Summary: After receiving hundreds of comments, questions, and personal stories from readers about her blog post, Laryngeal Paralysis in Dogs: A Vet’s True Story, integrative veterinarian Dr. Julie Buzby shares her answers to reader questions about canine laryngeal paralysis. By the end of this follow-up article, you’ll have answers to frequently asked (and some more unusual) questions about lar par in dogs.
Canine laryngeal paralysis: when a sweltering summer day is the enemy
As the days become sweltering and humid, some call this time of year “the dog days of summer.” But as a veterinarian, I call it lar par season. The temperature escalates, and so do the cases of laryngeal paralysis presenting to veterinarians, often as life-threatening emergencies.
I firmly believe that we can all learn from each other, so I’ve captured the “best of” questions, comments, and personal stories from dog owners whose lives have been touched by lar par. Additionally, I’ve compiled my own answers to commonly asked questions about canine laryngeal paralysis.
If your dog suffers from this condition, I’d like to offer hope and inspiration by sharing this quote I received from one reader:
Dr. Buzby answers questions about canine laryngeal paralysis
Q: How could I have missed noticing the symptoms of lar par in my dog?
Dog Owner: My dog ended up at the vet after I took her out for a walk in the middle of the day in May. She started to struggle to breathe and to walk. I’d never seen her like that so I carried her home, loaded her in the back seat, and went straight to the vet. I feel horrible because I had never seen her act like that before and I had no idea she had a breathing problem. How could I have missed something so serious?
Dr. Buzby’s answer: I assure you that your mom guilt is unfounded. You’re clearly very observant and conscientious and probably saved your dog’s life by rushing her to the veterinarian that day. It’s worth noting that—just as many people’s first symptom of heart disease is a full-blown heart attack—some dogs’ first symptom of laryngeal paralysis is a crisis on the first warm day of summer. In my comprehensive article Laryngeal Paralysis in Dogs: A Vet’s True Story, I explain some of the subtle and not so subtle signs of lar par in dogs.
Q: Why is heatstroke more likely for dogs with laryngeal paralysis?
Dog Owner: My dog was recently diagnosed with lar par and I’m doing everything I can to keep him cool this summer. Could you explain why heatstroke can happen to dogs with laryngeal paralysis?
Dr. Buzby: Dogs pant to cool off, and dogs with laryngeal paralysis are much more prone to heatstroke because of their inability to dissipate heat. As dogs with laryngeal paralysis begin to overheat, they begin to breathe harder, but they can’t move air efficiently. This creates a vicious circle where neither the exchange of air nor the dog’s attempt to cool the body works properly, leading to heatstroke.
Q: What can I do for my dog with laryngeal paralysis and hind end weakness?
Dog Owner: My Labrador was recently diagnosed with GOLPP. He has hind end weakness and it breaks my heart to see him struggle to get up off the ground. What do you recommend?
Dr. Buzby: Neurologic weakness and slipping are biomechanical problems which medication does not treat that effectively, in my opinion. Treatment of GOLPP (Geriatric Onset Laryngeal Paralysis Polyneuropathy) should be multimodal. In other words, your veterinarian will likely recommend a combination of medicine, supportive care, and home management practices. One of the best-kept secrets for GOLPP dogs is the use of ToeGrips non-slip grips. Placed on the toenails, ToeGrips provide both stability and increased conscious proprioceptive stimulus. ToeGrips help improve mobility and confidence for dogs with GOLPP.
Our blog readers explain ToeGrips for GOLPP dogs:
“I had a Border Collie with GOLPP…symptoms were very consistent with what you describe. Fortunately for us, the laryngeal component of his neuropathy never got severe enough to require surgery. His hind end weakness did become problematic though, and the toe grips we got from Dr. Buzby’s were a great help his last few months. With good vet assistance and support, my boy made it just shy of 16, so there is good hope for those dealing with this problem for extended periods with good quality of life.” ~Lynda
“We lost our amazing foster failure, “clown in a Dogsuit”, Labrador, Beau to GOLPP…..not from a breathing crisis as Doxepin did help him tremendously, but due to the overall nerve degeneration and mobility and esophageal issues. We have tried to make something good come from his loss by helping others navigate the disease and passing on all the cooling and calming tricks we learned along the way. He also left his DNA at UW-Madison for their study in lar-par/GOLPP and at Cornell for their Biobank and Labrador Health Study. He lives on through the research done with his DNA. And we did use toe grips for Beau with success too!! I urge anyone with a dog with this condition to join the amazing support group on Facebook.” ~Ally
Q: Is gagging associated with canine laryngeal paralysis?
Dog Owner: We have a 9.5-year-old Bouvier des Flandres who often makes a coughing noise which sounds like croup or a barking seal. She also gags or wretches but nothing comes out. Is gagging associated with lar par?
Dr. Buzby: Yes, I would definitely consider what you are describing to be compatible with laryngeal issues. However, “inspiratory stridor” (raspy breathing) is considered the gold standard symptom. I recommend discussing your dog’s symptoms with your veterinarian.
Q: Why are sedatives prescribed for lar par?
Dog Owner: My vet prescribed sedatives to keep on hand for my German Shepherd with canine laryngeal paralysis in case he gets into a breathing crisis. Why would sedatives help improve his breathing?
Dr. Buzby: With laryngeal paralysis, stress compounds the problem. So much so, that keeping your dog calm is as important as keeping your dog cool. The “perfect storm” for these dogs is the combination of environmental stress, heat/humidity, and respiratory distress. Because of this disastrous trifecta, sedation may be a helpful part of the treatment protocol for certain dogs.
Q: Can lar par be caused by leashing pulling?
Dog Owner: When going for walks, sometimes my dog pulls. Could repeatedly pulling on the end of the leash cause a dog to acquire laryngeal paralysis eventually because of damage from the collar?
Dr. Buzby: There are documented cases of dogs developing laryngeal paralysis from damage to the nerves innervating the larynx as a result of the following:
- neck surgery
- cancerous tumor growth
- deep trauma (bite wound)
However, I have to confess that I didn’t know the answer to this specific question. To find out, I asked a board-certified veteran neurologist for his opinion. Dr. Bill Thomas shares a couple of key reasons why it is unlikely:
Dr. Bill Thomas: The most important thing to understand about laryngeal paralysis in dogs is that it’s almost always a polyneuropathy—that is, a disease affecting multiple peripheral nerves. If you do electrodiagnostic testing on dogs with laryngeal paralysis you typically find other nerves are also abnormal. Many neuropathies affect the longest nerves the most. And the recurrent laryngeal and sciatic nerves are the longest, so they are often the most severely affected. (Meaning symptoms would manifest first and most predominantly in the larynx and hind legs.)
It would be possible for any sort of severe cervical (neck) trauma to affect the recurrent laryngeal nerves. But these nerves are pretty well protected and lie in some loose fascia (connective tissue) right next to the trachea. So I think it would be pretty hard to damage both of those nerves, one on each side of the trachea, without damaging the trachea or larynx itself. Not to mention all the other important stuff in the neck larynx—esophagus, common carotid, vagosympathetic trunk, jugular veins, vertebrae, and spinal cord. ~ Bill Thomas, DACVIM (Neurology), University of Tennessee
Q: Will lar par surgery really help my dog?
Dog Owner: I am trying to decide whether or not the tie-back surgery is the right choice for my dog with laryngeal paralysis. I know there are a lot of possible problems that can happen after the surgery and it is not something my regular vet can do. Plus, it’s expensive. I would give any amount of money to help my dog, but I don’t know if it’s going to do more good than harm?
Dr. Buzby: I understand your dilemma and I have to confess that there was a time in my career when I felt much like you do. I was on the fence about whether or not the rewards of the tie-back surgery outweighed the risks. However, today I can say wholeheartedly that I would have the surgery done for my own dog by a veterinary surgeon.
I love these success stories from dog owners who have been in your shoes:
“Oscar, our 13-year-old, career-change yellow Lab had tie-back surgery for lar par and for the last year of his life breathed so much easier. The small chore of changing his food, watching him eat, standing, and making sure he didn’t eat or drink too fast was worth it…We were so happy to spend the money to give him a last 9 months of freedom from stress!” ~ Janelle
“My 13-year-old mutt was diagnosed with lar par last year. He had slight relief on Doxepin, but as the weather got warmer, he got worse. He had tie- back surgery done and is now living his best life as a 14.5 year old. Surgery can be expensive, but I highly recommend it! It immediately changed his quality of life, and mine, as I didn’t have the constant anxiety of worrying about him.” ~ Liz
“My Springer collapsed after a grooming appointment and was rushed to the ER. She was stabilized and subsequently scoped. She was diagnosed with bi-lateral lar par. In retrospect and after learning more about this disease, the symptoms had been there for a while. We also live in the deep south where the heat and humidity are oppressive. We had two options: surgery or euthanasia. Even though she was a senior (12), she was in good health overall. Surgery has given us more quality time with her and she is doing very well now at 14 years old. We are 30 months post op. We’ve had two incidences of AP [aspiration pneumonia] that were identified quickly and responded to treatment. There is life with lar par and we are living it.” ~K.A.
“My dog Hunter had the successful tie-back surgery and gained another five years in his beautiful life. Unfortunately, the surgery was costly but totally worth having more time with him.” ~Barb
Q: Is lar par hereditary?
Dog Owner: Our dog and his littermate both died from lar par. Are there any studies indicating a hereditary link?
Dr. Buzby: The precise cause of GOLPP, the polyneuropathy associated with laryngeal paralysis, remains unknown. However, since the condition is most common in certain breeds, it makes sense to suspect that there is a genetic factor. But this is just speculation.
Keep in mind that polyneuropathies can have many underlying causes. I’m sure some of those underlying causes are influenced by a hereditary predisposition.
Also, it’s worth mentioning that there is a congenital form of lar par which may show up in very young dogs. (As the name suggests, GOLPP manifests mostly in senior dogs.) For Black Russian Terriers and Leonberger dogs, there are tests for the congenital disease. For more information, please read these articles from veterinary colleges: JLPP in Black Russian Terriers and Genetic test available for early-onset inherited polyneuropathy in Leonberger dogs.
Q: Is canine laryngeal paralysis similar to collapsing trachea?
Dr. Buzby: Lar par and collapsing trachea are different structural problems. However, both conditions can manifest with a similar presentation—a dog struggling to breathe because the breathing channel has narrowed. In laryngeal paralysis, it’s because the arytenoid cartilage(s) are decreasing air flow. With collapsing trachea, as the name implies, the windpipe flattens and airflow is decreased.
Also, collapsing trachea tends to be a small dog issue and lar par is mostly a large breed dog issue. Interestingly enough, the cause in both conditions is unknown.
Q: Years ago, my dog had debark surgery for lar par. What’s your opinion on this option?
Dog Owner: I had a 9-year-old Irish Setter over 20 years ago that was diagnosed with laryngeal paralysis. I’m sure many advances have been made, but the success rate with the tie-back surgery was so low back then. My veterinarian chose to do a “debark” surgery. It actually worked quite well, not to mention that it was considerably less expensive. What is your opinion of this surgical option?
Dr. Buzby: A “debark” surgery, more properly known as a ventriculocordectomy, theoretically helps dogs with lar par because the vocal folds (which allow dogs to bark) do somewhat obstruct airflow in the larynx. However, the dysfunctional arytenoid cartilage(s) is a much more significant source of obstruction than the vocal folds.
This surgery has fallen out of favor in modern veterinary medicine—both for preventing dogs from barking and for treating lar par. While the debark is a much less difficult and thus a “cheaper” procedure to do on a dog, it’s also more risky, associated with more complications, and ultimately less effective for treating the condition. Today the tie-back procedure is the gold standard.
Q: Are lar par support groups available?
Dog Owner: My dog was recently diagnosed with canine laryngeal paralysis. I’m overwhelmed and trying to learn as much as possible. Can you recommend an online community for support?
Dr. Buzby: Yes! There is a dedicated private Facebook group called Laryngeal Paralysis (LP) Support Group (Dogs) with 2400 members. I’m confident this group would be happy to provide empathetic support and helpful tips.
Do you have questions about canine laryngeal paralysis?
Please keep the questions, comments, and stories coming. We can all learn from each other.