woof, woof, ouch! laryngeal paralysis in pets
Most pet parents can probably pick out their pet’s unique “voice.” But have you ever thought about what gives your pet his voice? Like humans, your pet has a larynx, or voice box, that produces his bark or meow. And if your pet happens to be a large or giant breed dog, he could be at risk for a condition we call laryngeal paralysis.
Besides giving your cat her singing voice and your dog his distinctive howl, the larynx provides a lifesaving function – it closes off the airway when your pet eats and drinks, keeping food and liquid out of the respiratory tract. No doubt you’ve experienced when a bite or a sip goes down “the wrong pipe” – this is a temporary failure of your larynx to do its job. While usually not life-threatening, it can be quite uncomfortable.
In dogs, laryngeal paralysis occurs when there is a failure of the cartilages and vocal folds in the larynx to open and close as they should. In effect, they are paralyzed, unable to open correctly to allow air into the respiratory tract. This occurs due to a degeneration of the nerves that provide muscular innervation to the larynx.
Laryngeal paralysis can occur on one or both sides of the larynx. When only one vocal fold is affected, clinical signs are generally not seen. However, when both sides are affected, respiratory crisis can occur. If both vocal folds collapse, an airway obstruction occurs, and air cannot get into the lungs.
Laryngeal paralysis in dogs can be congenital or inherited in the following breeds:
Bouvier de Flandres
While laryngeal paralysis tends to be more common in those breeds, it can occur in many others. Furthermore, congenital cases account for a small amount of the number of cases of laryngeal paralysis. Seventy-five to 80% of cases are actually acquired cases, meaning that they don’t have a congenital component. Acquired cases generally occur in middle-aged or senior large dogs, like Labradors, Greyhounds and Rottweilers.
Clinical signs of laryngeal paralysis include a change of voice, loud breathing sounds and respiratory distress. In fact, without immediate treatment, dogs can die during an acute laryngeal paralysis event. In any case, if your dog is showing signs of respiratory distress, consider this an emergency and get to your veterinarian as soon as possible.
In the case of an acute crisis, your veterinarian will first stabilize your dog and provide a patent airway. In many cases, this will involve sedating or anesthetizing your dog to place an endotracheal tube. Medications may also be given to reduce swelling in the larynx. Tests may be performed to look for an underlying endocrine or neurologic disorder that could be causing the laryngeal paralysis. Once your pet is stable, it is time to make a decision regarding long-term treatment.
Most dogs with bilaterally affected vocal folds will benefit from surgical intervention, usually in the form of a laryngeal tieback. As the name implies, this surgery opens the airway by permanently repositioning one of the vocal folds.
While the long-term results of a unilateral laryngeal tieback are good to excellent in about 90% of cases, the surgery is not without risk. The most common complication is aspiration pneumonia. If the folds are not surgically positioned properly, the larynx will not be able to fully close. Food and liquid would be able to pass into the respiratory tract, which can lead to pneumonia.
Unfortunately, a third to a quarter of patients who have tieback surgery experience some sort of complications, but often the surgery is the only way to ensure avoiding future respiratory crises. The risk of aspiration pneumonia also increases with age or the presence of other neurologic disease or esophageal abnormalities.
If your pet has been diagnosed with laryngeal paralysis, be sure to discuss all of the options with your vet and know that there are risks associated both with treating surgically and not treating surgically. Work with your veterinarian to find a solution that is best for your family. If you protected your pet with dog insurance or cat insurance from Petplan, it can help you focus on getting your pet the best treatment possible.