When Marley was brought into our clinic, she was in considerable respiratory distress. She had been taken to an emergency clinic the previous night where she was given oxygen and Valium. Although she settled for a few hours, come morning she was worse than ever. She had also experienced a similar attack a few weeks prior, but it had cleared over the day and her owner thought nothing more of it.
Showing a marked increase in both inspiration and expiration, Marley was having serious difficulty breathing in and out. She was admitted and placed on an anaesthetic and IV fluids with a propofol slow IV, allowing us to inspect her larynx and pharyngeal region (which is where we suspected the issue lay).
Our inspection of Marley’s pharynx (otherwise known as the back of her throat) revealed serious swelling at the base of her tongue. The swelling was obstructing air to the larynx, and we also noticed that her soft palate appeared to also be obstructing the larynx and epiglottis.
To safely recover Marley, we decided to perform a tracheotomy. After we incised the ventral neck skin and parted the tissues located above the trachea, a cut-down endo-tracheal tube was inserted between the second and third tracheal rings. The tube was then sutured to the skin. Marley was able to breathe with ease immediately and went on to recover uneventfully.
She was anaesthetised again 11 days later so that we could re-inspect the back of her throat. This revealed that the swelling at the base of her tongue had completely cleared.
As we were still unable to see the epiglottis or larynx, it was decided that we would resect a portion of Marley’s soft palate. We removed around 1.5cm of soft palate tissue then sutured the edges together and reversed the tracheotomy.
One of our nurses monitored Marley for an hour following her surgery and her owners monitored her for a further two hours to ensure that her breathing was fine. She didn’t show any respiratory issues and was allowed to return home. Her owners texted us the next day, saying that “it was like Marley was never unwell” - she no longer snored or had any breathing issues, plus she was more active than she had been in months.
Both of these procedures (including two anaesthetics and two surgeries) cost a total of $1700. If Marley had been treated at the original referral centre, her owners would have been faced with a bill of $10,000 to $20,000 (depending on how long she spent in hospital between surgeries). Short-nosed brachycephalic breeds – like French Bulldogs, Boxers and Pugs – are known to experience respiratory issues as a result of their soft palate interfering with their epiglottis, making it difficult for air to pass into and out of the larynx.
In Marley’s particular case, the continuous effort of breathing is what led to swelling in the surrounding tissue. Whilst tracheotomies are dangerous and not undertaken lightly (as they can end in disaster), they can sometimes be a necessary and lifesaving procedure. Marley’s case has also shown that owners are able to manage their pet’s recovery at home, which can make the procedure even more affordable (as high costs can be a contributing factor in euthanasia in many cases). At Melbourne Pet Surgery, alleviating breathing issues in brachycephalic dogs can cost as little as $600 to $700.
