Case report: Laryngospasm following ethanol ablation of a parathyroid nodule in a dog with primary hyperparathyroidism

Abstract

A 12-year-old female spayed dachshund was presented for emergency assessment of respiratory distress, characterized by inspiratory dyspnea with stridor. Percutaneous ultrasound-guided ethanol ablation of a functional parathyroid tumor was performed 72-h earlier for management of primary hyperparathyroidism. The dog was hypocalcemic (ionized calcium 0.7 mmol/L, reference interval: 0.9-1.3 mmol/L) at the time of presentation and had evidence of laryngospasm on a sedated oral exam. The dog was managed conservatively with supplemental oxygen, anxiolysis, and parenteral calcium administration. These interventions were associated with rapid and sustained improvement in clinical signs. The dog did not demonstrate any recurrence of signs afterwards. To the authors' knowledge, this is the first description of laryngospasm following ethanol ablation of a parathyroid nodule in a dog that developed hypocalcemia.

Keywords: ethanol ablation; hyperparathyroidism; hypocalcemia; iatrogenic; laryngospasm.

Figure 1

(A, B) Images of the larynx obtained under a light plane of anesthesia following the administration of butorphanol and alfaxalone in the dog 72 h after percutaneous ultrasound guided ethanol ablation of the parathyroid nodule. Inappropriate laryngeal movement was noted, including minimal movement of the arytenoid cartilages on inspiration (A) and complete closure of the cartilages on expiration (B). No significant perilaryngeal edema or secretions obstructing the airway were visualized. Both left and right sides of the larynx were able to move, albeit minimally, and was most consistent with laryngospasm.