Laryngeal paralysis in dogs is a potentially serious condition affecting the folds of the larynx (back of your dog’s throat). The larynx, also called the voice box, is a body part made primarily of cartilage that helps to close off the trachea when your dog swallows. That keeps food or fluid from getting into your dog’s airways and possibly causing inhalation pneumonia.
When the nerves and muscles controlling the movement of the cartilage flaps are defective, the flaps tend to flop inward, closing off the airway. That means your dog does not have normal airflow into his lungs.
Laryngeal Paralysis in Puppies
Rarely, a dog may be born with a defect. Congenital laryngeal paralysis can show up in puppies as young as 3 months old. Cornell University’s College of Veterinary Medicine’s Richard P. Riney Canine Health Center says these breeds are at highest risk for this form of the defect: Bouvier des Flandres, Dalmatians, Siberian Huskies, Rottweilers, American Staffordshire Terriers, and Black Russian Terriers.
Pneumonia from aspiration of food or drink may be the first sign in these cases. DNA tests can identify possible carriers in the Black Russian Terrier breed. Carriers should only be bred to dogs who are normal.
Secondary Laryngeal Paralysis
Secondary laryngeal paralysis—meaning the problem is caused by another ailment—is much more common. Sometimes the cause is never found. Tumors and trauma to the throat area may damage the nerves, but most cases are age-related, called “geriatric onset laryngeal paralysis and polyneuropathy,” or GOLPP.
Senior dogs with GOLPP will show signs in many areas of their bodies such as weakness in their legs and megaesophagus. Laryngeal paralysis is often the first symptom though, and initial signs may be subtle. Labrador and Golden Retrievers have a high incidence of laryngeal paralysis.
Signs of GOLPP in Dogs
The first clinical signs you may notice are not specific for laryngeal paralysis. You may notice a decrease in stamina and some exercise intolerance. The dog who dragged you for a mile every morning now strolls for half a mile and turns around. His breathing may be louder than usual. He might cough or gag while eating or drinking. Astute owners may notice a change in the sound of his bark (yes, owners can pick out their own dog’s bark!). Some cardiac and respiratory conditions can have the same symptoms.
In severe cases, laryngeal paralysis can precipitate an emergency with your dog’s tongue and mucous membranes turning blue from lack of oxygen and collapse. This is a true emergency requiring veterinary care and oxygen via a cannula or special cage.
Diagnosing GOLPP
A physical exam is part of the diagnostic plan, but your veterinarian needs to evaluate the larynx itself with an endoscope. This may require sedation. Other diagnostics such as X-rays and bloodwork may be done to rule out other causes of abnormal breathing.
Managing GOLLP
Early onset and mild cases may be managed medically and with some environmental adjustments. Anti-inflammatory medications can help.
Keeping your dog calm and limiting his exercise are important. Avid activity when it is warm and humid. Consider air conditioning, at least for your dog’s favorite room and where he sleeps at night. Use a harness for walks.
You may need to end swimming due to the risk of inhaling water, but wading will still be safe unless your dog likes to gulp water.
What to Feed a Dog with GOLLP
It can help to switch from one or two meals a day to multiple small meals spread over the day. Weight loss if your dog is heavy and physical therapy to maintain muscle mass and condition may help.
Surgical Cases for GOLLP
For many dogs, surgery is required to maintain good quality of life. A “tie back” surgery literally ties (sutures) the cartilage flaps back so they can’t obstruct airflow. This does help your dog’s breathing, but it increases the risk of aspiration pneumonia since the airways are no longer totally closed off when your dog eats or drinks. Surgery does not “cure” your dog but provides a “work around” to keep him comfortable.
The cost of surgery may vary. Your dog will need careful monitoring while under anesthesia. Some veterinarians may be more comfortable referring you to a board-certified surgeon as opposed to doing the surgery themselves. An experienced surgeon could mean less time under anesthesia, so less risk of aspiration pneumonia for the procedure.
Post-operative care requires some vigilance on your part. Don’t let your dog gulp a large amount of water. If he is a food gulper, switch to bowls designed to slow down eating speed.
No wild running or zoomies. Switch from fast-running games of fetch to rolling a ball. Those guidelines should apply to future life, not just the healing period.
If your dog gets aspiration pneumonia, you will notice a lack of energy, coughing or an increase in coughing, a drop in appetite, and possibly a nasal discharge. Fevers are common. If you notice any of these signs, your dog should go to the vet. He will need antibiotics and may need some intravenous fluids and oxygen therapy.
Prognosis for Dogs with GOLPP
Dogs with congenital laryngeal paralysis have a poor prognosis compared to dogs with GOLPP. Dogs who are diagnosed early in the disease progression tend to do better. Dogs who suffer through multiple episodes of aspiration pneumonia often end up with some permanent damage to their lungs.
This probably sounds depressing, but many (if not most), dogs with some form of laryngeal paralysis have good quality of life and reasonable life spans. It does require some effort on your part and potentially adjusting your expectations for you and your dog.
Remember that dock diving and lake swims are out. Marathon hikes need to be shortened and skipped altogether in hot, humid weather. Adjust your dog sport goals from speed-heavy sports like agility to scent work. Always be willing to cancel even low-grade activities if it is hot and humid.
Your dog needs to be kept trim. Diet may need to be adjusted to frequent canned meals versus large meals with dry kibble.
I have had two dogs with laryngeal paralysis (lar-par as my vet called it). The first dog, in retrospect, had had minor symptoms for at least a couple years—e.g. he quit “singing” but had no other “vocal issues; huffed more when playing; and occasionally panted without exercise, but he was also 11 years old. He went into crisis the day after we had been playing with him in the snow in the mountains. He had no problem that day, but enroute home he began to have difficulty breathing and was gasping for air. We called ahead and went directly to the vet who gave him a tranquilizer and oxygen and sent us to a speciality vet clinic where he was immediately intubated. After discussion about his health, risks plus a number of tests he had tie-back surgery that evening. He was home in 2 days and amazingly ate & drank without issue. He had three more wonderful years and I never had a moment of wondering if I did the right thing. He died of old age and other unrelated issues.
From this experience I started to notice breathing issues in my next dog and that she gagged when she tried to roll on her back. I asked the vet to evaluate her for ”lar-par” She confirmed a degree of lar-par and referred us to the same specialty vet clinic where the same symptoms, risks, tests were evaluated. This time we were able to pick a surgery date a couple weeks in advance with the understanding that she would have immediate surgery if there was any deterioration in her state. She came through the surgery well and had another 3 wonderful years—and as with the first dog, no regrets on doing the surgery, just gratitude for the option and vet insurance.
Good luck, I just switched Vets after the loss of my 12.5 y/o golden retriever; I went looking for a Veterinarian with “compassion”, and one who researches past normal office hours…hard to find these days!
Question to Dr. Eldredge, DVM: does the GOLLP present with infrequent, but definitely after meals, regurgitation? I have shortened her walks, esp. when temperature is above 60 degrees F. I bring water, and she will drink, then cough, & we go home for her to quiet. At night she seems to want warmth. She has been sleeping more during the day. She has a harness because she is a puller. We do titers. (It is only difficult in that kennels won’t always allow boarding with a recent titer, that shows the dog with good protection& no rabies inoculation.) Mostly it is a question with their insurance? Or mandated requirements? Anyway, I will bring in the pertinent info to our current vet as something to rule out or confirm for diagnosis.
This showed up after our senior dog was given a ‘legally required rabies shot’ although our pup was still recovering from a previous unrelated problem. He also had a positive titer and the vet could have done a new titer with the blood he was planning to draw anyway that day. But this vet didn’t care about titers and insisted on the shot. Unfortunately, I didn’t walk out with our pup before the injection since the vet didn’t even seem to have any interest in determining ways to help speed recovery from the previous problem. He didn’t even listen to us. All that was on his mind was vaccinating. An unhealthy dog, although even rabies vaccine manufacturers insist that their products are only intended for use in healthy animals. Aside from the laryngeal paralysis, at least 3 other rabies vaccine-induced symptoms appeared within 10d after injection. Just in case, anybody else also wondered why so many dogs suddenly have urinary incontinence: It was definitely a consequence of the rabies shot in our dog. It was the first noticeable and persistent ‘side effect’ we observed. I am no longer surprised why urinary incontinence ‘suddenly’ happens in so many dogs… I hope there are still veterinarians in practice who adhere to the desire to help animals instead of acting as brutal law enforcers and pharmaceutical representatives. No more vets for our pets unless I hear about a good one from people who know more than I did before this fatal visit.