings, imaging findings, anaesthesia and surgery durations, perioperative medications and if surgery was performed as an emergency. Aspiration pneumonia events in the first 72 hours after surgery were recorded. The study group received a preoperative cisapride constant-rate infusion; historical 'controls' did not receive the cisapride protocol. results: One of 50 dogs in the cisapride group and six of 52 dogs in the historical group developed aspiration pneumonia within the immediate postoperative period. The cisapride protocol was largely well tolerated. A markedly lower rate of aspiration pneumonia in patients administered butorphanol with acepromazine preoperatively and buprenorphine postoperatively was noted, but the overall low frequency of aspiration pneumonia and variation in case management protocols precluded definitive conclusions with respect to optimal perioperative drug choices.clinical significance: Laryngeal paralysis is commonly treated by unilateral arytenoid lateralisation, and aspiration pneumonia is one of the most serious potential complications of this procedure. This study suggests that further investigation of a cisapride constant-rate infusion to prevent this complication is warranted.

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Section: Discussionmentioning

confidence: 98%

Section: Introductionmentioning

confidence: 99%

Effects of preoperative cisapride on postoperative aspiration pneumonia in dogs with laryngeal paralysis

Ogden¹,

Ovbey²,

Saile³

2018

J of Small Animal Practice

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“…In that study, glottal closure, consisting of adduction and approximation of vocal cords and arytenoids, constituted the primary preventative mechanism against aspiration during swallowing, whereas the epiglottis provided no apparent airway protection . The importance of active glottal closure in prevention of aspiration is further supported by the well‐recognized risk of aspiration in dogs with laryngeal paralysis despite a normally functioning epiglottis . The human literature is mixed regarding the risk of aspiration after epiglottectomy .…”

Section: Discussionmentioning

confidence: 96%

“…6 The importance of active glottal closure in prevention of aspiration is further supported by the wellrecognized risk of aspiration in dogs with laryngeal paralysis despite a normally functioning epiglottis. 7 The human literature is mixed regarding the risk of aspiration after epiglottectomy. [8][9][10][11][12][13][14] Abscessation of I-EP occurred in 1 dog in our study after initial failed hyoepiglotticus imbrication and has not been reported as a complication in previous studies.…”

Section: Discussionmentioning

confidence: 99%

Intraoperative and major postoperative complications and survival of dogs undergoing surgical management of epiglottic retroversion: 50 dogs (2003‐2017)

et al. 2019

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Objective To report intraoperative and major postoperative complications in dogs treated surgically for epiglottic retroversion (ER), compare the incidence of major postoperative complications between procedures, and report survival of surgically treated dogs. Study design Multi‐institutional retrospective study. Sample population Fifty dogs treated with 78 procedures. Methods Medical records of dogs diagnosed and surgically treated for ER from 2003 to 2017 at 11 institutions were reviewed. Complications were divided into intraoperative and major postoperative complications. Results Intraoperative complications occurred during 2 of 78 (2.6%) procedures. Thirty‐six major postoperative complications were documented in 22 dogs after 36 of 74 (48.7%) procedures. Postoperative complications occurred after 7 of 12 (58.3%) nonincisional epiglottopexy, 23 of 43 (53.5%) incisional epiglottopexy, 2 of 4 (50%) partial epiglottectomy, 2 of 12 (16.7%) subtotal epiglottectomy, and 2 of 3 (66.7%) other surgical procedures. Epiglottopexy failure was the most common major postoperative complication. The incidence of major postoperative complications did not differ between procedures (P = .1239), although, when combined, epiglottopexy procedures (30/55) had a higher incidence of complications than epiglottectomy procedures (4/16; P = .048). Thirty (60%) dogs were alive at a median of 928 days (range, 114‐2805), 8 (16%) were lost to follow‐up after 411 days (range, 43‐1158), and 12 (24%) were dead/euthanized after 301.5 days (range, 3‐1212). Median survival time was not reached after a median of 716 days. Conclusion Although intraoperative complications were uncommon, major postoperative complications were common, especially after epiglottopexy procedures. Clinical significance Although surgical treatment of ER is associated with a high rate of major postoperative complications, especially epiglottopexy procedures, long‐term survival can be achieved.

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“…2007, Bahr et al . 2014, Wilson & Monnet 2016. A presumptive diagnosis of aspiration pneumonia is commonly made using a combination of history, clinical signs and thoracic radiographic evidence of pneumonia.…”

Section: Introductionmentioning

confidence: 99%

Comparison of bacterial cultures of the larynx between dogs with laryngeal paralysis and normal dogs

Ganjei¹,

Langenbach²,

Watrous³

et al. 2016

J of Small Animal Practice

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Risk factors for the development of aspiration pneumonia after unilateral arytenoid lateralization in dogs with laryngeal paralysis: 232 cases (1987–2012)

Cited by 41 publications

References 19 publications

Effects of preoperative cisapride on postoperative aspiration pneumonia in dogs with laryngeal paralysis

Effects of preoperative cisapride on postoperative aspiration pneumonia in dogs with laryngeal paralysis

Intraoperative and major postoperative complications and survival of dogs undergoing surgical management of epiglottic retroversion: 50 dogs (2003‐2017)

Comparison of bacterial cultures of the larynx between dogs with laryngeal paralysis and normal dogs

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