Laryngeal Paralysis

Laryngeal paralysis is a common upper respiratory disease of dogs. It most often affects
large breed dogs such as Labrador retrievers and Golden retrievers but it can affect any dog of any breed or size. Normally when a dog inhales the larynx (voice box) opens to allow air into the trachea and lungs. The larynx closes between breaths to prevent food and water from going into the trachea and lungs. In laryngeal paralysis the muscle that opens the larynx stops functioning. This results in a very narrow passageway to get air into the lungs instead of the normal wide-open larynx. Dogs with laryngeal paralysis have difficulty inhaling and the harder they try the more difficult it becomes to inhale adequate air.

What are the signs of laryngeal paralysis?

Several signs may suggest that a dog has laryngeal paralysis:

• Harsh breathing – laryngeal paralysis usually leads to a characteristic harsh breathing sound
  that gets louder with exercise. This noise is caused by air passing through the narrow
  space in the larynx
• Voice change – laryngeal paralysis will often cause a change in a dogs bark, making it sound
  more hoarse.
  Coughing – Some dogs may have a cough with laryngeal paralysis that sounds like it comes
  from the throat.
  Gagging – Many dogs with laryngeal paralysis may gag when they eat or drink.

How is laryngeal paralysis treated?

Laryngeal paralysis is best treated by surgery. There are several surgical options although one
procedure, the “tie-back” is the most accepted and most commonly performed by Board Certified
surgeons.

Tie back

In the tie back procedure the larynx is approached through the side of the neck. The failed muscle is then identified and replaced with a suture to permanently open the larynx on one side. This procedure produces the best airway with the least complications of any of the available surgeries.

Partial arytenoidectomy

In this procedure the portions of the larynx that obstruct the airway (the arytenoids) are removed
by scissor or laser through the mouth. This procedure is not recommended because
of the high risk of scar formation that can severely obstruct the airway.

Castellated laryngofissure

This procedure enlarges the airway through a complicated series of incisions and reconstructions
from the underside of the neck. There have been no definitive advantages shown with this procedure and it is rarely performed.

Permanent tracheostomy

A permanent tracheostomy should only be performed when a tie back procedure will not
correct the airway obstruction. Dogs with permanent tracheostomies cannot swim and may
have other chronic airway complications.

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