Acute Upper Airway Obstruction Due to Inflammatory Laryngeal Disease in 5 Cats

Abstract

Objective: To describe a clinical syndrome of upper airway obstruction in 5 cats due to inflammatory laryngeal disease. Series Summary: Medical records of 5 cats with upper airway obstruction and a histopathologic diagnosis of inflammatory laryngeal disease were reviewed. Historical findings included: dyspnea, anorexia, voice change, and gagging/non‐productive retching. Thoracic radiographs revealed a bronchial pattern in 2 cats, with consolidation of the right middle lung lobe in one cats. Laryngeal examinations typically revealed severe swelling and erythema which could not be grossly distinguished from neoplasia. Histopathologic examination of laryngeal biopsies revealed neutrophilic (n=5) and lymphoplasmacytic (n=4) inflammation. All of the cats were treated with corticosteroids and 4 cats received antibiotics. Two cats died while hospitalized, one was discharged and lost to follow‐up, and 2 are doing well 7 months and 4 years later, respectively. New information provided: Inflammatory laryngeal disease in cats may present as an acute upper airway obstruction. These cases may respond to corticosteroids and antibiotics, and some cases may have an excellent long‐term prognosis.(J Vet Emerg Crit Care 2001; 11(3): 205–211)

Outcome of permanent tracheostomy for treatment of upper airway obstruction in cats: 21 cases (1990–2007)

“…In a study 15 of alterations of the tracheal mucosa in dogs that underwent tracheostomy, it was found that the tracheal mucosa had adapted in most dogs by 8 weeks after surgery and had returned to a relatively normal histologic appearance by 16 weeks after surgery. In addition, ILD has previously been attributed to endotracheal intubation in cats, 8 and 1 cat in the present study had undergone endotracheal intubation for dental extraction shortly before signs of respiratory tract disease had first been noticed. When crusting and thick secretions are evident during the immediate postoperative period, nebulization may be required as frequently as every 2 to 4 hours.…”

“…9,13,14 In human patients, humidification is routinely used as a method to reduce tenacity of mucous secretions, with the method and frequency of humidification tailored to individual patient need. Underlying causes of these disease processes in cats have been identified, 7,8,16 and it is likely that multiple factors contribute to these conditions. Thus, it appears that humidification is required most frequently during the first 3 months after surgery and less frequently thereafter.…”

“…Thus, it appears that humidification is required most frequently during the first 3 months after surgery and less frequently thereafter. Importantly, despite an early report 17 of an excellent prognosis for cats with granulomatous laryngitis, 18 subsequent reports 7,8,16 of cats with ILD have indicated that the prognosis is much more variable and often poor. 9 Maintaining patient hydration is also important in maintaining normal mucociliary transport and consistency of mucous secretions.…”

“…7,8 In a study 1 involving 34 dogs and cats that underwent permanent tracheostomy, morbidity and mortality rates reportedly were low and overall quality of life was improved in most SMALL ANIMALS/ EXOTIC patients. To our knowledge, however, there have been only 4 published reports 1,2,7,8 on the outcome of permanent tracheostomy in cats, and 2 of these were only case reports.…”

Managing the dyspnoeic emergency Patient

“…A coagulopathy should be ruled out before performing a tracheostomy. Cats develop laryngeal disease much less commonly than dogs, but inflammatory conditions such as granulomatous laryngitis (Costello and others 2001), and neoplastic processes such as lymphoma, have been reported. Histology is required for a definitive diagnosis as gross appearance is unreliable.…”