Angel is our Surgery Patient for the month of September!
Angel, a lovely 13 year old chocolate Labrador, was initially presented to the West Hills Animal Hospital surgery service in November 2014 with a primary complaint of increased respiratory effort when active and slight change to the sound of her bark. Based on Angel’s age, breed, and clinical signs, Dr. Hirshenson discussed concerns about a condition called laryngeal paralysis.
As Angel’s signs were fairly mild at the time, a conservative management plan was created, including ensuring she was kept in a cool environment and not allowed to overheat. Angel did well at home through the winter, but re-presented to the surgery service in April 2015 for worsening signs, including several episodes of collapsing with activity.
Laryngeal paralysis (“Lar Par”) is typically seen in older dogs. Labrador retrievers are more frequently affected; though any breed could develop this condition. Laryngeal paralysis results from degenerative loss of neurologic function to the muscles responsible for opening the larynx, the part of the airway located at the back of the throat. When the larynx fails to open, air cannot pass normally from the mouth or nose into the lungs.
Owners of dogs with laryngeal paralysis frequently note their dogs showing signs of exercise intolerance, increased panting and occasionally a change to the sound of their bark. Dogs can still breathe with this condition, but exercise, heat and inflammation can rapidly exacerbate their signs, making it difficult for them to breathe.
In extreme cases, pets collapse from lack of oxygen! It is unclear exactly why dogs develop laryngeal paralysis, but evidence supports the theory it is part of a systemic neurologic degeneration that occurs as dogs age.
Patients with mild clinical signs can often be managed conservatively, where owners must keep their pets in cooler environments (i.e. air conditioned houses and cars) and not allowing them to become too excited. For severely affected dogs, like Angel, surgery is recommended.
The recommended procedure is called an arytenoid lateralization or “tie-back”, and entails making an incision into the neck and suturing one side of the arytenoid cartilage in a fixed position to widen the airway opening. The procedure works well, but carries a moderate risk of a complication called aspiration pneumonia. Angel’s signs were severe enough she required surgery to maintain a good quality of life.
Angel had surgery and recovered with flying colors! Following recovery, her breathing was quieter and she was more relaxed. She was able to sleep through the night without respiratory difficulty and can now go on longer walks and enjoy the yard without effort, even in the dog days of summer!