Also, you could have a a regular dog and cat and maybe a parakeet in the same room as the throatfucker scene is filmed. You could cut back and forth between the pets reactions to the sounds the woman's UPSIDEDOWN head makes. Maybe imply they are her pets somehow (no dialogue, please). And you know what, with some creative editing, some quite fine effects could be achieved. I'm think specifically of overlaying a shot of the parakeet fluttering around its cage as if alarmed with a soundtrack of a particularly nasty hack/cough/wheeze/gag from the throatfuckered woman.