Ala vestibuloplasty for treatment of feline brachycephalic syndrome: a description of the procedure and long-term outcomes in 27 cats.

ObjectivesThe aims of the study were to describe a technique for feline ala vestibuloplasty and report long-term postoperative outcomes in 27 brachycephalic (BC) cats.MethodsThe study was a retrospective, questionnaire-based study of owned, clinically affected BC cats (n = 27). Owners completed a single, two-part questionnaire regarding presence or absence, frequency or severity of clinical signs before and more than 6 months after ala vestibuloplasty. The questionnaire consisted of questions regarding respiratory and gastrointestinal signs, sleep and activity-related behaviors, and ocular, aural and dental health before and after surgery. Response options were scored and individual scores summed to give a total clinical severity score for each cat (range 0-129). Relationships between clinical variables and outcome were evaluated by regression analysis. A total of 13 cats in the cohort were also enrolled in a previous questionnaire-based study reporting real-time preoperative clinical signs. Owner responses regarding preoperative clinical signs gathered at that time and in the present study were compared to assess for recall bias.ResultsOf the 27 cats, 25 (92.5%) sustained long-term clinical improvement for a mean of 1190 days (range 354-1802 days) after ala vestibuloplasty. Median clinical severity score improved from 48 preoperatively to 17 postoperatively (P <0.0001). Owners reported reduced frequencies of sneezing (P <0.0001), coughing (P = 0.001), nasal discharge (P = 0.0002), snoring (P <0.0001), open-mouth breathing (P = 0.001), dyspnea (P = 0.0001), difficulty eating (P = 0.04), messy eating (P = 0.01), dyspnea while eating (P = 0.003), regurgitation (P = 0.03), vomiting (P = 0.03) and dyspnea during activity (P = 0.007). Owners also reported increased frequency (P = 0.0002) and duration (P = 0.0004) of activity. Owners of cats enrolled in both studies recalled their cats' preoperative clinical signs as slightly more severe than originally reported.Conclusions and relevanceAla vestibuloplasty yields long-term clinical improvements in cats' respiratory, gastrointestinal, sleep, activity, aural and ocular signs. Ala vestibuloplasty should be considered for effective treatment of the described clinical signs of feline BC syndrome.