Page 648 - WSAVA2018
P. 648

 25-28 September, 2018 | Singapore
Suture material/special instruments:Malleable retractors, head lamp, long-handled laryngeal cup biopsy forceps (or similar instrument), long-handled Allis tissue forceps, long-handled scalpel handle, long-handled rat tooth forceps, 3-0 or 4-0 Dexon, Polysorb or Vicryl with a cutting or sharp taper needle.
Postoperative care and assessment: Any patient requiring surgery to relieve airway obstruction should be monitored carefully (preferably in a critical care environment) for the first 24 hours postoperatively. The degree of care may vary depending upon the patients presenting signs and surgical manipulations required to correct the airway obstruction. Examples of the authors degree of postoperative care based on patient presentation and surgery performed are listed below:
Stenotic nares only: These patients are generally held for observation 12 24 hrs postoperatively and discharged from the hospital the day following surgery.
Soft palate resection only: Patients that present with mild clinical signs (i.e., noise, mild exercise or heat intolerance) and are bright and alert 24 hours after surgery can be discharged that day. Patients that present with moderate to severe clinical signs (i.e., severe exercise intolerance, episodes of cyanosis, syncopal attacks) are monitored in a critical care environment until signs resolve. Immediate postoperative gagging and coughing are observed in about 13% of patients. Patients requiring a tracheostomy prior to surgery, or an emergency tracheostomy, remain in a critical care environment until the tracheostomy can be removed.
Combined nares, palate, saccule repair: These patients are treated similarly to patients with soft palate resection and are based on presenting clinical signs. Patients with multiple defects tend to present with moderate to severe clinical signs and may require more intensive care. Immediate postoperative gagging and coughing are observed in about 80% of patients.
Patients that present with mild clinical signs (i.e., noise, mild exercise or heat intolerance) and are bright and alert 24 hours after surgery can be discharged that day. Patients that present with moderate to severe clinical signs (i.e., severe exercise intolerance, episodes of cyanosis, syncopal attacks) are monitored in a critical care environment until signs resolve. Patients requiring a tracheostomy prior to surgery, or an emergency tracheostomy, remain in a critical care environment until the tracheostomy can be removed.
Prognosis: Prognosis for patients with brachycephalic syndrome is generally dependant upon the defects found at presentation.
Stenotic nares only: About 96% of dogs with stenotic nares will improve postoperatively.
Soft palate resection only: About 85 90% of dogs with
soft palate resection only will improve postoperatively. Young dogs (i.e., less than 2 years of age) are more likely to improve (90%) than dogs greater than 2 years of age (70%).
Stenotic nares and soft palate resection: Dogs having a combination of stenotic nares repair and soft palate resection are more likely to have a favorable outcome (96%) compared to those that did not (70%).
Soft palate and everted saccule resection: Dogs having this combination of defects repaired will have an 80% chance of significant improvement postoperatively.
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43RD WORLD SMALL ANIMAL VETERINARY ASSOCIATION CONGRESS AND 9TH FASAVA CONGRESS




















































































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