Vocal fold granulomas are not an uncommon entity in brachycephalic dogs and can contribute significantly to their morbidity. They can sometimes be mistaken for malignant conditions. Characterization, identification of potential causes and determining therapeutic options were the goals of this prospective study.

Subject of the study were dogs that were presented for treatment of brachycephalic syndrome and showed granulomas. We assessed preconditions such as regurgitating, vomiting or concomitant GI-disease, width of the rima glottidis and presence of everted laryngeal ventricles. Therapy consisted either of surgical removal or antacids or both.

Thirty-four dogs with vocal fold granulomas were presented to our clinic from October 2007 to October 2011 (29 French bulldogs, 3 pugs, 2 English bulldogs). Most dogs showed regurgitation of different grades, 6 were diagnosed with IBD or food allergy. Pugs showed only very small bilateral contact granulomas which did not require any treatment. 7 of the bulldogs had a large unilateral granuloma that impaired airflow considerably. Small granulomas were associated with smaller intralaryngeal lumina. Most dogs had at least moderately everted laryngeal ventricles. Regurgitation and concomitant diseases such as IBD were associated with larger granulomas.

Eighteen dogs received antacid therapy. Surgical removal was conducted in 17 dogs. Six-month follow-up was available for 17 dogs. Recurrence was seen in 6 dogs, 3 of which necessitated a second removal. Dogs that were treated more recently by laser ablation and with a longer course of antacids did not show recurrence. Dogs with small contact granulomas that did not receive any treatment had unchanged size of granulomas.

Histopathology was available for 6 cases and revealed benign granulation polyps.

Vocal fold granulomas can be easily misjudged as a malignant condition because they are often ulcerated, can be of large size and obstruct the laryngeal lumen. One should be familiar with this entity because it is a treatable condition and not rare in brachycephalic dogs. Regurgitation as one symptom of brachycephalic dogs that mainly affects bulldogs seems to play an important role in the development of granulomas. After surgery for brachycephalic syndrome and treatment of underlying conditions such as IBD or food allergy, regurgitating often decreases. For therapy of laryngeal granulomas, we currently recommend a combination of granuloma removal, surgical treatment for brachycephalic syndrome and antacid drugs amongst treatment of underlying conditions.