Moser John E, Geels Jeffrey J
Las Vegas Veterinary Specialty Center, Las Vegas, NV 89147, USA.
J Am Vet Med Assoc. 2013 Jul 1;243(1):102-4. doi: 10.2460/javma.243.1.102.
An 8-year-old castrated male Yorkshire Terrier was evaluated because of a 1-month history of inspiratory dyspnea that began 2.5 years after placement of extraluminal tracheal ring prostheses for tracheal collapse.
Physical examination revealed severe inspiratory dyspnea. Cervicothoracic radiography revealed a soft tissue opacity within the lumen of the cervical portion of the trachea at approximately the level of the fifth cervical vertebra. Tracheobronchoscopy revealed 2 prosthetic rings protruding into the tracheal lumen.
The dog was anesthetized, and the 2 protruding tracheal ring prostheses were removed via separate tracheotomies. Tracheoscopy was performed after surgery, and a third prosthetic ring that was found freely floating within the tracheal lumen was removed with an endoscopic grasping forceps. The dog recovered without complications. Dyspnea resolved within the first 2 weeks after surgery. Follow-up examination performed 6 months after surgery revealed that the dog was breathing normally, with no dyspnea or coughing reported by the owner.
Migration of extraluminal tracheal ring prostheses should be included in the differential diagnoses for any dog with dyspnea or persistent coughing after surgical correction of cervical tracheal collapse. Surgical removal of the protruding prosthetic rings, without provision of additional tracheal support, was a viable treatment option in this case.
一只8岁去势雄性约克夏梗犬因吸气性呼吸困难就诊,该症状始于气管腔内气管环假体置入以治疗气管塌陷2.5年后,病程1个月。
体格检查发现严重吸气性呼吸困难。颈胸段X线摄影显示,在颈段气管腔内,约第5颈椎水平处有软组织密度影。气管支气管镜检查发现2个假体环突入气管腔。
对该犬实施麻醉,通过单独的气管切开术取出2个突出的气管环假体。术后进行气管镜检查,用内镜抓取钳取出了在气管腔内自由漂浮的第3个假体环。该犬恢复过程无并发症。术后第1个2周内呼吸困难症状缓解。术后6个月的随访检查显示,该犬呼吸正常,主人未报告有呼吸困难或咳嗽症状。
对于任何在颈段气管塌陷手术矫正后出现呼吸困难或持续咳嗽的犬,气管腔内气管环假体移位应列入鉴别诊断。在本病例中,在不提供额外气管支撑的情况下,手术取出突出的假体环是一种可行的治疗选择。