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Laryngeal sacculectomy is the removal of the laryngeal saccules. An extraction of the saccules is often required for dogs that are experiencing brachycephalic airway syndrome caused by the eversion of the laryngeal saccules. If a canine has everted saccules, the structures may protrude from inside the throat, just above the vocal cords. Veterinarians consider eversion of the laryngeal saccules to be the first stages of canine laryngeal collapse, which can easily result in suffocation.
Prior to conducting the laryngeal sacculectomy, tests will be performed to ensure the canine is healthy enough to undergo surgery. A chemistry profile will tell the veterinarian how the internal organs are functioning, which is important when a surgical procedure needs to be performed. If the dog is in good health, the surgical procedure will proceed with a pre-sedative drug to prepare the canine for the procedure. As brachycephalic dogs experience difficulty breathing, an endotracheal tube will be placed as soon as possible to deliver an adequate level of oxygen to the canine prior to infusion gas anesthetic. The canine will then be taken to the surgical area where he/she will be positioned and prepped for surgery. The veterinary surgeon may require the use of an endotracheal camera to view the inside of the canine’s throat and locate the everted saccules. Once the saccules have been located, the protruding structures that are causing the problem can be firmly grasped using surgical forceps. It is at this time that the vet can remove the saccules using a surgical scissors or a scalpel blade. Bleeding is controlled with gentle pressure and sutures are only placed if the surgeon feels the bleeding will return. The surgical site will then be cleansed with a saline solution before the dog is allowed to return to the recovery area.
Laryngeal sacculectomy in dogs can be very effective if the abnormalities associated with brachycephalic syndrome were detected early and corrected. The overall prognosis for a canine that has undergone the procedure depends on how many anatomic abnormalities are present and the age of the canine.
Directly following a laryngeal sacculectomy, the endotracheal tube used to provide air and gas anesthetic to the patient will remain in place for a duration of time in recovery. Swelling of the airways, hyperthermia, and decreased pharyngeal reflexes are all possible complications of this form of surgery, requiring the patient to remain in hospital care for 24 to 48 hours minimum. Postoperative pain is controlled through a combination of long-acting anesthetics, opioids, and NSAIDs (non-steroidal anti-inflammatory drugs). Antibiotics are not necessary if the canine is otherwise healthy, but a broad-spectrum antibiotic may be given to those with underlying disease. Water will be offered to the patient after anesthesia and the canine will be allowed a soft food diet eight to 24 hours after surgery.
A laryngeal sacculectomy surgery can cost anywhere from $200 to $3,000 to have performed. The cost of the surgery depends on the severity of the dog’s condition and aftercare requirements.
Laryngeal sacculectomy in dogs poses a risk for postoperative swelling of the surgical site, which may interfere with the canine’s breathing. Other possible complications associated with laryngeal sacculectomy are hyperthermia and decreased pharyngeal reflexes. The dog will require adequate monitoring postoperatively to detect these possible complications early, before they can cause the dog severe side effects.
Laryngeal sacculectomy is difficult to avoid in brachycephalic dog breeds, but certain factors do decrease a dog’s chance of undergoing the surgical procedure. For canines with mild or intermittent symptoms, weight plays a large factor in worsening the symptoms of brachycephalic airway syndrome. An appropriate diet and daily physical activities should be set to prevent the need for a laryngeal sacculectomy procedure.
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Hello, I am a veterinary tech in school doing a project about laryngeal sacculectomy. I have some questions to ask about the surgery if it was a worse case scenario. Its a pug that is 3 years old and has serious condition of just laryngeal saccules. What medications would you use to premed and for pain management. What is the protocol for this surgery? What complications could go wrong during surgery and during recovery? Thank you!
July 26, 2017
There are a few different approaches to the surgery depending on severity; in severe cases a tracheotomy would be best to allow the use of inhalation anaesthesia and to easily visualise the saccules without an endotracheal tube obstructing the view. Pain management with corticosteroids (dexamethasone) would also help reduce inflammation and edema. The procedure is pretty straight forward: dog is placed in sternal recumbency; the saccule is grasped with Allis forceps and slight traction is applied and the saccule is cut either with scissors or with electrocautery. Further details regarding the surgery can be found on the link below or in Slatters Textbook of Small Animal Surgery p.977. Regards Dr Callum Turner DVMhttps://vetfolio-vetstreet.s3.amazonaws.com/59/5cda70a41911e087120050568d3693/file/PV0511_Trappler2_CE.pdf
July 26, 2017
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