What is Laryngeal Paralysis?
Lar Par refers to the inability of the larynx (voice box) to move. The
larynx is innervated by the recurrent laryngeal nerve, which allows the
larynx to open during inhalation. If this nerve is paralyzed, the
larynx stays in a half closed position and adjustments for increased
respiratory effort such as running or panting during hot weather cannot
be made. This results in poor oxygenation and overheating.
Lar Par is a disease that is usually seen in animals over 10 years old, and most commonly in Labrador and Golden retrievers. Lar Par can also be seen in puppies and young adult dogs as a symptom of a generalized neuropathy. Studies have been published about Dalmatians and Rottweilers having this condition as younger animals.
Lar Par usually has a subtle onset. A change in bark, slight exercise intolerance, or increased raspiness during breathing can be the only symptoms for several months. Your dog may breathe loudly and with an increased effort, clear his throat frequently, gag, or vomit up white foam. Symptoms can become severe enough to cause complete exercise intolerance and acute collapse.
If you see a change in color of his tongue or if he collapses, please rush him to an emergency clinic right away. If you notice mild symptoms such as bark change, occasional gagging, or mild increased noise while breathing, please make an appointment with your veterinarian.
Yes, myasthenia gravis (a nerve problem), a mass in the larynx, a foreign body in the larynx, mouth or trachea, or laryngeal collapse have to be considered.
A sedated exam is necessary to watch the movement of the larynx during respiration. If you are coming for a regular appointment and your animal is not in a crisis, please bring your animal to the clinic fasted for at least 8 hours.
Yes, an arytenoid lateralization, also called "tie back", is the procedure of choice. The larynx, usually the left side, is permanently opened during the procedure via an incision made in the side of the neck.
There are risks and complications with any surgical procedure. Due to the fact that most of the animals are geriatrics when presented, general anesthesia is more of a risk. About 10 % of animals may have, or develop right after surgery, aspiration pneumonia that requires intensive antibiotic treatment and could be life threatening. Sometimes the "tied back" cartilage is not very good and fails to heal, or the dog is too active and barks so much that the cartilage cannot heal. If that happens another surgery is necessary on the opposite side. Also, over time (months to years) this neurologic condition can get worse and affect hind legs and front legs or the larynx may collapse further.
Dogs need to learn again how to swallow after this procedure since the architecture of their larynx has been changed. We therefore recommend feeding canned food that is made into meatballs until we know he swallows well. Please offer water only in small amounts or ice chips at first. If lots of water is ingested at once, some dogs gag or vomit.
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