4470 El Camino Real

Los Altos, California 94022

Veterinarian Always on Duty

Laryngeal Paralysis

Fighting for Air

An old black lab named Mango, came in completely collapsed. He was close to dying . He was immediately intubated (meaning that a tracheal tube was put down through his larynx into his windpipe) and attached to oxygen and an anesthetic machine. His larynx was so bad that we kept him anesthetized all night long until surgery could be performed

Some old dogs, mainly, Labrador Retrievers, get laryngeal paralysis. As the larynx loses nervous function, the vocal folds that are used in humans for speaking and in dogs for barking, start flapping in the breeze of breathing. Normally, vocal folds pull back to the side of the larynx when we inhale and relax and can move out during exhalation. When the vocal folds nerves no longer function, the vocal folds form little sails that are pulled into the larynx by the wind of inhalation. This is not significant during quiet respiration but becomes a problem during panting. The harder the dog pants, the more the vocal folds are pulled into the middle of the larynx leaving only a tiny slit for air to go through. Dogs can actually be in such distress that their tongue turns blue and they can collapse and even die. This is most likely to happen when it is hot. The short term treatment, which in our poor old dog's case did not work, is to cool the harshly respiring dog down and then use sedation so that the panting stops.

To correct Mongo's breathing difficulties, a "tieback" operation was performed. This surgery involves dissecting down to the larynx by making an incision on the left side of the neck. Once we reach the larynx, we almost take it apart. We first cut the muscle that is around it. Then we semi-detach the outer cartilage, called the thyroid cartilage, and gently pull it to the side just enough so that we can reach the villain called the arytenoid. The arytenoid cartilage is loosened from its attachment and non-absorbable sutures are placed into it. These sutures are "tied back" to the most back part of the larynx. By pulling on the arytenoid, the vocal fold is tucked back against the wall of the larynx and no longer is able to flap in the breeze. Only one vocal fold needs to be tied back. Most dogs respond very nicely to this surgery. However, there are side effects that can occur; sometimes postoperatively, dogs can get food or water into their windpipe during swallowing. Happily, Mongo is not having any problems. He spent the night at Adobe and went home the next day. His panting is a little hoarse but there is no more fighting for air.

Date: June 2005

Species: Dog

Diagnosis: Laryngeal Paralysis

Doctor: Dave Roos

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