Greyhound Gang - Medical - Laryngeal Paralysis

Laryngeal Paralysis - LP

Date: Wed, 14 Sep 2005 00:33:20 EDT
From: Suzanne Stack DVM <Yumadons@AOL.COM>
Subject: MEDICAL: Laryngeal paralysis

First off, we do not do this surgery in our office so I am not familiar with
its ins and outs. LP surgery is usually done by a boarded surgeon, and they
are honestly pretty comfortable with it. The one we refer to ties back just one
side to minimize the likelihood of problems, realizing that the second side
can always be done later if needed.

Whether to do it or not really depends on how much trouble LP is giving your
dog. If she's just noisy but not having trouble breathing, there are lots of
unsurgicated LP dogs running around out there. This is actually a *good* time
for LP to start up if there is any such thing. The dangerous time is summer.
Imagine that the only way you can breathe is sucking 100-degree air through a
straw and you get the picture.

If you expect your dog to participate fully in life, do the surgery. Without
surgery, she's best off just hanging around the house. That would be another
qualifier IMO. If she's OK in her day-to-day activities at home, you can
probably get by without surgery. But this means no walks, gatherings, meet n'
greets, and especially no car rides. Anything that makes her upset needs to be
avoided, like especially the vet's office. If she's a high maintenance girl who's
always at the vet, you might want to get the surgery done. IMO, one of the best
ways to bring on an LP crisis is to pack her up in the car and off to a place
(like a vets office) that stresses her out. IF you ever have to take her
anywhere, do so in the cool morning or at night, not in the heat of the day. You
will have to supervise her outside time even in your own yard - don't expect
that she'll know when she's had enough and come in on her own.

It's best to have drugs on hand for a crisis. IF you have to load her up and
take her to a clinic in crisis mode, you're very likely to lose her. You're far
better to cool your house down like an icebox, point a fan at her face
(unless she fights it - nothing is worth stressing an LP dog for), and administering
drugs to decrease swelling and calm her down. Injectable preferably if your
vet will give them to you because not only do they work faster, you don't have
to shove pills into a dog who's struggling to breathe. It's best to use a
sedative you've used before if possible so that you know how she reacts to it. Or
if you haven't, "test drive" one before you need it. A steroid should also be
administered to stop swelling.

Suzanne Stack, DVM

Another Article

What is laryngeal paralysis (LP)?

Normally, the voice box (the "larynx") opens as the dog inhales and
partially closes during exhaling. Laryngeal paralysis (LP) occurs when the
nerves controlling the voice box slowly but progressively lose their
function. When dogs normally breath, the voice box is opened permitting
inhaled air to pass to the lungs. LP diminishes that ability when the tissue
folds edging the sides of the voice box either do not move at all or move
out of time with the phases of breathing. One or both these vocal folds may
be affected. "This syndrome has been reported as a congenital (present at
birth) problem in the Bouvier des Flandres, Siberian Husky and Dalmatian
breeds," according to the U. California at Davis Vet Medicine's "Book of
Dogs," 1995 ed., pp. 289-290. Thus, LP slowly narrows the dogs' airway
making breathing progressively difficult. The condition can occur in any
breed and at any age but veterinarians report it to be most common in older
dogs of large breeds. I now definitely know of two Dalmatians with LP - my
own male and a bitch.

What are the early signs of LP?

Symptoms during early LP can be merely changes in the sound of barking as if
debarked or with laryngitis. Frequent coughing and clearing-of-the-throat
may be seen plus slight panting for no detectable reason. The dog's
breathing can sometimes sound like the wheezing of an asthmatic. As LP
worsens, the dog pants strenuously after the slightest exercise or mildest
excitement. (The normal reaction is to inhale more at these times but
becomes a drastic struggle as LP narrows the airway.)

What are late signs of LP?

In late-stage acutely severe stages of LP, the dog is intolerant to
exercise, heat and stress...anything which puts the slightest burden on its
lessening ability to take in air. When stressed, the animal goes into
seizure episodes of desperately gasping for air. Those with fear of thunder
and lightning show alarming LP symptoms during their periods of anxiety. As
the dog struggles to inhale, the limited intake of air worsens its
excitement and the dog can collapse and even die from lack of oxygen. If
the animal also has coexisting heart problems, these episodes can be
ominously stressful to those dogs' capacity to endure them.

What causes LP? What are its treatments?

The California textbook states, "It was once thought that [LP] was linked
to... hypothyroidism...Instead it is now believed that [LP] probably occurs
as a component of a more serious inflammatory disease involving either the
neurologic system, the muscular system, or both." A specific cause rarely
is confirmed and may be just the aging process in some animals. Thyroid
medication and tranquilizers have been tried but surgery seems to be the
only significant and lasting relief.

What type of surgery is showing the greatest success?

"Unilateral arytenoid lateralization" is the surgical procedure most
currently in favor. It involves tying back one side of the voice box so
that a permanently open airway exists for the dog to breath through even
though the LP continues to progress. Tying back both sides proved to
create too many complications after surgery, as did conducting the surgery
internally through the mouth. It now appears preferable to surgically
access the voice box for the tie-back by opening up the neck externally.
Owners of dogs with LP, most 12 years or older, report with a few exceptions
that their dogs came out of the surgery rapidly, were home within two to
three days and rarely if ever had breathing difficulties again. The choice
of a surgeon experienced in the tie-back procedure is of course critical.
All dogs learned to drink and eat after the surgical tie-back within a very
few days.

Where can I obtain more information?

http://www.geocities.com/lplist/

http://pets.groups.yahoo.com/group/LP/

I sincerely hope readers will find this article of information only and will
never have to use it for their Dalmatians.

Carroll H. Weiss
Sunrise, Florida
carroll@suntech.net

Portrait and case history of my Dalmatian successfully recovered from
laryngeal paralysis:
http://www.geocities.com/lplist/dazzle.html