Nero was a lovely cross-bred rescue — and a client — who was used to going everywhere with his human. In fact, I’d regularly bump into them while out walking. This shiny brindle seal of a dog would come over to my boys and wag his butt like the dogs were hamburgers waiting to be eaten.
Over the years, my boys grew up, and Nero grew older but no less enthusiastic about life. It’s one of the perks of the job, knowing such wonderful dogs and being a part of their fur family as they age. As a vet, it also helps me recognize when that dog doesn’t have the bounce they once had. However, on one of Nero’s visits to the practice, there was nothing subtle about his signs.
It sounded like someone had brought an angry goose into the clinic. But it was Nero, struggling to breathe in the waiting room.
Diagnosis at a Distance
That characteristic honking sound is a giveaway that the patient has an issue with their larynx.
It comes about because the entrance to the trachea (windpipe) fails to open up fully when the dog breathes in. It’s this narrowing that causes turbulent air flow and a honk in a similar way that a piece of grass between your thumbs acts as a whistle.
Unfortunately, this condition is as serious as it sounds and causes great distress to the patients. Indeed, affected dogs often have tense, distressed faces because of their constant battle to breathe. Other signs include:
- Heavy panting
- Reluctance to walk or exercise
- A change of voice
- Occasional cough
- Struggle to cope in hot weather
- Excessive drooling
What Causes Laryngeal Paralysis?
There’s no one answer. One worry is that excessive pulling on a collar can damage the nerve that supplies the throat area.
The all-important laryngeal nerve is *trivia alert* the longest nerve in the body, and it travels down the left-hand side of the neck near the windpipe. Anything that severely compresses this nerve can damage the way the larynx works. This is why choke collars are not recommended (and, indeed, why a no-pull harness is a good idea for large dogs).
Aside from neck injury, let’s take a gander at the other causes:
- Genetic or hereditary factors: The husky and Bouvier des Flandres are linked to a hereditary form of laryngeal paralysis.
- Hypothyroidism: Under-active thyroid glands are a risk factor, possibly because there’s a link to the immune system attacking cells.
- Obesity: Overweight dogs from larger breeds are at greater risk.
- Idiopathic: A fancy way of saying the condition happens and no one knows why. This is most common in Labradors and golden retrievers.
- Cancer: Lumps in the chest can compress the laryngeal nerve.
So, aside from the goose honk, how is laryngeal paralysis diagnosed?
Reaching a Sound Diagnosis
Despite all the pointers, it’s essential not to jump to conclusions, to rule out other conditions and to identify any underlying problems. This means blood tests to check thyroid function and screening chest radiographs.
In addition, it’s important to watch the movement of the larynx to see what range it has. This means a brief, light anesthetic so the clinician can get a laryngoscope right to the back of the throat.
Check out the difference in this Lab’s larynx before and after tie-back surgery:
The Golden Egg of Treatment
Nero’s human was aware of an episode when his dog lunged forward on his choke chain and the problem had started after that. Fortunately, Nero was one of the few that responded to steroids, which helped swelling of the laryngeal nerve to subside. Since the damage was only temporary, he made a full recovery. Others aren’t so fortunate.
Unhappily, for those patients with permanent damage, surgery is their only option. The gold-standard procedure is called a laryngeal tie-back. It is highly skilled surgery that involves placing fine sutures to hold the larynx in a semi-open position.
When this surgery isn’t possible, another option is to place a permanent tracheotomy tube in the throat. This means the dog breathes through a hole in their neck rather than through their mouth. This is a salvage procedure performed when euthanasia is the only other option on the table.
Dear Nero did well and eventually passed away from an unrelated problem at a ripe old age. But if you take one thing away from reading this, it’s to be careful with dogs who pull hard on their collar — consider a no-pull harness instead.
This pet health content was written by a veterinarian, Dr. Pippa Elliott, BVMS, MRCVS. It was last reviewed May 19, 2017.