Information provided by Wesley Roach, DVM, DACVS
Laryngeal paralysis is a common cause for upper airway obstruction in geriatric, large breed dogs. Diagnosis is based on clinical signs and laryngeal exam, and unilateral arytenoid lateralization (“tie-back”) is the treatment of choice. While “idiopathic” is the most common cause of laryngeal paralysis, there is mounting evidence that geriatric, large breed dogs with laryngeal paralysis have a progressive generalized polyneuropathy (Geriatric Onset Laryngeal Paralysis Polyneuropathy or G.O.L.P.P.).
While only about a third of the dogs with G.O.L.P.P. will have concurrent clinical signs (esophageal dysfunction, muscle wasting, abnormal reflexes, and hind limb weakness) at the time of diagnosis of laryngeal paralysis, the majority of them will have concurrent clinical signs within a year. Confirmation of polyneuropathy includes electrodiagnostics, histopathology, and possibly dynamic contrast esophagrams.
Fortunately, the concurrent clinical signs associated with polyneuropathy are typically slowly progressive, and performing a “tie-back” to resolve the upper airway obstruction can still result in a good quality of life. It is important to inform the owners that their dog may develop a progressive rear limb weakness or esophageal motility dysfunction. These patients may benefit from physical therapy, sling support, and elevated feedings for long-term management.