Why Marley underwent a tracheotomy and soft palate resection
Marley, an 8 year old pug, arrived at our hospital in considerable respiratory distress. She had been taken to an emergency centre the night before and had been given Valium and oxygen, and though she settled over some hours, she was worse than ever by the morning. She had also had a similar attack a few weeks ago but this had cleared over the course of the day.
Marley was showing a marked increase in both inspiration and expiration, meaning she was having difficulty breathing in and out. We admitted her for an anaesthetic so that her larynx and pharyngeal region could be inspected, as we believed this was where the issue was occurring.
We placed her on IV fluids and anaesthetised her with propofol slow IV to effect. Our inspection of the pharynx (the back of her throat) showed a marked swelling at the base of the tongue. This was severely obstructing the passage of air to the larynx. It also appeared that the soft palate was obstructing the epiglottis and larynx as well.
We decided to perform a tracheotomy to safely recover Marley. After cut-down endo-tracheal tube was inserted between the second and third tracheal rings after incising the ventral neck skin and parting the tissues that are located above the trachea. The tube was then sutured to the skin. Marley recovered uneventfully and was immediately able to breathe with ease.
Eleven days later, we anaesthetised Marely again to inspect the back of her throat and discovered that the swelling at the base of her tongue had completely cleared.
However, we could still not see the epiglottis or larynx, so we decided to resect a portion of the soft palate. We removed approximately 1.5cm of soft palate tissue before suturing the edges together. We then reversed the tracheotomy.
Marly was monitored for an hour following her surgery by one of our nurses and a further two hours after that by her owners. She showed no respiratory issues, and Marley was allowed to return home. We received a text the next day to say that “it was like Marely was never unwell”, and that she no longer snored or had any breathing issues and was even more active than she had been in many months!
These two procedures – for the two anaesthetics and two surgeries – cost Marley’s family a total of $1,700. If this had been treated at the referral level, then her owners would have been faced with a bill of between $10,000 - $20,000, depending on how long she remained in hospital between the surgeries. Pugs, and other short-nosed brachycephalic breeds (such as French Bulldogs and Boxers) can experience respiratory issues due to the interference of the soft palate with the epiglottis. This makes it difficult for the air to pass in and out of the larynx.
In Marely’s case, it was the continuous effort required to breathe that led to swelling of the surrounding tissue. Though tracheotomies are dangerous and never undertaken lightly (as they can end in disaster), they are sometimes a necessary and lifesaving measure. This case also highlights the ability for the owners to manage the recovery period at home, which can make the procedure far more affordable. High costs can often otherwise lead to euthanasia in many cases. At Brisbane Pet Surgery, we can charge as little as $600 - $700 to alleviate breathing issues in brachycephalic dogs.