Page 48 - Problem-Based Feline Medicine

40 PART 1 CAT WITH UPPER RESPIRATORY TRACT SIGNS

Pathogenesis palatal resection, and resection of the everted lateral
ventricles.
Congenital anatomic anomalies characteristic of
brachycephalic breeds (Persians, Himalayans), are
related to the flat face and short neck. Stenotic nares is Prognosis
the most commonly evident anomaly.
The prognosis is excellent for nasal, palatal and laryn-
Brachycephalic syndrome includes stenotic nares,
geal defects with surgical intervention, if indicated.
elongated soft palate, eversion of the lateral laryngeal
Tracheal hypoplasia is currently not treatable.
ventricles, laryngeal collapse and hypoplastic trachea.
Prevention or treatment of obesity is a major prog-
nostic factor, as lean cats tolerate this much better than
Clinical signs obese cats.
Stenotic nares, hypoplastic trachea, etc., create a non-
dynamic, fixed obstruction leading to inspiratory and Prevention
expiratory dyspnea.
Prevention is via selected breeding programs. Not using
Dynamic obstructions occur with an elongated soft
severely affected cats for breeding will help to reduce
palate and create inspiratory dyspnea with stertor.
the prevalence.
Stridor is present with laryngeal collapse or lateral ven-
tricular eversion.
AIRWAY FOREIGN BODIES
Collapse, exercise intolerance, dyspnea or dysphagia
may also be reported.
Classical signs
Oronasal reflux, especially with fluids, occurs with a
● Sneezing and stridor (nasal foreign
cleft palate.
bodies).
● Coughing and stridor (pharyngeal and
Diagnosis tracheobronchial foreign bodies).
Diagnosis is based mostly on clinical signs of stertor
and stridor in a brachycephalic cat. Nasal stenosis Clinical signs
can be assessed visually. Pharyngoscopy and laryn-
goscopy are required to diagnose and stage the severity Grass is one of the most common foreign bodies. The
of palatal and laryngeal involvement. blade of grass becomes adherent to the roof of the pharynx
and extends into the nasopharyngeal region.
Lateral cervical and thoracic radiographs are needed to
assess tracheal hypoplasia. Cuterebra larvae may bury in the retropharyngeal
tissue or in the pharyngeal soft palate. A clue to
diagnosis is evidence of a hole in the mucosa or a mass
Differential diagnosis
lesion.
Upper airway foreign bodies and masses may mimic
Bone fragments and sewing needles may become
brachycephalic syndrome in a brachycephalic breed,
embedded in the pharnx. Cotton, string and fishing
although careful history-taking will usually differentiate
line may get caught around the base of the tongue.
them based on time of onset. Laryngeal edema may
Grass seeds may cause nasal foreign bodies.
occur due to causes other than congenital malformation.
Acute onset of sneezing and nasal discharge are
common signs of nasal foreign bodies. The cat may
Treatment
be in sudden and severe distress attempting to dislodge
If possible, surgically correct the defect, if the signs the foreign body. Pawing at the face and mouth is com-
are severe. This includes wedge resection of the nares, monly observed.