Diagnosis and fluoroscopic balloon dilation of nasopharyngeal stenosis concurrent to chronic displacement of the epiglottis in a pet rabbit

A 4-year-old, male neutered rabbit presented for chronic, antibiotics non-responsive upper respiratory disease. Computed tomography revealed sinusitis and nasopharyngeal stenosis resulting in upper airway obstruction. Deep nasal culture grew Pasteurella multocida. Airway fluoroscopy, performed with the rabbit conscious in a standing position, confirmed the location of the obstruction and subtle open mouth breathing. Pharyngoscopy further confirmed epiglottic displacement. In addition to antimicrobial therapy, three fluoroscopic balloon dilation procedures were performed to address the nasopharyngeal stenosis. Clinical signs improved during treatment course, and epiglottic displacement was resolved at the time of the third procedure. The rabbit was healthy 18 months after the last procedure. Nasopharyngeal stenosis should be considered a differential diagnosis for upper respiratory signs in rabbits. This rabbit was likely able to breathe through the oral cavity due to chronic epiglottic displacement secondary to the upper airway obstruction. Fluoroscopic-assisted balloon dilation was successful to treat this condition.