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Thread: Laryngeal Paralysis in Labrador Retrievers

  1. #1
    Senior Member EdA's Avatar
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    Default Laryngeal Paralysis in Labrador Retrievers

    Many of you with old dogs have dealt with this problem, it is common in older large breed dogs. Early signs include, gagging, throat clearing, hacking cough, and occasional wretching.

    My Kweezy, who will be 12 May 30, has been mildly affected for more than a year, indeed I have had to be careful roading her, especially in hot weather. I had pretty much resigned myself to let her live with it and just not hunt her much but last week for the first time she made a whistling noise when she was breathing. I was able to open her mouth and pull her tongue out and visualize her larynx which had 2 flaccid vocal folds obstructing her airway.

    Severly affected dogs have loud forceful respiration and sometimes almost total airway obstruction. In the normal respiratory cycle when inhalation occurs a laryngeal muscle contracts and opens the airway. Laryngeal paralysis does not allow this to happen and the dog has to inhale against an obstructed airway. Symptoms are typically worse in hot weather and dogs can die from airway obstruction and laryngeal edema.

    After discussions with several "dog family members" and sleeping on it I decided it was time the have laryngeal tie-back surgery performed. This procedure is generally done on one side and permanently pulls the arytenoid cartilage to the side creating an open airway. The down side is that dogs are more susceptible to aspiration pneumonia (about 20% of dogs who have had the surgery may develop aspiration problems) but these are generally controlled with antibiotics and only a very small percentage are serious.

    Since I was going to be in Auburn last week for a social visit we scheduled her for surgery. Last Wednesday Dr. David Tillson performed a unilateral laryngeal tie back procedure at the small animal clinic, College of Veterinary Medicine, Auburn University. Kweezy spent the night in the clinic in the capable hands of Dr. Tillson's senior veterinary students beginning their clinical year. I picked her up Thursday afternoon and the effect is dramatic.

    She is on exercise restriction until the surgical site has healed but I could not be happier with the outcome.

    A few interesting facts about laryngeal paralysis:

    1. It has been stated that laryngeal paralysis can be secondary to low thyroid gland function. In my experience this has never been the case.
    2. It has been theorized that laryngeal paralysis is the result of a neuropathy of the nerves supplying the larynx.
    3. A significant percentage of dogs with laryngeal paralysis are affected with megaesophagus which indicates a more generalized neuropathy.
    4. There is some recent thinking that the posterior weakness seen in old dogs may also be linked to this more generalized neuropathy.

    Kweezy's prospects for pheasant season look pretty good now....

    thanks Dr. Tillson et al...
    The epitaph written by one of his daughters:

    "Resting here until day break when shadows fall and darkness disappears lies Quanah Parker, last Chief of the Comanches"

  2. #2
    Senior Member FOM's Avatar
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    Quote Originally Posted by EdA View Post
    Many of you with old dogs have dealt with this problem, it is common in older large breed dogs. Early signs include, gagging, throat clearing, hacking cough, and occasional wretching.
    Dr. Ed,

    Glad to hear Kweezy's pheasant future looks bright!

    Your post is timely as we have an appointment with our vet in a few hours, but thought I would ask. Flash is shwoing the above symptom a lot lately. I would say it's going on about 4-6 months, give or take. But he hacks a couple times in a row, sounds like he is going to vommit, but never does. We are not sure what it might be, but it has us concerned. Other than that he is a healthy as can be. We had his blood work redone about a month ago after his obstruction surgery just to verify his kidney functions and no mention of any issues. The is no obvious trigger for the hacking, its random and usually only a couple hacks in a row.

    Thoughts?

    Thanks,

    Lainee
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    Senior Member EdA's Avatar
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    Quote Originally Posted by FOM View Post
    Dr. Ed,

    Glad to hear Kweezy's pheasant future looks bright!

    Your post is timely as we have an appointment with our vet in a few hours, but thought I would ask. Flash is shwoing the above symptom a lot lately. I would say it's going on about 4-6 months, give or take. But he hacks a couple times in a row, sounds like he is going to vommit, but never does. We are not sure what it might be, but it has us concerned. Other than that he is a healthy as can be. We had his blood work redone about a month ago after his obstruction surgery just to verify his kidney functions and no mention of any issues. The is no obvious trigger for the hacking, its random and usually only a couple hacks in a row.

    Thoughts?

    Thanks,

    Lainee
    laryngeal paralysis is certainly on the differential diagnosis list and should always be in an older dog exhibiting those symptoms

    the definitive test for laryngeal paralysis is to give them a respiratory stimulant (Dopram) under anesthesia and directly view the larynx during inspiration and expiration
    The epitaph written by one of his daughters:

    "Resting here until day break when shadows fall and darkness disappears lies Quanah Parker, last Chief of the Comanches"

  4. #4
    Kristie Wilder
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    Thanks for the great information. I know a few other people have had it done and were relieved with the results. Glad Kweezy is doing so well...

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    Senior Member LokiMeister's Avatar
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    Loki had his done at the end of March and while he is improved he is getting reflux, I believe, and has become a grazer. And I mean, he is competing with the cows for grass!! Medication was prescribed, one of the three was Pepcid and I don't remember the other two, and he improved but once he came off it, he was back to grazing. He goes to see the internist at Veterinary Specialty in Madison, WI (they did the surgery) to see what is going on. The clearing of the throat has not improved.

    The surgeon told me that of all the dogs that end up getting this affliction, 70 to 80% are Labrador Retrievers of them.

    This early hot and humid weather make for a frustrated Loki.
    Kevin Entwistle

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    Senior Member windycanyon's Avatar
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    My first lab, Winnie, had LP, as did a couple of her offspring. I believe 2 of the offspring had tieback and one may have had the one where they just cut (not recommended by the folks on the LP list)-- and she didn't do well at all. I didn't do the surgery w/ Winnie and instead just managed it as well as possible, but I always dreaded her getting excited as it was enough to take her down into a "blue" state. Another friend is now dealing w/ her 3 rd generation of LP in her old girl.

    Winnie was 13.5 when I put her to sleep, so I really can't complain much. She did get fecal incontinent that last year. I put her daughter Gala on cholodin which is a supplement that is supposed to help w/ neuro health. Gala never got much LP past the higher pitch bark and a little panting/huffing and never had incontinence issues. She lived to 14 + 3 mos when a splenic tumor did her in. No thyroid or megaesophagus issues here but my friend's dog is a bit low.

    I'm glad Kweezy is doing well post op. Sometimes I wish I had done the surgery on Winnie as it was really hard to watch her episodes.

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    Senior Member jeff t.'s Avatar
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    Glad Queezy is doing well with the UTB.

    My old guy "Diesel" (age 12) also had the tieback in Feb and is doing really well.

    I'm concerned about the possibility of aspirating dust or a small particle from his kibble, so all of his meals are presoaked for approx 12 hours. He also receives famotidine (generic for pepcid) with each meal to minimize reflux.

    Lainee, the symptoms you described sound exaclty like what we saw/heard with Diesel. I encourage anyone with a dog affected by laryngeal paralysis to consult with a board certified surgeon who does procedure on a frequent basis. Sometimes the symptoms start slowly than get worse in a hurry. I'm sure that Diesel would have experienced a breathing crisis due to the summer heat by now if we hadn't taken action while the weather was still cool.

    There seems to be a genetic component to this as Diesel's mother and at least one sibling died from untreated LP.
    Last edited by jeff t.; 05-25-2010 at 02:13 PM.
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    Senior Member EdA's Avatar
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    Quote Originally Posted by jeff t. View Post
    I'm concerned about the possibility of aspirating dust or a small particle from his kibble, .
    Interesting, my first question to Dr. Tillson, "should I alter her feeding in any way". His only recommendation was for immediately post surgery, after that feed as normal. I feed Euk Premium Performance dry to all of my dogs and I have been feeding her this way for 5 days now with no noticeable issues. Indeed I think aspiration is much less likely than if food is soft, also when swallowing the epiglottis closes the larynx and trachea. The threat of aspiration is greater from regurgitation or vomiting than it is from regular swallowing. This is not to suggest that you should change what works for you but only to point out that it probably does not matter one way or the other.
    The epitaph written by one of his daughters:

    "Resting here until day break when shadows fall and darkness disappears lies Quanah Parker, last Chief of the Comanches"

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    Senior Member jeff t.'s Avatar
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    Quote Originally Posted by EdA View Post
    Interesting, my first question to Dr. Tillson, "should I alter her feeding in any way". His only recommendation was for immediately post surgery, after that feed as normal. I feed Euk Premium Performance dry to all of my dogs and I have been feeding her this way for 5 days now with no noticeable issues. Indeed I think aspiration is much less likely than if food is soft, also when swallowing the epiglottis closes the larynx and trachea. The threat of aspiration is greater from regurgitation or vomiting than it is from regular swallowing. This is not to suggest that you should change what works for you but only to point out that it probably does not matter one way or the other.
    Thanks for the info re the epiglottis and swallowing.

    Did you elevate the food bowl? The possibility of aspiration pneumonia weighed heavily in the first few weeks post surgery. I timed Diesel's breathing rate at rest every night and took his temp 2x per day for the first couple of weeks so that I might catch AP as soon as it started to develop. After an adjustment period of getting used to his new noises, we are much more relaxed.

    Are you letting Kweezy swim?
    Jeff Telander
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  10. #10
    Senior Member EdA's Avatar
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    Quote Originally Posted by jeff t. View Post
    Thanks for the info re the epiglottis and swallowing.

    Did you elevate the food bowl? The possibility of aspiration pneumonia weighed heavily in the first few weeks post surgery. I timed Diesel's breathing rate at rest every night and took his temp 2x per day for the first couple of weeks so that I might catch AP as soon as it started to develop. After an adjustment period of getting used to his new noises, we are much more relaxed.

    Are you letting Kweezy swim?
    I have not elevated the food bowl, she still gags/clears her throat occassionally

    I am restricting her activity until soft tissue healing is complete, some surgeons are using absorbable suture for the tie back which indicates that scar tissue formation is the ultimate reason that the repair is permanent not that the suture lasts forever but good healing is desirable before any increase in activity is allowed.

    I will start taking her for our morning walks next week when she can free roam and swim if she chooses
    The epitaph written by one of his daughters:

    "Resting here until day break when shadows fall and darkness disappears lies Quanah Parker, last Chief of the Comanches"

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