Page 1887 - Cote clinical veterinary advisor dogs and cats 4th

946 Stunted Growth

• Stridor ○ If the obstruction is cranial to the mid- dogs with stertor can often breathe simply
by opening the mouth.
○ Laryngoscopy (p. 1125) under light cervical trachea and stridor and dyspnea • Cats are much more reluctant than dogs to
are severe, consider anesthesia and endo-
VetBooks.ir and oral anatomy and rule out laryngeal tracheal intubation or a tracheostomy if breathe with their mouths open. As a result,
general anesthesia to evaluate laryngeal
significant nasal cavity obstruction can cause
intubation is not possible (p. 1166).
paralysis
○ Pharyngoscopy and tracheoscopy with
a dog would mouth breathe to bypass the
vical trachea and stridor and dyspnea are
biopsies, cytologic exam, ± bronchoal- ○ If the obstruction is caudal to the midcer- marked respiratory distress in a cat, whereas
veolar lavage (p. 1074) severe despite the treatments mentioned obstruction.
○ If available, flouroscopy may be useful. above, immediate preparations should be • Stridor is often exacerbated by excitement
• Coagulation profile: rule out coagulopathies, made for tracheoscopy and/or surgical and exercise.
if appropriate intervention. • Tracheal collapse above the thoracic inlet is
○ If the site of obstruction is unknown, most apparent on inspiratory radiographs
TREATMENT the patient must undergo radiography or and below the thoracic inlet on expiratory
direct visualization of the pharynx and films.
Treatment Overview larynx to determine the best intervention.
Reduce/remove obstruction of the upper airway Technician Tips
when possible. If respiratory effort is increased, Chronic Treatment • Keep the environment around an acutely
oxygen supplementation and sedation may be Correction of underlying causes, as applicable. dyspneic animal as calm as possible. Do not
required. In severe cases, tracheotomy may be For example: force an oxygen mask on the animal if it is
necessary to restore airflow to the lungs (p. • Brachycephalic airway surgery (p. 128) resisting, but consider flow-by oxygen or an
1004). • Laryngeal paralysis: arytenoid lateralization oxygen cage. Sedation may help calm the
(p. 574) animal and reduce dyspnea.
Acute General Treatment • Surgical excision of masses, removal of polyps • Animals with stridor on a hot day often
• Stertor: rarely associated with crisis as open- • Endoscopic or surgical retrieval of FBs (pp. become hyperthermic; be sure to check body
mouth breathing can circumvent obstruction. 1074 and 1159) temperature and actively cool animals if
• Stridor: if associated with severe obstruction, necessary.
may cause (in increasing order of severity) Recommended Monitoring
severe upper airway dyspnea, cyanosis, col- Respiratory effort, mucous membrane color SUGGESTED READING
lapse, and respiratory arrest (pallor/cyanosis), pulse oximetry, and arterial O’Sullivan ML: Tachypnea, dyspnea, and respiratory
• Patients with marked stridor associated with blood gas analysis if severely affected distress. In Ettinger SJ, et al. editors: Textbook
exaggerated, severe inspiratory efforts require of veterinary internal medicine, ed 8, St. Louis.
immediate attention. PROGNOSIS & OUTCOME 2017, Elsevier.
○ Calm environment AUTHOR: Peter M. Foley, MSc, DVM, DACVIM
○ Oxygen supplementation (p. 1146) Depends on the underlying disease EDITOR: Leah A. Cohn, DVM, PhD, DACVIM
○ Sedation, especially if the degree of inspi-
ratory dyspnea is severe and the patient PEARLS & CONSIDERATIONS
is known to be otherwise healthy (e.g.,
butorphanol 0.1-0.3 mg/kg IV) Comments
• With deterioration or failure to improve • Stridor can be a sign of a serious or life-
despite the measures described above threatening airway obstruction. Conversely,

Stunted Growth Client Education
Sheet

BASIC INFORMATION GENETICS, BREED PREDISPOSITION • Pancreatic acinar atrophy: German shepherd
• Pituitary dwarfism: German shepherd, • Portosystemic shunt (PSS [p. 814])
Definition Saarloos wolfhound, Karelian bear dog • Polycystic kidney disease (p. 805)
Slower growth rate or failure to attain expected • Congenital hypothyroidism: toy fox terrier, • Familial renal diseases (pp. 51, 390,
body size/stature rat terrier, boxer, giant schnauzer, Abyssinian 875)
• Osteochondrodysplasia: Alaskan Malamute, • Juvenile hyperparathyroidism: German
Synonyms beagle, bull terrier, English pointer, Great shepherd (rare)
Failure to thrive, delayed growth, poor-doer Pyrenees, Irish setter, Labrador retriever, min-
iature poodle, Newfoundland, Norwegian RISK FACTORS
Epidemiology elkhound, Samoyed, Scottish deerhound • Malnutrition: poor-quality feed/parasitic
SPECIES, AGE, SEX • Cleft palate: shih tzu, English bulldog, infestation
• Dogs and cats pointers, Swiss sheepdog, Brittany spaniel • Group housing/lack of hygiene: infectious
• Male and female; sex predispositions vary • Congenital megaesophagus: Irish setter, diseases
with cause. German shepherd, Labrador retriever,
• Stunted growth is usually observed in the miniature schnauzer CONTAGION AND ZOONOSIS
first year of life, although pet owners may • Vascular ring anomaly: German shepherd, Some gastrointestinal (GI) parasites (e.g.,
recognize the problem later. Irish setter Toxocara, Giardia) present a zoonotic risk.

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