Canine Laryngeal Paralysis
sandylp

SANDY
JUNE 3, 1984 - SEPTEMBER 8, 2000

BREED: GOLDEN RETRIEVER
AGE AT TIME OF SURGERY: 12 YEARS 3 MONTHS
DATE OF SURGERY: SEPTEMBER 5, 1996
TYPE OF SURGERY: SINGLE TIE BACK
OWNER: LAURIE COLLINS
EMAIL: SaBrIrTo4@erols.com
Picture taken 1 week post-op

MORE PHOTOS

8/31/96

This morning I headed south to take Sandy, my 12-year-old golden, and Brandy, my seven-year-old Lhasa cross, for a camping/swimming weekend at Lake Gaston. I had planned to leave at 7:00, but instead did not leave until around 8:30. Even though the dogs had been out for quite awhile in the morning while I was packing, Brandy let me know within 15 minutes of driving that she had to go outside!!! I pulled off into the Beltsville Agricultural Research Center and found a place to let them out. Sandy was near me the whole time - was not in any weeds or grass, just on dirt.
All of a sudden, Sandy started gagging. Started having a hard time breathing. Didn't seem like she needed to vomit, and since she had just had breakfast an hour before she would have had plenty in her stomach to do that. She started panting really heavily and trying and trying to get air into her throat! I put my fingers down her throat and could feel nothing caught.
Well, thank God for things working out the way they did, because I was only ten minutes away from the vet I used to use when she was a puppy instead of being an hour and a half further down the road where I would know of no vet to take her to. And thank God for Brandy who chose to tell me that she needed to go out right then!! I loaded Sandy up in the car and took her to the vet's office, which had opened at 9 - so I lucked out there, too.
She walked in the vet's office under her own power but was still having a hard time breathing. The vet thinks it's laryngeal paralysis. He was going to give her some injections and possibly put her in an oxygen tank to help her breathe. At that point Sandy didn't want to walk any more, so they put her on a blanket and pulled her into the office. The look on my poor baby's face as they drug her away was a look of pure terror!
The vet said usually the signs of laryngeal paralysis manifest over time. Sandy HAS had a little labored breathing from time to time over the past year or so, but I always attributed it to the weather or exercise - not just because she was having problems breathing. I had the vet check her heart last time I had her in, and everything sounded fine to him. I didn't even think about mentioning the breathing because, as I said, there always seemed to be a logical reason for it.
I left her at the vet's at 9:30. I called at 11:30 and 1:30. Both times they said she looked a bit better and her breathing was improving. They want to keep her there overnight just so she doesn't get excited, and possibly through the whole weekend. In a way I feel better about that because they'll be able to monitor the situation closely, but I'll miss her dreadfully. I'll call again before they close at 5:30 to see how my girl's doing. The vet will be in from 9 to 12 tomorrow and will let me know if I can bring her home.
PLEASE, if anyone knows anything about this condition, please email me!! I know the vet seemed to indicate that Sandy wouldn't be able to handle stressful situations in the future, if she pulls through this, but she wasn't stressed this morning!! She's used to going for rides and going on trips, and since I did most of my packing when she was outside, she didn't even have time to get excited about the fact that I was taking them for a camping trip! I don't know what quality of life she'll have after this, so if anyone's experienced this in their dogs or heard of it in others, please let me know!

It's been a long time since I've prayed this hard. Please send prayers and good thoughts Sandy's way. I'm not ready to lose my best friend yet!

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9/1/96

I am overwhelmed by the amount of email I have received letting me know that prayers and good wishes are going out to Sandy. I have also received mail from a couple people who have gone through or are going through the same problem with their dogs. Many people have asked for an update on her condition.
I called the vet this morning, and she's breathing easier, but I guess when she gets a little excited, her breathing is still a bit labored. They wanted me to keep her in there another night so they can continue giving her the respiratory meds. I'm to call again tomorrow a.m. and check again.
I told them to draw blood and do a thyroid check on her since she's never had one done. Kim Campbell, who is a vet tech, told me that one dog who has this condition has been able to keep it under control just with thyroid medication. Obviously I'd much rather go that route than surgery, if possible. The vet hasn't said anything about surgery yet, nor has it been definitely diagnosed as laryngeal paralysis, but from all the information I've been getting, it sounds like that may be what I'm looking at. :( The one thing that doesn't fit in with laryngeal paralysis is that the quality of her bark hasn't changed. Sandy has had a quiet bark for a large dog ever since she was young.
Before I do anything, I'll contact my regular vet and let them know what's been done to her at this vet and go from there.

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9/2/96

For all of you who wanted updates on my 12-year-old golden, Sandy, who had an episode on Saturday morning where she couldn't breathe, this is for you. Please keep sending prayers and good thoughts Sandy's way.
I just got off the phone with the vet, and she wants to keep my girl yet another day. :( Even though the meds are oral - she's on a bronchodilator, diuretic and steroid - and her breathing is okay, when the vet has seen Sandy get a little excited, her breathing is labored again. She's afraid if I bring her home, due to the heat or due to seeing me, Sandy may end up back at square one and I'd have to take her to an emergency clinic. I can understand her thinking, but I'm obviously very disappointed.
I asked if they're still thinking it's laryngeal paralysis. The answer is yes, but they won't be able to tell until they look down her throat, and since it's a holiday weekend with a skeleton crew, she won't be able to do that until tomorrow morning. She's hoping I can bring her home tomorrow. I'm to call again tomorrow at 10 a.m.

9/3/96

Hey, guys!! I'm glad to report that Sandy is now home with me where she belongs!! When I picked her up from the vet's office she was happy to see me, but after a couple tail wags she kept on walking, as if to say get me out of this place NOW!!!! Brandy started whining like crazy when she saw that Sandy was out in the yard, and when I let her out, she immediately sniffed Sandy up one side and down the other wondering where Sandy had been!! So I guess the answer is definitely yes, she missed her big "sister"!
She's taking prednisone and theophylline for a few days. My regular vet gave me the number of a specialist to contact since, if it IS laryngeal paralysis, he says it's nothing to mess around with. I called the specialist after business hours this afternoon, so I will call early tomorrow morning and schedule an appointment with him. For my own peace of mind I'd like to know what the problem is and how much I can allow Sandy to do.
She seems a bit tired, and her breathing still seems to be a BIT more labored than usual for her, but it's not too bad. Her appetite's good, and she's happy to be home. I'll keep you posted on her progress. :)

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9/4/96

I took Sandy to the specialist today, and his thinking is it probably IS laryngeal paralysis after asking me questions and listening to her breathe. So, once again, Sandy's spending the night at a hospital. They're going to do pre-surgery blood work on her today, as well as a chest X-ray, and tomorrow she will have her throat scoped. If it is laryngeal paralysis, they will proceed immediately to surgery. If they find something else, they will call me and we will decide what to do. He's expecting that she would be able to come home on Saturday if she has surgery.
This specialist has done over 200 of these procedures. He was very thorough when he talked to me and spent time with me answering all my questions. He believes surgery would be the best option for Sandy, and he says he's even done the surgery on a police dog who went back to work and field dogs who went back to the field. I feel confident that he will do his best for Sandy - he knows how much I care about her.
Sandy's lifestyle will have to change after the surgery. She will more than likely need to stay on canned food for the rest of her life - there would be a chance of her aspirating small chunks of dry food into her lungs. Swimming in ponds or lakes would be out, as the chance of bacteria being introduced into her lungs would be too great, but she would probably be able to swim in a swimming pool. Luckily I do have a friend who has one who had offered to let me use it this year for Sandy, but I never took her up on the offer. She would not be allowed to eat any table scraps, but since I don't feed her many of those anyway, that won't be a problem. Any bones other than Nylabones would be out - but Sandy doesn't like Nylabones. She should be able to eat milkbones. And any liquids with calories in them would be off limits - good thing she's not a beer drinker!
Thanks again for all your support - the mail is still coming in! Please say an extra prayer tonight and tomorrow morning for Sandy. I'll post again tomorrow after I hear something. I feel like I've lived an eternity since Saturday morning - you guys are really helping me get through this. It means a lot.

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9/5/96

Hello, all!! Well, the surgeon called me just before 12:00 and said that Sandy, my 12-year-old golden, made it through surgery fine!!! :) She did have laryngeal paralysis, but the surgery was very routine - no problems! She was already awake, but she was groggy. (Probably wondering why her throat hurt, too!!)
They will keep her for a couple days to make sure she can eat and drink okay and that her throat doesn't swell, but I should be able to bring her home Saturday. Keep her in your thoughts!! Your prayers are obviously working!! We're not totally in the clear yet, but it sounds like she's on the home stretch!! :)

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9/7/96

My girl's home!!! YEAH!!! Her breathing sounds MUCH better than it has for over a year!! She did get her other leg shaved for this catheter, so she has two naked front legs, and a thin strip was shaved from her throat down to her breast bone, but that's not very noticeable. She has about 21 staples going down her throat, but that's hidden by the loose skin on either side of her neck.
I have to feed her small meals (about half a can of dog food) several times a day for the next two weeks. That needs to be rolled up into meatballs. Her activity has to be restricted for four weeks - no running, jumping or playing. She has to use a harness instead of a collar.
They did a thyroid test on her - which I had asked the vet who saw her over the weekend to do, but they never did - and I'll get those results by the 16th. And I go back again on the 23rd so the surgeon can take the staples out. Then she has a one-month checkup, and after that, she should be home free!
I had asked if she could have free choice of water. The vet who saw me today said I should limit it until I feel comfortable with her drinking. Well, when she came in, she immediately got a drink and had no problems at all!! I think I'll restrict it for today, but I think she'll be fine with that, too!
So sounds like we're on the way to recovery!! I'm also on the way to the poor house, but it was worth it!!! Here's hoping I have several more good quality years with my baby.
I have received a few questions about this, so I thought I'd enlighten people a bit more on what laryngeal paralysis is. Helen Redlus and Lynda Blair sent me some info out of the UC Davis Book of Dogs, as follows:

LARANGEAL PARALYSIS

"Normally, the vocal folds open during inhalation and partially close during exhalation. In laryngeal paralysis the vocal folds either do not move at all or move out of time with the phases of respiration. One or both vocal folds may be affected. This syndrome has been reported as a congenital (present at birth) problem in the Bouvier de Flandres, Siberian Husky and Dalmatian breeds. It also occurs commonly in older dogs of the sporting breeds, such as Labrador Retrievers. It was once thought that laryngeal paralysis was linked to an underactive thyroid gland (hypothyroidism). instead it is now believed that laryngeal paralysis probably occurs as a component of a more serious inflammatory disease involving either the neurologic system, the muscular system, or both. Clinical signs tend to develop gradually over a long period of time, and depend on the severity of the paralysis and the resulting obstruction to airflow through the larynx. The earliest sign is often a change in the quality of the bark. Affected dogs are easily fatigued, sensitive to heat, and pant excessively. In severe cases the condition can be life-threatening.

"Confirmation of the diagnosis can be made by direct visualization of the vocal folds with the dog under light anesthesia. Because laryngeal paralysis commonly occurs as part of a generalized neuromuscular disorder, affected dogs should have a thorough neurologic evaluation performed by a veterinarian who is skilled in this type of procedure.

"In general, treatment is similar to that for laryngitis or laryngeal edema. Correction may be attempted by surgically attaching one or both vocal folds to the outer sides of the larynx so that the larynx will remain open on inhalation and exhalation. While this often results in resolution of the clinical signs, it predisposes the dog to aspiration of foreign bodies and even food and water into the lungs. The prognosis often depends on the progression of the underlying inflammatory disorder."

In Sandy's case, the surgeon felt sure it was not due to any neuromuscular problems. Her bark had not changed, but she was easily fatigued, sensitive to heat and panted excessively. As I said in a prior post, I attributed those things to her older age and/or her bad hips.
Sandy's operation consisted of attaching one arytenoid cartilage to the side of the larynx. My surgeon said it's rarely necessary to do both of them, as one usually leaves the airway open enough.
I would like to publicly thank Jamie and Charlie Rodriguez from Alaska who responded immediately to my plea for help. Their black lab, Gus, had the operation a year and a half ago, and he is now 13 years old and doing well. Unfortunately, Gus ended up being in the small percentage of dogs who have some complications from surgery (scar tissue buildup), and he needed to have further procedures done. If I had not heard from Jamie, I may not have understood how serious this condition is and I probably would not have sought treatment as rapidly as I did. My surgeon said that Sandy's prognosis is very good since her condition had not progressed as far as a lot of other dogs he's seen. So thanks, Jamie and Charlie, for possibly saving Sandy's life!!!
Hopefully my next post regarding Sandy will be on the 23rd telling you that her staples have been removed and she's doing fantastic!! Thanks for the prayers, good thoughts and supportive email. It worked!! My best friend's back where she belongs!!!

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9/24/96

Thought it was time to give you guys an update on what's been happening with Sandy, my 12-year-old golden who had an episode on Aug. 30 where she couldn't breathe. She had surgery for laryngeal paralysis on Sept. 5 and just had her staples removed yesterday.
The surgeon is very pleased with her progress. Her breathing is very quiet - sounds like a normal dog now! I hadn't had any problems with her choking on anything between the time of surgery and yesterday.
>Originally I had gotten Ken-L Ration as her canned food. Well, as I'm sure a lot of you know, Ken-L Ration doesn't seem to digest very well. So I switched to Science Diet canned food, which definitely hardened her stools again. Well, when I went to the store to get a month's supply of that, it cost me $85!!! Luckily, the vet said I could start weaning her back on dry food, and I don't need to make her canned food into meatballs anymore.
I gave her a bit of dry food yesterday, but evidently I gave her too much. She's always inhaled her food, and yesterday was no exception. I ended up having to put my finger down her throat and clearing her airway for her since she couldn't breathe. So last night and this morning I only gave her enough in her bowl for two bites, made sure she swallowed that, and then added some more. She did fine with that. I think for the next two weeks I'll probably do about half canned and half dry food. Hopefully I'll be able to get her totally off the canned very shortly. She has good teeth for a 12 year old, and I'm sure the canned food will make it more difficult to keep them that way.
When she got her thyroid level checked, her T4 was a bit low, so I started her on thyroid medication yesterday. Between the extra energy she already has from being able to breathe again and what the thyroid meds will do, I may end up with a puppy again! Which, of course, is fine with me!! :) My mother came to see her over the weekend and was shocked by how excited Sandy was to see her. Guess the LP was slowing her down MUCH more than her age was!
I still have to keep her exercise limited for another two weeks. She goes back for her last checkup on the 7th of October, and then we should be home free. I'm taking her to Nags Head, NC, with me tomorrow through Sunday. Over Labor Day weekend I was afraid I wouldn't have her with me for that trip, which was basically planned with her in mind! It would have been tough to go without her, so I'm REALLY glad she'll be with me. No swimming in the ocean this time, but that's okay - at least she can sit on the beach with me and watch the waves! Quality time at its best!!!
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10/11/96

Hello, all! Just thought I'd let you know the latest about Sandy, my 12-year-old golden, who had surgery for laryngeal paralysis on Sept. 5. She had her last checkup with the surgeon on Monday, and she passed with flying colors!!! :) He was very pleased with her progress and told me that unless I have questions or there's a problem, we don't need to go back to see him. Sandy's pretty much totally back on dry food, but I still give her some canned food because she needs to put on a little weight. I can't just dump the dry food in her dish and let her eat it by herself yet, but I'm able to pour larger amounts in there now. She's starting to realize how much she can eat before she chokes, so I'd say within the next couple weeks she'll be able to eat by herself without trying to inhale too much.
Sandy had a Great time when I took her to Nags Head, NC, at the end of September! :) I DID let her get her feet wet in the ocean - couldn't take all her fun away from her! She was still on restricted exercise, but we managed to take a few short walks on the beach. Brandy (who thinks she's a golden with stubby legs!) really enjoyed it down there, too. She was having a ball swimming out to me and then body surfing back to shore. Sometimes she didn't even go all the way in to shore before she turned around and swam out to me again!! The only thing that would have made that part of the vacation better would have been if Sandy had been able to swim with us.
One thing the surgery did is take away two of her tricks - speak and tell me quietly. Now when she barks, she sounds like she's coughing (very similar to a debarked dog). Of course, she's getting very demanding - guess she figures I can't hear her as well so she has to bark twice as much! Luckily, she's never been much of a barker except when she's hungry or wants to come in or wants to go out or wants to play, so it's not too bad - but it's like she's saying now, hurry up already. Time's a wasting! :)
Some people have wondered why I spent so much money on surgery for an older dog. I tell them, of course, that she's a member of my family. If I had put her down at that time, it would have been murder - she loves life too much. And since this is a progressive disease, she WOULD have had another attack eventually - whether it was the next day, the next week, the next month, whenever. To me, other than fire, suffocation has to be one of the worst ways to die, and it would have been devastating for me to have come home and found that she had another attack one day when I wasn't there to help her. So I really had no option but to do surgery.
Looking at her now - the twinkle in her eyes, the smile on her face, the spring in her step - I would do it all over again in a heartbeat. I cherish every extra minute I get to spend with this wonderful dog, and the fact that the quality of her life is even better now than it was six months ago is a bonus. :)

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3/9/97

Hello to all! Just thought I'd post an update on how my 12.75-year-old golden, Sandy, is doing since she had surgery for laryngeal paralysis in September of last year. The vet had said that swimming in ponds or lakes would be out, as the chance of bacteria being introduced into her lungs would be too great, but she would probably be able to swim in a swimming pool. Well, I took her to Cleveland in October to meet some golden chat room people, and she did Great while she was up there! There were six people and five dogs - three goldens (Sandy and two 7 and a half month old puppies), one shepherd cross, and Brandy, my Lhasa cross who is a golden wannabe (right ears, right color, wrong tail, body and legs)!
Cleveland has a beautiful park system, and we found a place where we could take the dogs down to the river. Sandy was watching them throw tennis balls for the golden puppies and was dying to go in the river. My heart was breaking watching her "bark" at them (with only one vocal cord she doesn't have much of a bark anymore), so I decided to go in with her so she could have SOME fun. The water really wasn't deep enough for her to swim, but it came up to her chest (needless to say, I got pretty wet - and the water was cold, too! It's amazing what we do for our dogs!). Sandy has hip dysplasia and arthritis, so I had to help her a bit making it through the rocky bottom and the mud, but she was a happy, happy girl. After she had her time in the water, she was content to just lay on shore and chew on a root.
After we spent an hour or so at the stream, we took the dogs across the road to a big field. Sandy "stole" a tennis ball and carried it around proudly. She kept bringing it over to me so I would throw it for her. Later I had to use the facilities, and I was going to leave her behind since it was a pretty good walk. She saw me starting off and followed me. I decided to take her - figured it was as good a time as any to see how her stamina was - and she enjoyed her walk immensely. She was panting a bit when we got back, but recovered quickly, and her panting was just a normal dog pant - certainly not the labored breathing she had pre-surgery. She was also able to keep up with me at a decent pace - before surgery, she would have had to rest a couple of times and I would have been practically dragging her on her leash. I had attributed that to her hip problems - guess it was more due to her compromised breathing!
Even though I figured by this time she'd be really tired out, the silly dog only rested 15 or 20 minutes and then brought the tennis ball over to me again! I hadn't seen her this active in a year and a half or so!
I've pretty much decided that I will still let Sandy swim, but only with me beside her, and I won't have her retrieve anything while she's swimming. Obviously if her mouth is open around something, the water would have more chance of getting into her lungs. Swimming has been such a big part of Sandy's life that there's no way I could leave her on the shore of the lake while the other dogs were having fun.
Sandy's continued to do well over the winter. We haven't had much snow, but when we did have snow on the ground, she threw herself down in it and wriggled around. Then when I went outside after a few minutes to get her, she started running around in circles like a puppy! Even at this age, she still makes me laugh!
Everyone who saw her pre-surgery is amazed at how much more alive she is post-surgery. It's so neat to see her quality of life so much improved. Am I glad I had the surgery done? You bet! Someone asked me what my favorite Christmas present was. I thought for a second, and then I told them that still having Sandy with me was my best present. :) Don't know how much time I'm going to have left with my golden girl, but you'd better believe I'm going to enjoy EVERY SINGLE second of it!

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9/11/98

Sandy just had her two-year "rebirth-day" and is doing wonderfully! A year before surgery, she had to rest several times on an easy 45-minute walk. I figured that was her last "long" walk and didn't take her out for more than 20 minutes from then on. After surgery she's been able to go for longer walks and has been out for up to three hours with no problems other than being a bit stiff from hip dysplasia and arthritis, which Ascriptin takes care of.
She's back to swimming in ponds and lakes, and I'm even letting her retrieve things (she's always been a tennis ball fanatic, and she loves water kongs and bumpers, too!). We just went camping in Michigan last month, and she spent about two hours swimming in Lake Huron with barely a break. I keep a closer eye on her than I did before, but she's still enjoying life as a true water dog!
She's back to eating totally dry food. Occasionally she still eats a bit fast, but she realizes immediately when that happens. One or two coughs and she's able to clear her throat by herself. She's never had any trouble drinking water.
Other than her "bark" you'd have no idea she'd had any problems. She now sounds very similar to a debarked dog. She does "bark" more now than she used to - I'm not sure if she's trying to get her voice back or if, since she's pretty much deaf now, she just can't hear herself and she thinks I can't either.
At 14 years and 3 months, Sandy's doing better than she was at 11! It's hard for people to believe how old she is. I certainly wouldn't wish laryngeal paralysis on anyone, but Sandy's proof that it's not a death sentence. It can be treated, and your dog can go on to live a full and happy life.

Sandy's surgery was done at the Anne Arundel Veterinary Emergency Clinic in Annapolis, Maryland.

1998


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