In chronic cases in which the laryngeal cartilages have become inflexible, removal of the elongated soft palate and laryngeal saccules may not provide enough relief. Post-operative coughing and gagging are common. Pets are usually observed in the hospital for at least 24 hours. Occasionally a tube must be placed and maintained through an incision in the neck into the trachea (temporary tracheostomy) until the swelling in the throat subsides enough that the pet can breathe normally. Significant inflammation or bleeding can obstruct the airway, making breathing difficult or impossible. Pets must be monitored very closely immediately after surgery. Your primary care veterinarian may also recommend chest x-rays to evaluate your pet’s lower airways and lungs. Everted laryngeal saccules look like blue-gray soft tissue masses protruding into the airway just in front of the vocal folds (Figure 4). In chronic cases, the cartilages of the larynx become inflexible and begin to collapse, further narrowing the airway. The tip of the soft palate and the edges of the larynx are often inflamed (swollen and red). In severe cases the soft palate will extend directly into the laryngeal opening. Under anesthesia, elongated soft palates extend past the tip of the epiglottis (the entrance to the airway). Attempts to restrain the patient and retract the tongue sufficiently to allow visualization of the larynx are generally unsuccessful. Generally, brachycephalic breeds have a thick tongue that makes visualization of the larynx in an awake animal very difficult. Definitive diagnosis of both elongated soft palate and everted laryngeal saccules can only be made with the dog under anesthesia. Stenotic nares can be easily diagnosed on physical examination (Figure 3).
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