-Mullins R, McAlinden AB, Goodfellow M. Subtotal epiglottectomy for the management of epiglottic retroversion in a dog. J Small Anim Pract 2014;55:383-385. <From Discussion>

”Interestingly, the dog had a productive cough with mucous demonstrated throughout the bronchial tree on tracheobronchoscopy and evidence of chronic active neutrophilic inflammation on BAL. This was believed to be attributable to mucociliary escalator dysfunction secondary to upper airway obstruction and turbulent airflow (Pink et al. 2006↓). It was considered that addressing the primary problem would lead to cough resolution. This was subsequently deemed plausible with cessation of coughing shortly after relief of the dynamic obstruction.”



-Pink JJ, Doyle RS, Hughes JM, et al. Laryngeal collapse in seven brachycephalic puppies. J Small Anim Pract 2006;47:131-135. <From Discussion>

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FIG 3. Cross-section of the trachea of case 5 (A) and a normal dog (B) showing replacement of the normal ciliated epithelium with a thin columnar epithelium and necrosis of a mucus gland. (H&E stain, 400)






“While five dogs responded favourably to surgical management, two dogs died. The excessive mucus present in the airways of case 5 combined with stage III laryngeal collapse are considered to have been responsible for the respiratory obstruction and subsequent death seen several hours after recovery from anaesthesia. Histopathological examination of the larynx and trachea revealed a loss of the normal ciliated epithelium and dysplasia of the mucus glands with associated inflammation. It is possible that the failure of normal ciliary clearance and abnormal mucus glands were responsible for the large quantities of abnormally tenacious mucus found at surgery. Whether loss of the normal respiratory epithelium and mucus gland dysplasia is found in other BAS cases requires further investigation. Some authors recommend prophylactic temporary tracheostomy when performing brachycephalic airway surgery (Monnet 2003). While temporary tracheostomy in case 5 would have prevented respiratory obstruction due to the laryngeal collapse, the excessive mucus present in the trachea of this case would have increased the risk of tracheostomy tube blockage. Case 3 died seven weeks following discharge from the hospital and a postmortem examination was not performed. While the cause of death cannot be certain, the owner’s description of severe and worsening dyspnoea is suggestive of respiratory obstruction with or without bronchopneumonia.”