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Date:   03 September, 2014  
Focus: Small animals - dogs, cats, hamsters, guinea pigs, turtles & rabbits


The young Beagle barks
and barks every few minutes   

Dr Sing Kong Yuen, BVMS (Glasgow), MRCVS
First written:  30 June, 2013
Date:   03 September, 2014 
Be Kind To Pets
Veterinary Education
Project 2010-0129

Sunday, June 30, 2013

Ventriculocordectomy (devocalisation) of a Beagle using the laryngotomy approach

Devocalisation in a Beagle

"The Vet book makes it sound so easy," I said to Dr Daniel as I was preparing to operate on this rarely done surgery using the laryngotomy approach. "Pull out the vocal cords, cut it and suture the ends of the excised folds. There is a very small space to operate and after excising the vocal cords, the ends shrink and there is no possibility of suturing. I use electro-excision to control bleeding. But there is always a lot of bleeding in this surgery."

Sometimes I wonder whether the author of the article in "Small Animal Surgery 4th Edition, Theresa Welch Fossum" has ever done this surgery in the dog and actually stitch up the ends of the excised vocal cords, as illustrated in the article.

I have done this operation in racehorses with laryngeal paralysis  at the Singapore Turf Club when I was an equine vet. It was also a bloody surgery. 

For dogs, there is an oral approach which I don't do as there are complaints of ineffectiveness in many cases. It is less expensive.

For this Beagle, he was neutered but he still has a habit of barking the whole day long, disturbing the neighbours. It was either death by lethal injection as required by the authorities or this surgery. I tried to dissuade owners from doing it by training the dog but it is easier said than done (e.g. electric collars, spray collars activated by barking). 

After some weeks, the owner brought this dog in for the surgery.  In my 40 years in practice, I have had performed around 5 of such operations in the dog only in cases of desperation by the dog owner. It is not a surgery I will do as it is deemed cruel to dogs.

The operation is recorded to share my experience with other vets researching the internet for such cases.

Domitor + Ketamine at 80% of the calculated weight via the IV drip.* 
Dom = 0.45 ml + Ket = 0.56 ml IV at 80%.  5 years old,  14 kg bodyweight.
Atropine 1 ml IM after that. Isoflurane gas + O2 via a smaller endotracheal tube (size 6) so that it can be pushed to one side to access one of the vocal cords for excision. 
Maintenance dose as high as 3.5%.
*Dog went rigid and head extended after Dom + Ket were given via the IV drip. Duration of a few seconds. Atropine 1 ml IM given. No recurrences of excitement.

Electro surgery use to incise the skin, separate the sternohyoid muscles and incision of the midline of the thyroid cartilage and to excise the vocal folds.

The dog's head is place over a bottle to extend his neck.
Electro-excise skin and midline of the sternohyoid muscles retracted
Midline of thyroid cartilage electro-incised. The endotracheal tube could be seen taking up 50% of larynx

My assistant retracted thyroid cartilage so that the vocal folds could be seen. As the laryngeal space is so small, it is extremely difficult to see the depression in which the vocal folds reside. Insert the forceps into this depression slit and pull the vocal fold (around 1 cm x 8 mm across in this Beagle) out with the forceps.

View cranially and laterally into the laryngx for a depression slit. Use forceps to pinch out one tip of the vocal fold. Another forceps clamp below. Pull out as much as possible. I used the electro-excision to cut off the fold above the forceps and below the forceps whenever possible.

No stitching of the mucosa of the cut off vocal folds as stated in the Vet book as there is not much space to manipulate. This was not done by me in all my cases.

Lots of bleeding from the surgical areas, into the endotracheal tube and lungs. I was unable to stem the bleeding as it was not possible to locate the bleeders. The left vocal fold area has lesser bleeding. This profuse bleeding has been present in all the past cases including the horse. I stitched up thryoid cartilage, sternohyoid muscles and skin. I injected Antisedan to wake up dog after surgery. Bleeding continued to flow out from the nostrils for over 30 minutes after surgery.       

UPDATE ON JUL 6, 2013. The dog went back on Day 3 after surgery and to date, at Day 7 after surgery, no complaints were received from the owner. This case report is written to share knowledge of the ventral approach to devocalisation in the dog as it is rarely done. As debarking is deemed cruel to dogs, I discourage this surgery. The laryngotomy approach which is more effective than the oral approach. 

Most barking dogs in Singapore apartments are generally euthanased if the owners have been summoned by the authorities to get rid of them, owing to complaints by neighbours who may be working night-shifts or have babies needing silence. Training to change the anti-social behaviour and neutering are advised by me and only when the owners have no success will this surgery be done.  I do not perform this surgery unless the dog has to be euthanased, not being renewed in its licence or evicted under the terms and conditions of the regulatory or housing authorities.


Debarking - Ventral and Oral approaches in surgery and Alternatives

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