Approach to Laryngeal Paralysis

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Published on: 23.03.2018

Presenter:

Daniela Murgia DVM, DECVS, MRCVS
European Specialist in Small Animal Surgery
RCVS recognised Specialist in Small Animal Surgery
(Soft Tissue)

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About The Webinar

Laryngeal paralysis (LP) is a well recognised and potentially life threatening condition seen predominantly in older large-breed dogs. However it is also increasingly being recognised in cats. The condition results either from dysfunction of the caudal laryngeal nerves, which are terminations of the recurrent laryngeal nerves or from damage to the dorsal cricoarytenoid muscles.
A hereditary form of laryngeal paralysis in young dogs has been reported in Bull Terriers, Bouviers des Flandres, Siberian Huskies and Siberian Husky cross-breeds, Dalmatians, Rottweilers, white-coated German shepherd dogs, Leonberger and Pyrenean mountain dogs. Acquired LP is instead most commonly reported in Labrador and Golden Retrievers, Great Danes, Irish Setters, Afghan Hounds and Saint-Bernards. Congenital or acquired LP has been only sporadically reported in cats and no breed or sex predilection has been identified. Clinical suspicion is an important tool in diagnosing LP. If an affected animal is stable, it should undergo a through physical and neurological examination. Complete blood count, serum biochemistry and thyroid function profile should be tested as well as radiographs of the thorax and abdomen. Abdominal ultrasound is recommended to rule our concurrent abdominal conditions. Laryngoscopy and observation of the movements of the arytenoid cartilages under a light plane of anaesthesia is the diagnostic method of choice for LP. Patients presented with acute cyanosis or collapse as a result of a LP has to be stabilised with emergency medical treatment. Unilateral laryngeal lateralization procedure is still the most widely used surgical technique to correct LP in dogs and cats and to manage the symptoms. The purpose of laryngeal lateralization is to enlarge the rima glottidis by surgical retraction of the arytenoid cartilage on one side of the larynx and decrease airway resistance. Laryngeal lateralization has a high success rate providing immediate relief of the clinical signs. In facts, improvement is expected in 90% of animals undergoing arytenoid lateralisation. Patients undergoing laryngeal corrective surgery for LP should not be offered water and food until fully awake. It is recommended to hand feed meatballs not earlier than 24 hours after surgery and offer water only after animal cam swallow the meatballs. Owners should carry out hand feeding for the 2 weeks after surgery and rest should be recommended for the following 4-6 weeks.

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