A Message from the Vet - May 2016
Laryngeal Paralysis

Laryngeal paralysis is a condition that affects the larynx (voice box) of older large breed dogs. Breeds that are commonly affected by the condition are Labrador Retrievers, Golden Retrievers, and Siberian Huskies. In this condition, the larynx is normal at birth, but over time the nerves that control the opening and closing of the larynx lose function. This condition can cause difficulty breathing or swallowing. Typically owners will notice that the dog has a wheezing sound during exercise or heavy breathing. They may also notice that their dog's bark sounds "hoarse". In addition, some dogs may gag or choke while eating. Hot weather, obesity, and vigorous exercise can make these signs worse. In some cases, this condition can become so severe that the dog cannot take in sufficient air and may actually pass out.

This condition is relatively simple to diagnose. Your veterinarian will need to do an exam under short acting, light anesthesia in which he or she will look into the back of the dog's throat to observe the larynx while the dog is breathing. Sedated examination will also allow the veterinarian to examine the larynx for other problems including swelling, tumors, or trauma. In normal patients, the laryngeal cartilages (also known as aretenoid cartilages) will open when the dog inhales and close between breaths. The opening of the cartilages allows air to pass from the throat into the trachea and then into the lungs. In patients with laryngeal paralysis, one or both of these cartilages fail to open completely. Thus the dog cannot get a sufficient amount of air into the lungs.

In cases of mild disease, the condition may be managed wih lifestyle changes such as avoiding strenuous exercise, decreasing exposure to hot, humid weather, and using a harness instead of a neck collar. In more severe cases, surgery can be performed to correct this condition. In this surgery, which is known as laryngeal tie-back (or aretenoid lateralization), one or two permanent sutures are put in place to hold one of the laryngeal cartilages open. This allows more air to enter the lungs. Breathing improves drastically in most dogs that undergo this procedure. However after the surgery is performed, there is some risk of aspiration (inhaling) of food or water into the lungs because the cartilages remain open. Inhaling food or water into the lungs can result in pneumonuia.

Recently, it has been noted that most dogs diagnosed with laryngeal paralysis also have other generalized neuromuscular problems including weakness in the hind limbs and dysfunction of the esophagus (megaesophagus). Thus laryngeal paralysis is usually part of a larger condition called Geriatric Onset Laryngeal Paralysis and Polyneuropathy. Due to these associated conditions, veterinarians also usually recommend chest radiographs (x-rays) to evaluate the trachea, esophagus, lungs, and heart.

Beth Hudson, DVM

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Last updated 2016 June 15.