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Interesting Cases

Ventral Bulla Osteotomy (VBO): Surgery on the cats right ear to resolve a chronic suppurative discharge

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Our feline patient is Onslow Hobbes ( OH ), who is on a very effective diabetes mellitus treatment program. He is a domestic  shorthair born May 1st, 2009 who had an ongoing (4 months plus)  suppurative/exudative right ear until a ventral bulla osteotomy (VBO) was performed in combination with a myringotomy in March, 2021. All reasonable steps were taken prior to surgery in cooperation with the owner and our hospital team to establish an accurate diagnosis and alleviate the persistent discharge from the right ear. Extensive treatment included:  multiple antibiotics both systemic and topical directly into the ear, aerobic/anaerobic cultures, anti-inflammatories and skull radiographs. A diagnosis of otitis media was established early in the treatment. The chief problem was the the discharge from the ear was persistent, messy and discomforting for the patient. There was a very limited response to an extensive array of therapies/tests over 4 months. It was decided after all reasonable, extensive therapy was provided with minimal result, that surgery had to be the next step.

The common reasons for middle ear discharge in the feline include the following: polyp, neoplasm, foreign body and exudative sterile or bacterial inflammation. Note that any of these differentials listed would most likely be the reason for conservative treatment failure, the need for imaging and investigative surgery.

A ventral bulla osteotomy with a myringotomy was performed on March 4, 2021 on the right ear. The secretory tissue was debrided inside the bulla and the area opened to allow all exudative matter to escape.

Onslow Hobbs’ recovery was uneventful and the ear remains discharge free since surgery. In addition, there were none of the side effects that are commonly expected as a result of this type of procedure eg. Horner’s syndrome.

The owner continues to manage OH’s diabetes with insulin (Glargine 3 units 2 times per day), a strict diabetic diet (PVD DM Purina) and a home environment rich with encouragement and love.

Staffs’ recent conversation with this thankful owner in September, 2021 says Onslow Hobbes is doing amazing!

OH and home life.

white dog with big ears

“Smelling the Roses” Watt, Oliver and many others after early Bachycephalic Surgery (BOAS)

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Brachycephalic Obstructive Airway Syndrome (BOAS) is a result of many soft tissue factors directly related to design with shortened skull bone length .  Various breeds are recognized as brachycephalic including Boston Terriers, Shih Tzus, Boxers, English and French bulldogs, Lhasa Apsos, Pekingese, Pugs and Shar Peis.  It should be noted that not all brachycephalic breed dogs suffer from this syndrome.  Bulldogs are usually the most severely affected.

The primary soft tissue abnormalities are stenotic nares and soft palate elongation. The secondary changes include eversion of the laryngeal saccules (Stage 1 laryngeal collapse), further elongation of the soft palate, tonsil enlargement, more advanced irreversible laryngeal collapse and often gastrointestinal symptoms.  These changes can be halted by early surgical correction of the primary airway obstructive problems.  Stenotic nares may be the only issue that needs correction.

Stenotic nares is a congenital abnormality where the nostril diameter is diminished and therefore reduces airflow as the pet breathes.  BAS is a progressive disease and the best treatment is an early treatment. Air passage through the nasal cavities accounts for approximately 75 % of total airflow resistance in dogs. It is a known fact that a 50 % reduction in tube radius (the narrow nasal opening ) leads to a 16 fold increase in resistance to air flow. (Poiseuille’s Law)

BOAS individuals may have laboured breathing example, snorting, noisy breathing, gagging etc….. as they struggle to obtain sufficient oxygen.  The reason this occurs is due to the excessive negative pressure that occurs with every breath they take.  With their airway pathway being reduced, the individual exerts this negative pressure during inspiration in attempt to maintain air flow which distorts the pharyngeal tissue.  This results in a vicious cycle of more tissue stretching, swelling and more severe laryngeal collapse. It just goes from bad to worse!

Here are two recent surgical cases that have been performed at our Mississauga hospital that have greatly benefited from early corrective upper airway surgery! In the majority of cases once corrective surgery has been performed, the dog has carefree, effortless breathing with a much more active, healthier lifestyle.

 

 

1) Wyatt is a male, neutered, English Bulldog, who had BOAS surgery when he was 7 months old.

Structural findings were as follows:  (All these features are visible in the photos)

  • Severe stenotic nares ( surgical correction)
  • Laryngeal saccule eversion/Stage 1 Collapse ( surgical correction)
  • Inwards position of the aryepiglottic folds/Stage 11 Collapse)
  • Enlarged tonsils
  • Normal length to soft palate with a deformed shortening on the left side.

It's my good looks that most people adore!     A view of Wyatt's Larynx during surgery Wyatt Evans Pre Op WebNostrils opened surgically

                        A view of Wyatt’s Larynx during surgery

 

Wyatt’s photo clearly demonstrates that his good looks will forever be adorned.

 

2) Oliver is a male, neutered, French Bulldog, who had BOAS surgery when he was 5 months old.

Structural findings were as follows:

  • severe stenotic nares (surgical correction)
  • laryngeal saccule eversion (surgical correction)
  • enlarged tonsils (common)
  • normal length soft palate

Oliver Batchelor Web    Oliver Batchelor Mid Op WebOliver Batchelor Pre Op Web   Oliver Batchelor Post Op Web

 

In this photo Oliver’s nose has completely re-established pigmentation 2 months later.

 

It is expected that both these pets will do very well in life now that corrective surgery has created a good airway!
Time does fly when every day counts. Both these dogs have maximum activity and ability to breath-September 2017

 

 

Key Points:

1) Owners always comment that after surgery as in the case of Wyatt and Oliver smelling everything is a new found gift.

2) People always say that they are surprised that their dog doesn’t make any noise when he/she breathes.

Pleased note that these advanced airway surgeries are done at both our animal hospitals in Mississauga and Oakville.

Our health care team at Southdown Animal Clinic in cooperation with Wyatt and Oliver and their respective parents are proud to share their success stories.

 

My name is Mason (French Bulldog) :

 

My name is Brock: I am also a Frenchie and I am Mason’s brother. We both had stenotic nares surgery (BOAS) on the same day!

My name is Leo (Shih Tzu):

Pre and post surgical appearance of stenotic nares surgery

 

My name is Finn:# 10011  I am a male Pug, born on Feb 28, 2021. My parents describe my personality as perfect. It is just that my breathing has always been a problem.

I had stenotic nasal surgery (Rhinoplasty) in the month of September 2021.

 

Pre surgical photo along with immediate post surgical airway opening as illustrated in photos.

The owners noticed immediate benefits. The most obvious findings are that Finn’s breathing is now quiet and has a lot more energy.

(Sutures removed on Oct 1, 2021 under a light anesthesia)

 

 

 

 

 

 

 

Cherry EYE: Surgery to save my TEARS

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The importance of sufficient tear production is a critical part of keeping a healthy ocular palpebral opening. For these prolapsed bulbous nictitans gland of the third eyelid (cherry eye) a surgical

procedure that anchors the gland in a creative pocket is the desirable treatment.

The gland of the third eyelid produces large portion of the aqueous tear film, it is believed to be 30- 50 %.

We have provided photos of before and after surgery for 2 recent cases with both eyes involved.

 

 

               

My name is Champ C #9494 : I am a one year old Bulldog born May 2020.

 

 

 

My name is Bella K #9412. I am a Saint Bernard x, born March 27, 2020.

big eyed cat

A Kitten with a Ear Tumor : Major Surgery and Immediate success.

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Harry is a happy and thriving 7 year old male neutered Abyssinian cat. When we first saw him and his brother Ryley for their first kitten appointment in November 2013, he was not doing quite so well. Harry presented with a bad eye infection, nasal congestion and discharge, and an ear infection. On physical exam we noted that there was an infection in both eyes and inflammation in the left eye. The nasal discharge and congestion were worse on his left side, and the ear infection present affected the left ear only. Once the debris was cleaned away we could see a fleshy, lobulated structure deep in the canal: this is called an aural polyp (Ear Tumor). In this case we suspected a viral cause based on his combination of signs and the particular concerns with his eyes. Harry was put on antibiotics to control secondary infections of his upper respiratory tract and ear, and antibiotic drops for his eyes. He was also put on some antiviral therapies to mitigate the viral component of his issues. The polyp in his ear continued to grow with time, totally blocking the  canal so surgical removal of the polyp was recommended.

Harry underwent surgery at our Mississauga (Southdown) hospital to the remove the tumor (polyp) inside his left ear by a procedure called a Ventral Bulla Osteotomy (VBO). This a very detailed procedure in which an incision is made at the base of the bony structure of the ear, just behind the lower jaw. The sensitive muscles, blood vessels and nerves that supply the head and face must be dissected very carefully to access the bony base of the ear canal (bulla). Once this landmark is reached special instruments are used to open the bulla which then allows access to the middle ear. A swab is used to take a sample of the internal contents (including pus) and is submitted for culture. In Harry’s case pus, necrotic debris and the stalk of the polyp were found in this location-the middle ear. Culture of the fluid showed mycoplasma-like species. The stalk of the polyp was cleanly transected within the delicate middle ear and the entire mass was freed to be removed through the external ear canal. The bulla was scraped clean with mini curette/small osteotome then lavaged several times with saline and the overlying muscles, subcutaneous tissue and skin closed with sutures. The opened area in the bulla is left open permanently and a special drain is placed temporarily to facilitate healing.

Ear Tumor: Surgery VBO

Ear Tumor dissected free of the middle ear and removed through the outer ear

 

Harry spent the next few days in hospital then was sent home for his owner to continue care. He bounced back, and has not looked back since.

Our clients have provided the following comment for this article in December 2015 and an brief overview of the experience: “Harry is now 2 years old and a vibrant mischievous boy that is the love of our lives. Although Harry’s early days were extremely difficult, fraught with numerous visits to the clinic, near death experiences and several surgeries, through all of this we never gave up hope that he would survive this ordeal. He has flourished with the tireless care provided by his family and the dedication by the talented Southdown Veterinary Team!

Key Points:

1) Polyps are uncommon in cats

2) In young cats (<2 years old), they are usually associated with an underlying virus

3) Polyps can grow in the ear, nose and throat

4) Polyps are usually benign (non-cancerous) fleshy growths that are infiltrated with inflammatory cells

5) They usually cause copious amounts of pus to be produced and are associated with a secondary bacterial middle ear infection

6) Polyps can also cause nasal discharge, sneezing, pain, voice change and other symptoms

It has been approximately 1.5 years since Harry’s major ear surgery, following 3 to 4  months of health problems as a kitten. Harry and his brother visited our clinic/veterinary hospital for their Annual Health Check in early December 2015 and received excellent health reports. This video shows the beauty of the individuals and their preparation for the trip home from the veterinarian’s.

The year 2021 and Harry continues to live life at its best!

 

The is a near post pandemic updated report to July 22, 2021 . Harry has never had any ears problems since surgery several years ago!

August 2021: As expected their regular visits to our hospital always brings out just a small tincture of their vibrant feline personalities!

 

white dog with eye issue

Surgery for chronic prolapsed THIRD EYELID GLANDS (Dog) : EYELIDS can now be fully CLOSED*

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  Chronic Cherry Eye PRE SURGERY Modified Pocket T.Midge is a 5 year old spayed female Yorkshire Terrier mix that has had prolapsed glands of the third eyelid for 3 years. The prolapsed gland appears as red masses (also know as Cherry Eye) that protrude from behind the third eyelid( Midge in pre:surgery photo).This gland is vital for aqueous tears. Surgical replacement of the prolapsed glands of the third eyelid was reviewed with the owners in detail before proceeding with surgery.  The advantage of the Modified Morgan Pocket technique is that it allows the third eyelid to move normally after surgery. There are a number of key fundamental steps to ensure optimum success with this procedure including attention to detail suturing and innovative thinking. It is important to note that Surgical Treatment For Dogs with Nictitans Gland Prolapse of several months’ duration has a less favourable prognosis for success.  We fully discussed  the benefits of surgery with the owners and the possibility of unsuccessful results.  We always approach these cases with favourable outlook and with goal of excellent results. Surgery was performed  in our surgical suite at our  Mississauga Hospital  (Southdown Animal  Clinic) on  October 07, 2016.This technique uses the scar tissue of the subconjunctival to hold the gland in place. Things that must be considered for a successful outcome: 1) Schirmer tear test-that measures that for adequate tear production is still good ( greater than 16 mm/minute ). 2) Use of topical steroids for 1 to 3 months to reduce inflammation and swelling of the nictitans gland before surgery. 3) The sooner surgery is done after obvious prolapse of the glands the higher the success rate. We are always reluctant to unequivocally state that something is beyond hope no matter how chronic. There are a tremendous number of variables that enter into the picture. 4) Attention to detail in surgery. 5) The bodies ability to heal. 6) With the Pocket Technique once the gland stays down for 30 days then it most likely will stay down permanently 7) The breed of dog maybe a factor; for example,  the British Bulldog may have a higher failure rate. The owners comments on the last follow up at 6 weeks post surgery: “It is the first  time in many months that Midge has been able to sleep with her eyes closed!” Midge has done amazing well with perfect vision up to the time of this update September 2017.

 

Prolapsed Gland of 3rd Eyelid in Place Chronic Cherry 7 days PO Surgery #6493-2Cherry Midge 6 weeks PO(9) copy

Exophthalmia Eddie Pug

This Is An Eye Popping Read!

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Eddie presented to Southdown Animal Clinic for his initial puppy examination and vaccinations at 14 weeks of age.  On physical examination our primary concerns included his eyes and his nostrils.  Eddie had shallow eye orbits causing exophthalmos (bulging of the eyes) such that he was unable to close his eyelids.  Since he was unable to close his eyelids his corneas were exposed at all times to the environment leading to abrasions on the surface of the eyes, redness of the conjunctiva and dryness of the surface of the eye.  There was also minimal tear production in both eyes.  Eddie had stenotic nares (narrow nasal openings) leading to difficulty with breathing.  Eddie was started on medications to treat the abrasions on his corneas and to keep the eyes lubricated.

Eddie was scheduled for surgery. We elected to do multiple procedures – neuter, stenotic nares correction and eyelid surgery.  Check out our other posts for details on stenotic nares surgery.  For surgical correction of the eyes we elected to do a tarsorrhaphy, which is a surgical procedure in which the upper and lower eyelids are partially sewn together to narrow the eyelid opening.  Once the eyelid opening is narrowed the cornea is able to heal.

As you can see in this photo Eddie’s eye is bulging out of the socket and the upper and lower eyelid are so far apart, hence unable to close.

The left eye has been surgically corrected by carefully suturing the upper and lower eyelid medially.  Great care must be taken to not incorporate the tear ducts into the suture line.

Both eyes have been surgically corrected.  As you can see the upper and lower eyelids are now closer to each other and once the swelling is gone he will be able to close them for the first time!

Eddie has a new face! He will now be able to blink and he will be able to breathe better now that his nares have been opened up.  This is Eddie the next day.  Both eyes and his nares were surgically corrected. He also got neutered. He is just so very cute!!!

Eddie recovered very well from his surgical procedures and is a happy puppy!

 

 

4 Month Old Guinea Pig with Leg Injury

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Dexter is a male, 4 month old smooth-haired guinea pig who came to us because of an injury he sustained to his right hind leg. He got his leg stuck between the bars of his cage which caused bruising and limping. On physical exam his right hind foot was swollen, bruised and painful and he was having difficulty walking. The swelling and bruising extended up just beyond the tarsal (hock) joint. There was also grinding palpable in the hock joint.

Our next step was to take xrays of his hind feet and hocks. Both hind legs were xrayed in order to provide a comparison of normal and abnormal structures. The images taken revealed moderate soft tissue swelling of the right hind leg extending from the digits to the tarsal (hock) joint. There was also a dislocation at the tarsal-metatarsal joint. Treatment options discussed with the owner included surgery (pin or wire placement to maintain the joint in proper alignment) or splint placement. A splint was decided on.

Dexter’s leg was held in alignment while the splint was placed. This included a layer of soft cast padding followed by the custom-molded splint. The toes were left visible but protected so that Dexter’s owner could check to make sure there was no abnormal swelling or discolouration. Dexter was also sent home with a pain and anti-inflammatory medication that he loves to eat with his lettuce. The splint needs to stay in place for a minimum of 4 to 6 weeks.

So far Dexter has adjusted very well to having a splint on his hind leg. He is full of energy, eats very well and is not letting his injury get in the way of making the most of life! Dexter’s family has been diligent about giving his medication and checking his toes to make sure that he is not developing any complications. We expect Dexter to make an excellent recovery.

mouse

A Young 80 gram Chinchilla: Life Saving front leg amputation

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Chin LF PO Jasper All 80 grams (3 Legged)

Jasper on a revisit to our hospital 1 month after surgery-Happy and very energetic.

Canadian Chinchilla Rescue (Canada). Jasper still rocks with enthusiasm and with optimum mobility in the year 2019. It all happened Summer 2014 when an 80 gram chinchilla came to us at Southdown Animal Clinic under the guiding care of “TLC” an individual with Chinchilla Rescue, Canada.  Jasper was just a baby Chin, D.O B. April 19.2014 with a big problem! The left front leg was useless/non-functional with no blood or feeling in the lower extremity. This most likely would have been the result of limb entrapment (strangulation). These guys  are very gregarious and the environment must be safe. Our clinical finding was a strangulated/devitalized left front leg with no chance of recirculation. The recognized descriptive diagnosis would be gangrene. The only chance for survival and a future was major surgery. Authorization to proceed was given for live saving surgery which meant a complete limb amputation. Key Points: 1) Chinchillas are very active acrobatic animals and require lots of safe space/housing for play, climbing, jumping etc.. 2) Everyone deserves a chance to experience the beauty of life. 3)  The advances in modern day medicine in the areas of anesthesia, pain management, current therapies and the competency/skill of the surgical team makes anything  possible. 4) Youth, age, mini size should not be a deterrent -do no harm and just do it! 5) Conversation in August 2015 with TLC speaks to the success and the great uninhibited life that this nearly 500 gram individual lives.  A  more recent conversation in April 2016 with “TLC” indicates that for this individual it is all great!

CHIN Presurgery LF (2)

Minutes before the anesthetic encouragement with the support of loving hands.

Chinchilla LF Surgery Table

Ready to proceed with surgery while under a general anesthesia

 

CHIN Surgery Team LF (7)

Our Mississauga veterinary surgical team in action in surgical suite at Southdown Animal Clinic

Pet Surgery

Disc Disease (IVDD)-After acute paralysis and back surgery- Rue (Rue update-Nov 15)and Peika are “Walking the Line” again.

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We are please to share Peika’s ( a Shih Tzu, female, D.O.B. April 15, 2006 ) and Rue’s story (a Coton De Tulear, female D.O.B September 13, 2011) who both have experienced thoracolumbar disc disease with spinal cord compression, pain, hind leg paralysis and expedient recovery after back surgery here at our Mississauga Hospital/Clinic. Surgical  intervention was the best choice for both these dogs as both had been staged Grade 4 paraplegics. This means the inability to move hind legs (non ambulatory) but still with nociception in place (the ability to feel pain). Surgery within the shortest time period 24 to 72 hours after the acute insult and major neurological dysfunction gives the best prognosis for a full recovery. This is what happened here in both these pets. The ability to stand followed by the ability to walk somewhat was within 24 hours to 5 days in Peika’s and Rue’s cases respectively.

Rue and Peika are typical family pets who live great lives, live for the moment, cherish exercise and thrive on family affection.

Rue-Media Disc T12-13 IVDD web

Rue’s survey radiographs indicate a suspect lesion at T12-13

Peika Henderson Survey T13-L1 Web YES

Peika’s survey radiographs with a suspect lesion at T13-L1

 

Rue #3_ mediaSzostok DYE extradural lesion

Rue’s Myelogram: Confirming a compressive lesion at T12-13

Peika_Henderson  YES DYE web T13-L1

Peika’s Myelogram: Confirming a compressive lesion at T13-L1

 

Note: The #’s below correspond to findings on Rue’s survey radiographs above.

The survey radiographs of both patients have evidence of disc disease as follows:

1) Narrowing of the disc space

2) Narrowing of the intervertebral foramen

3) Collapsing of the articular facet(s)

4) Increase density (calcified disk) of disk material at the site or adjacent disk spaces

The myelograms of both patients are excellent and identify the problem area precisely:

1) Dye in the columns which is in the subarachnoid space (meninges) around the spinal cord.

1) Elevation of the dye in the ventral column

2) Narrowing or absence of contrast material through the ruptured disc area

In both these cases we were able to not only identify the problem area on survey radiographs but confirm precise compression of the spinal cord using contrast dye by performing a L4-5 lumbar myelogram.  Surgical dorsolateral hemilaminectomies + fenestration of the specific problem disc were performed immediately following confirmation in both cases.

Video 1 show Rue with no ability to walk minutes before having her back surgery.

Video 2 shows Peika 48 hours after back surgery with the ability to stand and take steps forward.

Video 3 shows Peika 21 days after back surgery demonstrating mobility without pain.

Key Points;

-Chondrodystrophoid breeds of dogs such as Rue and Peika are more prone to disc disease.

-Grades 1 and 2 are good candidates for conservative/medical management including the use of Class IV laser therapy

-All severe Grade 3,4,5 disc cases should be regarded as surgical emergencies

-Neurological grading of disc disease is one critical determinant as to the ideal treatment plan.

Grade1-no deficits/pain only, reluctancy to move

Grade 2-paresis/walking-wobbliness with mild ataxia but does not fall

Grade 3-paresis not walking, falls, an inability to bear weight

Grade 4-paraplegic with deep pain sensation,cannot move legs (no motor function) even when supported (non ambulatory), urinary incontinence

Grade 5-parplegic with no pain sensation (nociception)

 

It is always very exciting for our caring staff at both our Southdown Animal Clinic and Oakville Animal  Clinic to see legs moving, a pain free status and ultimately the ability for the pet to “walk the line” again with their love ones.

Rue 1

Rue’s Puppy Photo

Peika 1

Peika

 

 

 

 

 

 

 

 

It has been nearly one year since Rue had surgery for a compressed spinal cord. We are please to provide the client’s update.

Hello,
“We were just talking today about how it is coming up to a year that she had her surgery. We can’t thank you enough for all that you have done for her. You would never know that a year ago she couldn’t walk. Her recovery has been incredible. We are so happy and grateful to have her still in our lives.”
Thanks again,
The Family

Video provided:

British Bulldog

Mack- Major Upper Respiratory Tract Surgery (a 5 year old English Bulldog)-and 4 years later doing WELL!

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Mack is 5 year old male neutered British(English) Bulldog who has always exhibited all the enthusiasm for life that this breed is known for. In the last few years this level of joy had become markedly muted as his breathing became progressively difficult with any degree of exercise or excitement. This summer the owner noted that Mack’s respiratory distress had become more troublesome and appreciated that something had to be done to help Mack.

On presentation to Southdown Animal Clinic Mack’s symptoms were classical of advanced brachycephalic airway disease with stridorous/sterterous breathing, exercise intolerance, frequent retching, choking and gagging up of phlegm, with anxiety and restlessness after any form of exertion. After a full physical examination we performed blood work and radiographs of Mack’s larynx and thorax. Mack was admitted to our hospital for upper airway surgery. Once under general anesthetic we were then able to evaluate the upper airway structures in greater detail to determine the degree of pathology and take an appropriate course of action.

The major findings were as follows:

Severe stenotic nares before surgical interventionSurgical correction of the left stenotic nose

SurgeryElongatedSPMackweb (2) - Copy copy

1) Severe stenotic nares, as pictured above, creating a resistance to airflow

2) Elongated soft palate – approximately 6.0 cm too long

3) Everted laryngeal saccules blocking the lower rima glottis

4) Stage II and Stage III laryngeal collapse

There was no significant redundant pharyngeal tissue, the tracheal diameter was good with no evidence of collapse and the tonsils were within their respective crypts.

Surgical intervention was as follows:

1) Stenotic nares – A combination of a vertical wedge technique and horizontal removal of alar wing tips

2) Everted saccules – Removal of everted tissue-see more recent photo showing #2 and # 4 in the article “Smelling the Roses and a whole lot more after early brachycephalic surgery”.

3) Soft palate – Shortened the elongated soft palate by about 6 cm (> 3.5cm is a lot of redundant soft tissue sucking into glottis on inspiration and back up into the roof of the mouth on expiration) just to cover the tip of the epiglottis

4) Laryngeal collapse – Transect the folded tissue (on one side only) that was obstructing the entry to the glottis which leads directly to the trachea

As brachycephalic airway syndrome progresses many of the secondary components of the disease are irreversible. Mack’s recovery has however been excellent as best described by the owner’s comments (also note the increased size of Mack’s new nares!):

A happier healthier English Bulldog

“Mack is much happier and has more energy. He is sniffing more when outside and now enjoys being outdoors. He has the ability to be included in activities for hours not just minutes and loves going to the leash free park. After the leash free we can’t hear him breathing. He still pants after exercise but no longer has stressed breathing. Mack has a much quicker recovery after activity with no vomiting, choking or gagging. Mack is now able to lie down and rest comfortably, something he could not do in the past after any exertion. It is the best thing we ever did for him- we should have done it earlier!”

Note: That the tissue pinkness just inside the wider nasal opening will re-pigment.

Update: In October of this year 2013, the owners say Max now 7 years old has been given extra years of quality life since upper airway surgery 2 years ago at Southdown Animal Clinic in Mississauga.

Update: Max just had his Annual Health Examination and Screening Test at our Mississauga Hospital in May 2015.  He remains healthy with the ability to breath without distress.

 

Mack lived a very rewarding active life after having airway surgery. It was in the late summer age 11 years, 2017 that he departed with unrelated critical illness.