Laryngeal paralysis is a condition that severely impacts a pet’s breathing. In the veterinary world, we tend to call it “Lar Par.”
Laryngeal Paralysis in Dogs: Symptoms and Treatments
The throat is the medical name for the voice box. Please note, it is throat and not “lar-nynx” as lots of people call it. If you’ve ever had a sore throat or laryngitis, then your very own throat was inflamed. The larynx’s job is to close off after we breathe in, open when we breathe in, and once again shut down when we eat and drink so we do not “swallow the incorrect way.” However in pets (especially dogs), when laryngeal paralysis occurs, none of these things take place. Taking a deep breath becomes impossible, and the family pet generally suffocates.
Who is affected by Laryngeal Paralysis?
The typical patient is an older, big breed dog. The poster child is the Labrador, and other typical breeds consist of Golden Retrievers and Setters.
What are the signs of Laryngeal Paralysis?
Lar Par is a very stressful condition to the patient — who undoubtedly does not comprehend what is going on. The dog actually suffocates. Typically, the signs are progressive. The dog pants without exercising, has loud and labored breathing, and burns out rapidly during routine strolls. Guardians might observe that their dog’s voice modifications and sounds hoarse.
Unfortunately, due to the fact that Lar Par frequently happens in older dogs, the signs are typically incorrect for old age and arthritis, which postpones treatment. For that reason, Lar Par patients are typically presented to a vet when they are in genuine difficulty, typically when they can barely breathe. This commonly takes place as the weather becomes hot and humid, and weight problems can exacerbate the condition. At worst, Lar Par can become life-threatening.
What causes Laryngeal Paralysis?
Most of the time, we do not know. This is called “idiopathic” Lar Par. Lar Par takes place due to the fact that the nerves that manage the muscles which act on the cartilage of the larynx are infected. Usually, the condition starts on one side (“unilateral” paralysis or hemiparesis). Just when the condition impacts both sides of the larynx (“bilateral” paralysis) will most pet owners recognize that there is an issue.
How does a vet understand my dog has Laryngeal Paralysis?
A knowledgeable vet or surgeon will suspect Lar Par the 2nd they walk into the examination room. To verify the suspicion, a test of the larynx under sedation is necessary. Under sedation, the mouth is opened and the throat is observed. With Lar Par, the folds of the larynx will not open and close as the patient inhales and out. The folds remain closed — paralyzed. Before this can be done safely, we carry out full blood work and chest X-rays.
What is the emergency treatment?
When a patient presents on an emergency basis, it’s crucial to soothe the patient and offer them with an ample supply of oxygen. This is generally done by placing the dog in an “oxygen cage.”
If the patient’s temperature is actually high from overheating, emergency procedures are required to reduce it. Once the patient is steady, surgery is the best treatment.
What happens in surgery, what is the diagnosis, and exist any complications?
The objective of surgery is to permanently open up the throat to allow more air to get in. These days, many cosmetic surgeons will do a “tie-back” procedure. Usually, surgery involves placing two heavy nylon sutures (i.e. long-term) to open up the left side of the larynx. Just one side is opened up to reduce the risk of goal pneumonia.
In experienced hands, the outcome is typically good. In theory, surgery offers instant relief: with an open larynx, the patient can lastly breathe. Then, of course, the pet has to recover and heal after surgery.
Clients consistently stress over doing this surgery in their older dog. My basic replies are:
- Age is not a disease.
- Lar Par is not a death sentence. It’s a bump along the road, which shouldn’t considerably affect the patient’s life span as long as they do not get aspiration pneumonia.
Coughing is anticipated after surgery, typically after consuming and mainly after drinking. That’s a good thing, as it will hopefully prevent the dog from “swallowing the wrong way.” The voice will change, and barking disappears. Nevertheless, failure of the stitches and a disease in the cartilage of the throat is a rare however severe problem, which is why we insist on confinement, peace, and quiet after surgery. Another serious problem is aspiration pneumonia (likewise called AP). This is a kind of pneumonia due to aspiration, or inhalation, of food, water, saliva or vomit into the lungs. Thankfully it, like suture failure, is an unusual complication.
What if my pet gets aspiration pneumonia? Then what?
It’s vital that aspiration pneumonia is caught early. We search for 4 requirements: coughing, lethargy, bad cravings and a fever. If you ever presume AP, time is of the essence. A vet should see the patient ASAP, pay attention to the lungs and take chest X-rays to confirm the medical diagnosis. Treatment includes hospitalization, IV fluids, strong antibiotics, nebulization and a kind of physical therapy called coupage.
What’s new with Laryngeal Paralysis?
We now give patients an anti-vomiting drug (metoclopramide), for life, after surgery. The hope is to reduce the risk of vomiting by helping move food downward. It is inexpensive with few side effects, though one impact is hyperactivity. Ironically, Labs are the number one breed impacted by Lar Par, and much of them are rather active to begin with! So far, we have actually not heard numerous grievances about using metoclopramide, though contra-indication is patients with seizures, so another anti-vomiting drug needs to be used. It is important to keep in mind that not all cosmetic surgeons will recommend this drug, so please do not be shocked if it is not suggested. It is definitely not necessary.
These days, we do not make the opening in the throat as big as we used to, simply enough for the patient to breathe conveniently. This is clearly art more than science, and you can see how experience comes into play. What’s the disadvantage? The patient will likely have a noisier breathing, as air goes through a smaller sized opening. But again, as long as the patient can breathe easily, we don’t mind. As I now inform my customers, “I do not treat sound, I treat dogs.”
What do I need to do at home after surgery?
This will depends on your cosmetic surgeon’s recommendations. In our practice, we recommend:
- Strict rest for two months to permit healing with scar tissue
- Soft food (“meat balls”) for two weeks
- Not too much water consumption at the same time
- Pain killers for seven days
- Metoclopramide for life (again, not all cosmetic surgeons do that)
- Weight loss (these patients are frequently chubby), or weight control as needed
- Long term, we suggest utilizing a harness rather of a neck collar
The only restriction is swimming: your dog will have a completely open throat, with no possibility of closing it off, must (s) he swallow water. There is therefore a risk of aspiration at best, and drowning at worst.
Overall, Lar Par is a demanding condition for the dog and a demanding circumstance for the guardian. Luckily, in many cases, outcomes of Laryngeal Paralysis surgery are good to outstanding.
Also read: Weird Breathing in Dogs