Despite the oxygen mask, Roxie labors to breathe. The veterinarian and team try to calm her, but she continues to struggle. Her laryngeal paralysis has progressed, and this crisis has caused swelling. Her airway is almost completely blocked. Chest X-rays reveal severe pneumonia. Fluid is building up in her lungs and her body temperature is rising. Her gums are beginning to turn blue. Roxie is anesthetized and a breathing tube is placed. The team continues stabilizing her vital signs before taking her to emergency surgery.
Laryngeal paralysis in dogs: The breathing emergency
Roxie is a fictional character but, unfortunately, this life-threatening situation is real for many dogs. Yet, this crisis could have been avoided if Roxie’s condition had been diagnosed earlier. At Animal Internal Medicine and Specialty Services (AIMSS), we have the necessary equipment and expertise to diagnose laryngeal paralysis at an early stage. We also help pet families manage the condition, so pets don’t have to experience the severe complications like Roxie.
The slow progression in pets
Laryngeal paralysis, sometimes referred to as “lar par,” is a slowly progressing disease that, with an early diagnosis, can be treated and managed to avoid a crisis. Lar par is usually seen in dogs 10 years of age and older, and affects Labrador retrievers more than any other breed. The disease can be congenital in some breeds, and the symptoms will appear early in puppies. The breathing problem is the first sign of a syndrome called geriatric onset laryngeal paralysis and polyneuropathy, or GOLPP, in which certain nerves degenerate at the microscopic level. If affected dogs live to an advanced age, they begin to have more nervous system problems, including weakness in the legs and esophagus enlargement. Lar par is rare in cats.
The early symptoms in pets
At early stages, loud or strange breath sounds may be the only sign of a problem. Often families don’t notice the early changes because they see their pet every day, and the changes occur gradually. Later, the pet’s voice may change, because the larynx (i.e., voice box) is affected, and they may pant more than usual, slow down more quickly on walks, or gasp for air.
When lar par is suspected, our AIMSS surgeons will sedate your pet, pass an endoscope into the throat, and view the function of the larynx, which serves as a “gate” at the back of the mouth. When a pet swallows, the larynx closes in from both sides to keep food and water out of the lungs. When a pet breathes deeply, the larynx opens to allow air into the lungs. With laryngeal paralysis, neither side of the larynx moves. When your pet’s larynx is stuck partially open, they not only have a hard time getting needed air into the lungs, but food also can get in and cause problems. Our surgeons will use the endoscope to assess laryngeal function and ensure the nerve malfunction is not caused by damage or a mass. After they have confirmed laryngeal paralysis, the surgical procedure can be performed.
The surgical treatment for lar par in pets
When their symptoms become severe, your pet will require surgery, which is not a cure, but is performed to open the pet’s airway so they can breathe more easily. Several surgical options can help, and our surgeons will select the best approach for each case. In one method, called arytenoid lateralization, or “tie back,” the paralyzed laryngeal structure is pulled open on one side and sutured in place, creating a bigger opening for breathing. Other techniques involve removing laryngeal tissue to enlarge the opening. Surgery allows your dog to breathe easier, but creates a larynx that is permanently partially open.
Post-surgery management of pets with lar par
After surgery, your pet may require sedation to help prevent excitement and barking while they heal. Coughing while eating is common after surgery, but improves with time. A harness is recommended instead of a collar, to keep pressure off their throat. Your pet may never be allowed to swim, as water may enter the lungs. Avoiding heat, stress, and strenuous exercise in your pet is vital, and anti-anxiety medication may be prescribed. Your pet will also need monitoring—the larynx will never close perfectly again, and food particles can enter the lungs, causing an infection called aspiration pneumonia. This is a serious problem that develops in 25% of surgically treated dogs and requires veterinary treatment. The pet also may need to eat wet food, learn to eat slowly, or eat from an elevated bowl.
The veterinary surgeons at Animal Internal Medicine and Specialty Services can diagnose and treat laryngeal paralysis before it becomes a life-threatening emergency. We can also help you manage your pet’s lifestyle before and after surgery to help them have the best life possible. Call us if you are concerned about your pet’s breathing, voice, or swallowing.