Laryngeal Paralysis

What is it?• Failure of arytenoid

cartilages to open• Obstructs the upper

airway• Can be unilateral or

bilateral

Complications• Respiratory Distress• Exercise intolerance• Heat Stroke• Aspiration Pneumonia

Common Breeds• Congenital:

– Siberian Huskie– Bouvier des Flandres– Bull terrier– Pyrenean Mountain dog– Dalmatian

• Usually present at 4-6 months of age

• Acquired: Middle aged-older– Afghan hound– Chesapeake Bay retriever– English Springer spaniel– Greyhound– Irish Setter– Labrador Retriever– Rottweiler– Saint Bernard– Other large breed dogs

Risk factors• Overweight• Hot/humid weather• Lower airway or

pulmonary disease• Hypothyroidism• Progressive neuropathy

Meet Max• 4-year-old Golden

retriever• 114 lbs (overweight)• Presented to ER for

respiratory distress• Had recovered from knee

surgery the previous day

ER Treatment of Max• Triaged to the treatment area• Unable to stand• Loud upper airway noise and dusky color of

mucous membranes• Started on blow-by oxygen, and placed IV

catheter• Given sedation and intubated to provide

oxygen supplementation• Temp was 108 so cooling measures were

taken• Kept sedate and started on fluids

Extended care• Bloodwork showed low

platelets (thrombocytopenia) with normal clotting times

• Blood pressure and ECG were monitored but normal

• Chest radiographs did not show pulmonary edema or aspiration pneumonia

• Max was able to be extubated once cool and maintained adequate oxygenation while sedated.

• Platelets continued to drop over the course of the next day

Surgery at ISU• After 2 days of ER care and monitoring,

Max’s platelet values started to increase.

• He was sent to Iowa State University College of Veterinary Medicine for surgery

• At ISU, endoscopy confirmed bilateral laryngeal paralysis

• Max had left arytenoid lateralization surgery to permanently open his airway.

At Home Care• Max was sent home with several

medications to keep him calm and pain free during his recovery, as well as prevent infection of the surgery site and decrease the risk of a lower airway infection.

• It was recommended that Max lose some weight to prevent complications

• Max can no longer go swimming, and should be kept as calm and quiet as possible.

• He should avoid extreme temperatures

• Can only eat wet soft food to prevent aspiration pneumonia and drink small amounts of water at a time

Prognosis• Good to Excellent• Max can lead a long and

happy life• Continued risks include

aspiration pneumonia, infection, and tearing of tissues resulting in laryngeal collapse.

Works Cited• http://www.vin.com/members/cms

/document/default.aspx?objecttypeid=2&template=articleview&objectid=318678&said=1&sx=1342743&n=6

• http://www.vin.com/Members/Associate/Associate.plx?from=GetDzInfo&DiseaseId=567&sx=1343104&n=1

• http://www.vin.com/members/cms/document/default.aspx?objecttypeid=2&template=articleview&redirect=1&objectid=178680