Resp Surgery

Question 1

briefly describe the characteristics of BOAS

Answer 1

stenotic nares, elongated soft palate, everted laryngeal saccules, hypoplastic trachea

others: laryngeal/tracheal collapse, oversized tongue, aberrent turbinates

Question 2

what are some clinical signs of BOAS?

Answer 2

resp nois, stenotic nares, cyanosis, collapse, GI signs (difficulty swallowing, reflux), heat intolerance, obstructive sleep apnea

Question 3

a frenchie comes to you with classic signs of BOAS. what diagnotics are available to you?

Answer 3

physical exam during rest, and during exercise to examine breathing and the nares

laryngo/endoscope: look at tonsils, pharynx, larynx, nasal cavity

CT/rads: tracheal hypoplasia, tracheal collapse, aspiration pneumonia, hiatal hernia, etc

Question 4

an owner with a frenchie with BOAS wants to know everything that can be done to help her dog. What options does she have?

Answer 4

-weight management
- avoid overheating
- rhinoplasty to open the nares
- open nasal turbinates (endoscope guided)
-shorten the soft palate (staphylwctomy) or make it thinner (folded flap palatoplasty)
- partial tonsilectomy
- laryngeal sacculectomy

Question 5

what is the prognosis for a dog with BOAS?

Answer 5

depends on how severely affected

risks: aspiration pneumonia, airway inflammation and swelling

main goal is to improve quality of life

Question 6

what is a hiatal hernia?

Answer 6

when stomach herniates thru the diaphragm into the thorax

Question 7

laryngeal paralysis typical presentation?

Answer 7

older large breed dogs (labs and goldens common)

gagging, coughing, stridor, dyspnea, cyanosis, syncope, exercise intolerance, change in voice

Question 8

why does laryngeal paralysis happen?

Answer 8

idiopathic acquired disease
usually the recurrent laryngeal nerve (and caudal laryngeal nerve) become damaged, and the circoarytenoidesu fails to abduct the arytenoid cartilage. can be a polyneuropathy (damage to peripheral nerves)

Question 9

a 6yo lab comes to you with exercise intolerance, coughing, gagging and retching when he eats, and the owners say there is a change in his bark. how can you investigate this?

Answer 9

laryngeal paralysis

could do rads and see concurrent disease like aspiration penumonia, non cardiogenic pulmonary edema, megaesophagus, etc

laryngoscope with light anesthesia

Question 10

the owner with the laryngeal paralysis wants to know what treatment options are available to take care of her dog. you say…

Answer 10

• for emergencies: cooling, anxiolytics, oxygen therapy

weight loss, stress reduction, exercise restriction, avoid heat

tie back surgery: unilateral cricoarytenoid lateralization

Question 11

prognosis for GOLPP?

Answer 11

geriatric onset laryngeal paralysis polyneuropathy

it is progressive and cannot be cured. tie back surgery improves quality of life and survival

Question 12

pleural space can be filled with what 3 things:

Answer 12

air, fluid, tissue

Question 13

what is spontaneous pneumothorax?

Answer 13

when there is no evidence of trauma and there is leakage of air from the lungs into the pleural space

Question 14

what is a pulmonary bullae?

Answer 14

a sac or air in the pulmonary parenchyma, can cause spontaneous pneumpthorax

Question 15

treatment for pneumothorax?

Answer 15

thoracocentesis

Question 16

what is pyothorax and what causes it?

Answer 16

accumulation of septic fluid in the pleural space

cause not often identified, usually polymicrobial infections with obligate anaerobes OR a mix of obligate and facultative anaerobes. bacteria are usually from the oral cavity and upper respiratory tract

Question 17

clinical signs of pyothorax?

Answer 17

can be insidious…

tachypnea, dyspnea, cough, lethargy, weight loss, anorexia, restrictive breathing, muffled heart and lung sounds. can have SIRS and sepsis

Question 18

how do you diagnose pyothorax?

Answer 18

thoracocentesis and do cytology of the fluid and culture it

consider imaging to look for pleural effusion

Question 19

after draining the chest, how do you medically manage pyothorax?

Answer 19

antimicrobials: fluoroquinolones and penicillin or clindamycin to start, ideally IV, THEN based on culture results

Question 20

the most common cause of a diaphragmatic hernia is

Answer 20

trauma

Question 21

i dont care about the rest ugh

Answer 21

bruhhhh