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Laryngeal Paralysis or “Lar Par” in Dogs

The larynx, which is the opening through which outside air flows into a dog’s lungs, allows for vocalization and prevents food inhalation (aspiration) — both of which are important functions. Paralysis of the larynx, otherwise known as laryngeal paralysis or “lar par” for short, means that either one or both of the vocal folds does not fully open during breathing. The condition can occur in cats but is more common in dogs, and specifically in large-breed dogs. It can be hereditary in Bouviers, Huskies, Bull Terriers, Dalmatians and Rotweillers and is also commonly seen (but not necessarily hereditary) in Labs, Goldens, St. Bernards and Newfoundlands.

The first thing you might notice if your dog is suffering from lar par is a change in his or her bark, which might sound more hoarse, because the vocal folds are not moving as they once did. Due to the importance of panting, which is essentially moving air through the larynx, as a cooling function in dogs, you might also find that your dog has exercise intolerance and/or might breathe very noisily or heavily in warm weather. As well, when paralyzed, the larynx might not be able to protect the lungs from aspiration, so your dog may experience coughing, gagging and/or retching. In extreme situations, you may even notice respiratory distress or heat stroke. The clinical signs usually correlate with the degree of paralysis.

To diagnose laryngeal paralysis, your veterinarian will need to do a sedated exam and watch the larynx move as your dog breathes. Because the larynx is so deep in the throat, it is not possible to get a good look at it without sedation. A workup for lar par might also include blood work on thyroid levels, since up to 10 percent of dogs with lar par also have concurrent low thyroid. Chest x-rays may also be taken if your vet suspects aspiration pneumonia, which commonly happens with laryngeal paralysis.

The only treatment for laryngeal paralysis is a surgical procedure to tie back the laryngeal folds. This procedure, actually quite common with race horses, is called a “tie back” and is usually performed by a surgery specialist — so your primary vet may refer you to a specialty practice. The surgery can only be performed on a stable patient, so If your dog has a lar par complication such as pneumonia, he or she will likely be hospitalized until stable enough for anesthesia and surgery. The major risk of the surgery is an increased likelihood of aspiration pneumonia, since the folds will no no longer able to completely close and protect the lungs.

Lar par is a disease that can range in seriousness from minimal clinical signs to severe respiratory distress and even death. If you notice any of the hallmark signs, such as a change in bark, increased respiratory noise, or exercise or heat intolerance, please bring this to the attention of your veterinarian. It is very important to note that dogs with this condition can overheat easily, so they should be kept in an air-conditioned environment and have limited exercise until they can be examined and/or have surgery. The good news is that after tie back surgery, dogs usually do quite well.

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13 Comments
  1. Reply
    Jamie Fisher

    Hello Dr. Stewart

    I have read about a laser procedure being performed on LAR PAR patients. Do you know if there are complications with this procedure?

    Thx,

    Jamie Fisher

    • Reply
      Dr. Stewart

      Good question. I dont know enough about it to comment. I would ask your local boarded surgeon. I have heard good things about LarPar surgical treatments, but I do not know all the details.

  2. Reply
    Debbie Lawver

    Will my dog be able to bark after lar-par surgery?

    • Reply
      Dr. Stewart

      Usually it gets much higher and less loud. Yes but different.

  3. Reply
    kelly wilkinson

    I just returned from Emergency Vet to remove the IV needle that my vet forgot to remove earlier today. So flaky. At first she told me my dog has CHF. Then, after xrays she said, abnormal results. Echo today. Not helpful as he was breathing too hard. Lar Par was never mentioned. She suggested putting him down. He is 8 and until now doing well. I have been so sad and scared and now I have a glimmer of hope. My Ollie is a 145 pound Newf/Lab. Can you give me more info on surgery needed and prognosis for recovery? Thanks, Kelly Wilkinson Eugene, Oregon

    • Reply
      Dr. Stewart

      LarPar is a pain but surgically often treatable. The diagnosis is based on pysical exam, history as well as a sedated laryngeal exam or scope. This is just sedation, no bid deal. The surgery is performed by a boarded surgeon and is a tie back of the laryngeal fold and is very successful with a few behavior changes and concerns about aspiration (this fold hold food back when you breath.) I would google the surgery: laryngeal tieback in dogs. The first step is making an appointment with a surgeon to discuss the diagnosis. Bring all your other vet paperwork. I have personally seen very good results from the surgery, but there are behavioral and life style changes needed. Weight loss and slight reduced exercise for sure……. hope this helps and you get to see a surgeon.

  4. Reply
    Candy Thomas

    My dog had tie back surgery 2 months ago for lar par. He is breathing somewhat better but he is coughing, retching, gagging, every time he drinks water, and when he eats and sometimes just for no reason. I have gotten a special slow feed bowl and raised his food and water. The panting is still present and sometimes harsh, he does seem to have more energy. His overall health the vet said is good. Clear lungs, heart looks good, etc. I have read many blogs and I feel he is having excessive side effects to surgery and Im wondering if something did not heal correctly. Do you have any advise. Candy Thomas

    • Reply
      Dr. Stewart

      Wow, seems like you are doing everything I would recommend. I would have a second opinion from another surgeon or have him re-checked at the surgeon who did the surgery. They can have failures or possibly have excessive swelling and scar that needs to be addressed. Both sides tied back? If only one side then the other might be a problem. I would certainly have him looked at by the original surgeon just to be safe. They usually like to follow up on their work anyway. Sorry I cant be more helpful, but you are already doing what I would recommend.

    • Reply
      Marianne Cottee

      Hi
      Can you also move over to raised drinking and feeding bowls at chest height?
      Although I’ve heard conflicting reports back from ‘knowledgeable’ husky owners saying this can cause bloating, I have had no issues at all with my three HuskyxMals. In fact they eat pretty enthusiastically but are not ‘gulping’ up the food, and I notice little or no gagging or retching after.
      A very well known vet in all fields , esp, dogs & horses (racecourse vet), livestock, designed this but never patented it – Bob Cook. His widow advised me and it certainly looks to be a better eating & drinking position.
      Of course slow feeding bowls can be implemented to be used raised as well this avoid bloating/indigestion.
      M xx

  5. Reply
    Ryan

    Check out stem cell treatment. Roscoe village animal hospital in Chicago did a treatment for my 12yr old lab that was successful. No tie back needed. Back to breathing normal.

    • Reply
      Rissely Rojas

      Ryan, I am so hopeful after reading your post. How is your dog doing? Would you mind disclosing the cost of the procedure ? Our Maltese dog Zack is also 12 recently diagnosed with lar par, he has a sister we like to say they are twins. Thus far they both have enjoyed overall good health until Zack and an episode of seizure las September. We want to do everything possible and hopefully avoiding surgical procedures.

  6. Reply
    Scott H. Bittner

    We have a 14 year old Yellow Lab with Lar Par. We seem to have the breathing and anxiety part under control with 250 mg/day of Trazadone. But, his rear end is becoming more unstable. I’ve read about acupuncture and cold laser treatments and was hoping you could tell me if there was any data that supported trying either or both of these or if you could recommend any other treatments, medications or supplements we could try. He still loves going on walks, though they are much shorter than they used to be. Loves to ride in the car and is excited by his meals and treats. Thank you for your help. Scott Bittner
    We are located in Newport News, Va.

    • Reply
      Dr. Stewart

      I am an ER vet, so this is way out of my knowledge base. The research I have seen supports acupuncture, and some (mixed reviews) support cold laser. There are NO KNOWN side effects (except $$$) to either so there’s absolutely no reason not to try and see if there is improvement. There are plenty of good supplements like OMega 3, and glucosamine that can help with arthritis as well as good safe NSAIDs to help with the pain. I would try to discuss this with your local vet and see what is in the area. I have even heard of chiropractic and massage working wonders. VA is very advanced in veterinary medicine (we are in VA!) so your options are very broad and varied. I would give everything a try and see which helps the most, with NSAIDs as the last resort. Start the omega 3’s and glucosamine for sure with your vets supervision, but there are sometimes enough. Good luck.

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