A Shetland Sheepdog was diagnosed with acquired nasopharyngeal stenosis after exhibiting upper respiratory tract signs following laparoscopic ovariectomy, during which she regurgitated gastric contents into her nasal cavity. Extensive imaging and balloon-dilated, nasopharyngeal, covered stent placement were performed. Subsequent stent failure and loss necessitated a second procedure, during which surgical entrance through the palate and debridement of scar tissue was followed by placement of a new metallic covered stent. A return of mild signs several weeks later necessitated antibiotic treatment for a suspected bacterial infection. Resolution of signs was briefly achieved, but relapse prompted prescription of additional antibiotics, with the final outcome still unclear. The course of events suggests that severe acquired nasopharyngeal stenosis may require aggressive and multi-faceted approach to facilitate successful treatment.