Unilateral left laryngeal palsy post-intubation in a brachycephalic patient: A case report
DOI:
https://doi.org/10.31533/pubvet.v16n11a1253.1-9Keywords:
Aspiration pneumonia, dog, laryngeal collapse, laryngeal paralysis, orotracheal intubationAbstract
Unilateral or bilateral loss of laryngeal abduction capacity during inspiration, of acquired or congenital origin, is defined as laryngeal paralysis. This pathogenesis is usually associated with middle-aged to elderly, male, large dogs. The occurrence of laryngeal paralysis secondary to intubation in dogs is uncommon, unlike what occurs in humans. The present study aimed to report the case of an 8-year-old sterile male Pug treated at the Veterinary Hospital of the Federal University of Paraná. The patient in question underwent a surgical procedure under intubation, and returned to the hospital around 30 days later, in emergency care due to respiratory distress and complaints of aphonia, and more intense and frequent snoring, starting one week after intubation. After stabilization of the condition on admission, the animal was submitted to a laryngoscopy, under light outpatient anesthesia, for evaluation of the upper airways, in which it was possible to observe an extension of the soft palate, eversion of laryngeal sacs, cuneiform processes of the arytenoids collapsing towards the laryngeal lumen during inspiration, grade 2 laryngeal collapse and left unilateral laryngeal paralysis. After stabilization, the dog was discharged from the hospital for treatment of hemoparasitosis prior to rhinoplasty and staphylectomy. Two weeks after discharge, the patient returned to the hospital with a severe respiratory crisis, requiring a temporary tracheostomy and monitoring in an intensive care unit to stabilize the condition. Three days later, after stabilization, he was then submitted to staphylectomy, rhinoplasty and sacculectomy, with second degree laryngeal collapse and left unilateral laryngeal paralysis being confirmed again. After two days in the hospital for postoperative care, the temporary tracheostomy tube was removed and he was discharged under clinical treatment and management guidelines. One week after the return, the animal in question died at home after an episode of emesis followed by respiratory distress reported by the tutor. It is suspected that there was a condition of bronchoaspiration, which is a very frequent complication in cases of laryngeal paralysis.
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