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Laryngeal paralysis
- 2. What is it? • Failure of arytenoid cartilages to open • Obstructs the upper airway • Can be unilateral or bilateral
- 3. Complications • Respiratory Distress • Exercise intolerance • Heat Stroke • Aspiration Pneumonia
- 4. 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
- 5. Risk factors • Overweight • Hot/humid weather • Lower airway or pulmonary disease • Hypothyroidism • Progressive neuropathy
- 6. Meet Max • 4-year-old Golden retriever • 114 lbs (overweight) • Presented to ER for respiratory distress • Had recovered from knee surgery the previous day
- 7. 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
- 8. 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
- 9. 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.
- 10. 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
- 11. 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.
- 12. Works Cited • http://www.vin.com/members/cms/document/default.asp x?objecttypeid=2&template=articleview&objectid=318678 &said=1&sx=1342743&n=6 • http://www.vin.com/Members/Associate/Associate.plx?fro m=GetDzInfo&DiseaseId=567&sx=1343104&n=1 • http://www.vin.com/members/cms/document/default.asp x?objecttypeid=2&template=articleview&redirect=1&objec tid=178680