Cuddles – abnormal respiratory sounds

 Cuddles is a 5 year old, female spayed Morkie (and a peanut at that weighing about 4.5 pounds!).  She started experiencing episodes of abnormal respiratory sounds and a cough  which was easily stimulated when her throat was tickled.  The signs were initially reported in March 2015, and discussions with Cuddles’ primary veterinarian recurred every 3 to 6 months.  X-rays were taken of her chest and head at two separate occasions (October 2015, and again in December 2016) and were normal both times. Medications were also tried along the way including antibiotics, bronchodilators and steroids.  Some improvement was noted with the cortisone therapy but the symptoms never resolved completely, and they always came back.

 

Cuddles came in for imaging to investigate the sources of her abnormal breathing sounds and cough.  Two different types of imaging studies were completed, each revealing different information.

A fluoroscopy study (an action video of an X-ray) was performed with Cuddles awake to look at the trachea during a coughing episode.  The still shot below shows one frame from the study and demonstrates the different sizes of the trachea which happen during the cough.  This is an abnormal condition called tracheal collapse which is often seen in small breed dogs.

The video link below is a segment of the actual study on Cuddles but is slowed down to help view the variable tracheal size during the cough.

 

 

A CT study was done on Cuddles’ head after the fluoroscopy.  Three images are provided below from her scans. The larger image on top is a sagittal view (the body is “cut” into left and right sides).  The red arrow is pointing to an abnormally long soft palate extending down her throat and covering her airway opening.  The endotracheal tube can be seen below it keeping her airway open during anesthesia.  Two axial views below (where the tip of the nose is “cut” off and you’re viewing the cut surface) are shown.  The left image has a blue arrow pointing to an area/opening called the nasopharyngeal meatus.  The area is much smaller than desired and is considered stenotic.  The axial view on the right has a green arrow pointing to a deviated septum.  The nasal passages are otherwise pretty normal!

 

 

 

 

 

 

 

 

 

 

 

 

The CT showed brachycephalic conformation, along with the other noted observations shown above.  Cuddles’ owner is currently investigating surgical intervention for the soft palate to see if there’s an opportunity to improve her quality of life.