Upper Airway Obstruction in Cats : Diagnosis and Treatment

Clinical signs of upper airway obstruction provide valuable information regarding the degree of airway compromise and the anatomic compartment involved but are not specific to any disease process. The purpose of the diagnostic workup is to determine the extent and nature of the condition. The extent of the physical examination depends on the degree of upper airway obstruction, and complete evaluation may need to be postponed until the patient is anesthetized. However, rapid assessment of respiratory impairment is crucial because it allows appropriate triage of patients. In cats with mild upper airway obstruction, radiographs of the thoracic and cervical areas may be obtained with the patient either awake or under sedation. A complete oral and laryngeal examination should be performed with the patient under anesthesia. Additional tests may also be indicated. Manipulation of the upper airway in a compromised patient is likely to exacerbate signs; therefore, diagnostic tests and corrective surgery should be scheduled under the same anesthetic episode. This article describes the corrective surgical techniques for obstructive airway diseases. Although these techniques may be technically demanding, they do not require specialized equipment and, depending on the nature of the disease, often provide good results. Clinical signs of upper airway obstruction are variable and not specific to any disease process. Signs may help to localize disease, but a thorough diagnostic approach is needed to diagnose the condition. The severity of signs will depend on the degree of functional obstruction and will dictate the initial therapeutic approach. On presentation, triage should be conducted immediately so that patient care can be prioritized accordingly. Cats with severe upper airway obstruction should be anesthetized and intubated as quickly as possible. Placement of a cricothyrotomy tube or emergency tracheostomy should be limited to patients that cannot be intubated and that require bypass of the larynx. Diagnostic evaluation should be performed after respiratory function has imCE ■ Flexible endoscopy is valuable for evaluating the choanae, nasopharynx, and subepiglottic