Laryngeal Paralysis (LARPAR)
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Our guide has been authored by qualified veterinarians, but should not be taken as substitute for medical advice or professional veterinary consultation. If your pet displays any unusual symptoms, we strongly advise seeking guidance from a veterinarian
Understanding Laryngeal Paralysis (LARPAR) in dogs
Laryngeal paralysis, A.K.A. LARPAR, is a neurologic condition common in dogs, especially older, large breed dogs. The larynx, also commonly called the “voice box”, is located at the front of the throat, over the trachea. It opens and closes to allow air to flow in and out, while preventing food and water from entering.
Laryngeal paralysis prevents it from opening and closing properly, thus restricting airflow and causing related complications. Symptoms may be mild at first, only requiring conservative management, but in some cases LARPAR can lead to significant breathing difficulties and even life-threatening suffocation that necessitates surgery.
Dylan's story
Dylan is an adorable black Labrador who never had any health issues until, at 12 years old, his dedicated owner Steve noticed Dylan was less energetic during walks, panting heavily with little exertion and wanting to head home. This gradual change misled Steve to believe these were just natural signs of aging. One hot day, during their usual walk, Dylan suddenly collapsed, struggling to breathe. Steve rushed to the vet with Dylan, who was barely responsive and his tongue was blue. He immediately received a breathing tube and a ventilator with oxygen. Dylan was diagnosed with severe laryngeal paralysis, which had significantly restricted his airflow. After two days of supportive care, Dylan underwent tie-back surgery, and days later, he seemed like his younger self again.
Laryngeal Paralysis (LARPAR)'s Causes: Uncovering Triggers
Laryngeal paralysis is caused by a disruption of the normal nerve function to the muscles controlling the two cartilages protecting the tracheal opening. This prevents them from opening and closing properly.
The most common cause is degeneration of the larynx nerves and muscles, which is seen mostly in large, geriatric dogs and happens due to genetic reasons. LARPAR is often part of a larger degenerative nerve disorder known as geriatric onset laryngeal paralysis and polyneuropathy (GOLPP).
Other possible causes include traumatic injury, hypothyroidism, neuromuscular diseases, or tumors in the throat, neck, or chest.
Congenital laryngeal paralysis is very rare but possible, appearing in puppies as young as a few months old.
Recognizing Laryngeal Paralysis (LARPAR): Signs and Symptoms
- Struggling to breathe and breathing with an open mouth: with minimal physical exertion.
- Unusual breathing sounds: resembling squeaking or whistling, often accompanied by hoarseness.
- Changes in barking sounds: resembling wheezing or hoarseness.
- Coughing: sometimes accompanied by mucus or phlegm.
- Difficulty walking and reduced stamina: especially in hot weather.
- Characteristic stance with legs spread apart
- Pale or bluish mucous membranes: visible on the dog’s tongue and gums.
- Sudden collapse during intense activity
Laryngeal Paralysis (LARPAR) Diagnosis: How it's Identified
Initial suspicion typically arises based on the above-mentioned clinical signs, especially in large breeds and older dogs, and following a physical exam. Definitive diagnosis is reached following a test under sedation where the dog’s airway is evaluated to check the movement of the laryngeal cartilage during breathing and to see if the airway opening is obstructed. Additional tests to rule out other potential causes include comprehensive blood tests, like thyroid function tests, and advanced imaging, such as X-rays or a CT scan of the neck and chest.
Treating Laryngeal Paralysis (LARPAR): Options and Approaches
Mild cases that don’t significantly harm the dog’s daily life require conservative treatment, including maintaining a healthy weight, appropriately limiting activity (especially in hot weather), and minimizing stress. Medications that help manage the associated symptoms may include steroids to reduce inflammation, cough suppressants, sedatives to ease anxiety or rapid breathing, and antibiotics in the case of aspiration pneumonia caused by food or water entering the lungs.
In severe cases, tie-back surgery may be recommended, where one of the laryngeal cartilages is secured to the inner wall of the throat to keep the trachea permanently open and allow constant airflow. Only one side is secured to reduce the risk of aspiration pneumonia, but unfortunately this is a common complication of this surgery regardless. For this reason, it’s recommended that post tie-back dogs be fed smaller, more frequent meals from an elevated position.
In emergencies involving severe respiratory distress, immediate intervention may include providing oxygen, administering sedatives, and sometimes administering mechanical ventilation before surgery can be performed.
Laryngeal Paralysis (LARPAR): Surprising Facts
Studies show that the risk of laryngeal paralysis increases significantly with size, excess weight, and age. In certain breeds where the condition is common, more than a quarter of dogs aged seven and older may suffer from this condition. Research also shows no difference in prevalence between males and females.
Since the larynx is responsible for producing sound, it’s no surprise that dogs suffering from this disease often seem to be “barking on mute”.
The diagnostic test for laryngeal paralysis must be performed under sedation, as it involves opening the dog’s mouth to look inside. Since many anesthetic substances can suppress the respiratory system, potentially masking the condition, specific ones are typically used, sometimes along a respiratory stimulant.
Vet's Tip: Dealing with Laryngeal Paralysis (LARPAR)
On the one hand, large, elderly dogs suffering from more severe laryngeal paralysis often struggle significantly with daily activities. On the other hand, any surgical procedure poses a certain level of risk.
Please note that laryngeal tie-back surgery can be a rewarding procedure, as most dogs recover quickly and their breathing improves dramatically. The risks are significantly reduced when a skilled team closely monitors the process. Complication risk can be reduced when post-surgical care instructions are followed carefully. This is an excellent example of how advanced medicine can significantly improve the quality of life for our beloved pets.
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Latest in Research and Treatments
Despite the decent success rate of tie-back surgery, it’s still an invasive procedure performed near major blood vessels and sensitive areas under anesthesia, with the risk of complications or failure.
In humans with upper airway paralysis, silicone implants help keep the airways open and are inserted through the throat without invasive surgery. This technique has been recently adapted for use in dogs with high success rates.
There are many advantages to this method. It’s not as invasive and doesn’t require advanced surgical expertise while still offering a long-term solution for dogs who are unsuitable for tie-back surgery. The implants are relatively inexpensive, easy to produce, and can be customized using 3D printing, which is being used more often in veterinary medicine. However, the risk of aspiration pneumonia should be considered, as the implant also keeps the airway partially open, and similar recommendations apply following this technique.
dogs breeds Prone to Laryngeal Paralysis (LARPAR)
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