Laryngotomy as a treatment for chronic laryngeal obstruction in cattle: a review of 130 cases

Diagnosis of a sublaryngeal abscess in a Japanese Black calf using computed tomography

A 76-day-old Japanese Black calf presented with severe stridor, resenting palpation of the laryngeal region. Endoscopic examination revealed an expansile process restricting the esophageal and tracheal lumina caudal to the arytenoid cartilage, hyperemia and edema of the pharyngeal mucosa, right arytenoid cartilage swelling and displacement, and marked airway obstruction. The absence of an endotracheal wall abnormality impeded a definitive diagnosis. Computed tomography (CT) revealed a mass (CT value: 40–45 HU) caudal to the arytenoid cartilage, causing tracheal stenosis and esophageal displacement. The presence of gas in the mass suggested the presence of an abscess. Diagnosis of deep retropharyngeal lesions by conventional endoscopic and ultrasonographic examinations may be challenging; CT can then provide more comprehensive diagnostic information on a lesion.

Use of a national identification database to determine the lifetime prognosis in cattle with necrotic laryngitis and the predictive value of venous pCO2

BACKGROUND

Necrotic laryngitis, caused by Fusobacterium necrophorum, frequently requires surgical intervention (laryngostomy) in the chronic stage.

HYPOTHESIS/OBJECTIVES

To determine survival until slaughter of cattle surgically treated for necrotic laryngitis and to identify predictors of mortality.

ANIMALS

A total of 221 cattle diagnosed with necrotic laryngitis by laryngoscopy and surgically treated METHODS: Retrospective cohort study. Clinical records were matched with the national cattle identification, registration, and movement database. Information on possible predictors including clinical examination, biochemistry, and surgery was collected. A multivariable Cox proportional hazard model was used to identify predictors of mortality.

RESULTS

The overall survival rate was 65.2% and 58.6% of the animals with a completed life cycle could be slaughtered. Animals <6 months old experienced significantly higher mortality risk (hazard ratio [HR], 2.0; 95% confidence interval [CI], 1.1-3.5). The venous partial pressure of carbon dioxide (pCO2 ; HR, 2.4; 95% CI, 1.4-4.2) at a 64.5 mm Hg cut-off was most significantly associated with mortality. Sensitivity and specificity of the final model consisting of age and pCO2 were 49.1 and 86.4%, respectively. Instead of pCO2 , total carbon dioxide (TCO2 ) could also be used, with similar diagnostic accuracy.

CONCLUSIONS AND CLINICAL RELEVANCE

The lifetime prognosis for chronic necrotic laryngitis in cattle with surgical intervention appears fair. Age, venous pCO2 and TCO2 are easily accessible predictors of survival to support owners and veterinarians in their decision process of whether or not to operate and to identify high risk animals that require more intensive follow-up.

Respiratory Surgery

This article is a review of the most frequent disorders affecting the upper airway of cattle that are suitable for surgery. Information regarding the clinical signs, diagnostic methods, and the chemical restraint of cattle in respiratory distress are highlighted. Surgeries that can be performed in a field setting are thoroughly described.

Subtotal or partial unilateral arytenoidectomy for treatment of arytenoid chondritis in five calves

CASE DESCRIPTION

5 calves were evaluated for abnormal respiratory noise associated with variable degrees of respiratory distress.

CLINICAL FINDINGS

Tachypnea and inspiratory dyspnea were detected at initial evaluation in all calves. Endoscopic evaluation of the upper respiratory tract revealed enlarged and immobile arytenoids. Radiographic (n = 3) and computed tomographic (1) evaluation of the laryngeal area revealed images that were indicative of a large soft tissue mass at the level of the arytenoids obstructing the rima glottis. A presumptive diagnosis of arytenoid chondritis was made.

TREATMENT AND OUTCOME

A tracheostomy tube was placed in all calves. Medical treatment (with antimicrobials and anti-inflammatory drugs) was attempted in 4 calves after initial evaluation. Unilateral arytenoidectomy via a laryngotomy was performed under general anesthesia in all calves. Dysphagia and coughing were the most frequent postoperative complications. Three calves survived at least 6 months after the procedure. One calf died of a perforated abomasal ulcer 3 months after the surgery. Another calf died suddenly 1 month after the surgery of an undetermined cause.

CLINICAL RELEVANCE

Unilateral arytenoidectomy was a viable surgical treatment for arytenoid chondritis in calves. Further research in a larger number of affected cattle is needed to determine the advantages or disadvantages of this procedure over other surgical techniques.

Diphtheroid necrotic laryngitis in three calves - diagnostic procedure, therapy and post-operative development

Diphtheroid necrotic inflammation of the larynx in calves in its advanced stage mostly requires surgical therapy. Diagnostic procedure, surgery and post-operative care were described for three calves (aged 3-8 weeks). The clinical diagnosis was confirmed by laryngoscopy. In all three cases, a laryngotomy with resection of necrotic tissue was performed. After surgery two calves showed complications (tracheal stricture, mucosal hyperplasia). Both were cured in further surgery. In cases of post-operative complications, further surgical intervention can be very promising.

Tracheolaryngostomy as a treatment for laryngeal obstruction in cattle

Inspiratory dyspnoea may be the result of chronic laryngeal obstruction or, rarely, because of tracheal collapse. Chronic laryngeal obstruction, as a result of necrobacillosis or infectious bovine rhinotracheitis, responds poorly to medical treatment. A tracheolaryngostomy technique under general anaesthesia is described with closure of the laryngotomy incision. Animals were selected for surgery following radiography and endoscopy. With a permanent cranial tracheostomy incision, calves could be managed easily by the farmer as a tracheotomy tube was found to be unnecessary 1 week after surgery once the postoperative swelling had subsided. The technique had a high success rate at 6 months follow-up. In animals with severe bronchopneumonia without laryngeal abscesses at endoscopy, tracheotomy and medical therapy with antibiotics and steroids may be successful. Chronic laryngeal obstruction is more common in double-muscled calves because of the anatomy of the upper airways, increasing laryngeal resistance to airflow.