Sooti's case of laryngeal paralysis
"Sooti" is a long term patient at Prospect Road Veterinary Hospital. She is a beautiful 13 year old german short haired pointer who lives with a younger more boisterous 4 year old german short haired pointer who shares none of "Sooti"'s poise and calm demeanour. Sooti had had an ongoing but mild cough since being boarded that responded to antibiotics. At that stage, it was thought that she may have had Canine Cough. In August 2002 however, the owner also noticed that her bark had changed and the gagging cough remained.
After a physical examination it was recommended that she be admitted for radiographs (xrays) of her chest. Her throat was to be fully examined whilst under general anaesthesia. Her chest xrays were normal. Before placing the endotracheal tube (breathing tube), the vet could see that the cartilage of her larynx was not opening when she breathed. It was also obvious that this was the area where the "gaggy" cough was coming from. She was diagnosed with laryngeal paralysis.
The larynx is a set of interlinking cartilages that sit at the back of the throat. It forms the opening of the trachea (windpipe). The vocal cords are here also. During normal respiration ( breathing) the arytenoid cartilage will open fully on inspiration (breathing in) allowing maximum air to go into the lungs. Closing the arytenoid cartilages prevents food from going down the wrong hole. Dogs pant in hot weather as a means to cool themselves (rather than sweating as people and horses do). Excessive panting when the larynx is not functioning properly can lead to heat stroke.
The owner was given the options to keep Sooti quiet and cool to prevent her from overheating or surgical correction. They opted for the former as they were reluctant to put their dog through surgery at her age.
However, during the following summer, Sooti was not coping well in the heat. She came into the hospital one day with respiratory distress and mild heat stress after running around with young and spritely Alice. At this stage, her owners decided to proceed with surgery.
Surgery for this condition involves permanently tying back the arytenoid cartilage so that it does not block or inhibit air movement. It can be a technically challenging surgery with several serious complications. However, we are all very pleased that Sooti's operation proceeded very well. She recovered from surgery uneventfully but had lost her howl.
A month after surgery she was going well but coughing intermittently. Her chest radiographs were repeated. These showed that she had developed mild aspiration pneumonia. This responded well to appropriate antibiotics with follow up radiographs showing her chest to be clear. A year down the track, Sooti continues to bound along. Her owner comments that she seems much happier and has more energy than prior to the surgery so all in all they are happy with outcome. She still has no bark but Alice, apparently, barks enough for both of them.