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Laryngeal Paralysis

Laryngeal Paralysis

This condition occurs when the cartilages of an animal’s larynx are not able to open and close normally as they breathe. Laryngeal paralysis typically occurs in middle-aged or older large dog breeds such as Labrador Retrievers, Irish Setters, and Great Danes. The larynx’s job is to block off the lungs when your dog eats or drinks, and to open the windpipe wider when they need a deep breath. When the nerves that control the muscles that move the cartilage plates become weak or paralyzed, the cartilage can’t move properly and begins to collapse inward.

Signs of laryngeal paralysis include a dry cough, gagging, changes in the sound of your dog’s bark, and noisy breathing that eventually progresses to more obvious difficulty breathing during stress and exertion, and eventually to collapse. Dogs experiencing laryngeal paralysis may also more frequently regurgitate or vomit. Symptoms can subtly progress over months or even years before respiratory distress is noticeable. While most common in large-breed dogs, this condition can also be present in smaller dogs and cats.

Surgical Repair – Laryngoplasty

Surgical correction can be extremely effective depending on the severity of your companion’s condition. In this procedure, the collapsed cartilage plates on one side of your companion’s throat are tied back to keep their airway clear. Here is a diagram depicting a normal larynx, a paralyzed larynx, and an open larynx after surgical repair.

What to Expect

After your initial consultation with our surgeon, if you decide to go ahead with surgical repair for your companion’s fracture, there are some details to consider in order to make the surgery and recovery process as smooth as possible for yourself and your companion. Below you will find a collection of key information to help you understand exactly what to expect. Once you have had a chance to review this information, we are happy to answer any questions or concerns you may have – please feel welcome to ask!

Typical Treatment Schedule

  • Surgery Day! – Generally a full day in hospital, with a morning drop-off and late afternoon discharge (plan about half an hour to discuss homecare details with our rehabilitation technician).
  • 2 Weeks Post-Surgery – Progress Check – The opportunity for the surgeon to check on how the surgical site is healing, spot potential issues or concerns, remove sutures if needed, and answer any questions you might have about the recovery process.

Preparing for Surgery

Take the time before Surgery Day to prepare your home to welcome your companion back after their procedure. It’s much easier to make sure your space is prepared ahead of time, rather than struggling to sort things out with a groggy companion on your hands. Because you will need to restrict your companion’s movement after surgery so they can rest and heal, make sure you have an enclosed area of your home set up for them. You might want to move their crate or bed into the area, getting them used to where they will be spending most of their time.

One of the most important instructions to follow when preparing for Surgery Day is to stop offering your companion access to food about 12 hours before the procedure (but in most cases they should retain access to water). We generally flag 10 PM the night before as the cut-off time for food, although your vet will let you know if they recommend any changes to this. The reason it is so important to fast animals before surgery is to prevent them from accidentally inhaling any regurgitated food into their lungs while they are under anesthetic. Sometimes the anesthetic drugs can cause vomiting; because your companion’s muscles will be relaxed under sedation, their swallowing reflex is suppressed and it is easy to choke or inhale material into the lungs. For this reason, it is much safer to enter surgery with an empty stomach.

As the day of the procedure approaches, maintain your regular routine as much as possible so that your companion feels settled and secure. The day before, make sure to take them for a good walk or have a good play session so that they have a chance to burn off some extra energy, but avoid excessive roughhousing to make sure they’re not starting their day with sore muscles. Feed them their dinner at a regular time, and allow them to settle down for the evening as normal.

In the morning, plan ahead to make sure you’ve got a bit of extra time. Make sure that your wake-up time allows for morning medications to be given three hours before your appointment time. Take your companion for a short walk so they have a chance to go to the bathroom – if this isn’t successful, let the team know when you drop your companion off so we can make sure that they have another chance to go out before their procedure. Also allow plenty of travel time to get to the hospital, helping to minimize stress for everyone involved.

When you arrive, please feel welcome to ask us any final questions. We are happy to clarify anything, and will be looking forward to connecting with you after the surgery to let you know exactly how things went.

Pre-Visit Pharmaceuticals (PVPs)

PVPs are medications chosen to address specific neurotransmitters associated with fear, stress, and anxiety. They can have a sedating and anxiety-reducing effect, helping to keep your companion calm and comfortable on surgery day. Giving these medications before anesthesia also often reduces the volume of sedation drugs used during the surgery. We also typically prescribe a medication that helps to reduce any nausea they may feel from the anesthetic drugs, and can help them with their appetite when they return home.

Ahead of your appointment, the surgical team will discuss any ongoing medications or supplements your companion is taking, to evaluate if they will have any impact on the surgical protocol. It may be the case that you will need to stop giving some medications (such as those that impact circulation, for example) ahead of the procedure day.

On your admission form, you’ll also be asked to confirm the medications and dosages you are giving your companion – this information is very important, as having a full picture of the pharmaceuticals your companion is taking can help the surgeon create the safest and most effective anesthesia protocol possible.

Post-Surgical Care

Depending on the nature of your companion’s condition and the surgical repair performed, the details of your post-surgical care may vary – during your discharge appointment, one of our veterinary technicians will go over exactly what you’ll need to do to support your companion. There will be a variety of medications to manage pain, prevent infection, and help keep them quiet during their initial recovery phase. Below you will find information on the key aspects of post-surgical care – please read through this information before Surgery Day, so that we can help answer any questions or concerns you may have.

POST-SURGERY MANAGEMENT & HOMECARE

A significant factor in ensuring a successful surgery is what happens after the main event – the sometimes-challenging recovery process. Fortunately there is plenty you can do to help your companion heal safely in the weeks post-surgery.

E-COLLAR TIPS FOR DOGS OR CATS

Sometimes called a cone or lampshade, an Elizabethan collar is a plastic device that fits around your companion’s neck and is designed to keep them from licking, biting, or pawing at their surgical sites. Essentially, its purpose is to keep your companion from hurting themselves during their recovery – here’s how to help them stay safe and comfortable along the way. For laryngeal paralysis surgery, the e-collar is typically paired with a soft ‘turtleneck’ tube of material placed over the bandage dressing to protect the surgical site from the plastic collar.

LASER THERAPY – TREATMENT AND BENEFITS

Laser therapy assists in tissue repair by encouraging blood vessels to dilate – this increases the blood flow to the tissue, bringing in oxygen and the cells involved in the healing process. The main benefits of Laser therapy include decreased inflammation, decreased pain, and improved wound healing. Depending on your companion’s condition, this may be a beneficial treatment after surgery.