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What is the most common cause of laryngeal paralysis?

The most common cause of laryngeal paralysis is acquired degeneration of the recurrent laryngeal nerves, particularly in older large-breed dogs.

Understanding the Most Common Cause of Laryngeal Paralysis in Pets

Laryngeal paralysis is a serious upper airway condition found in both dogs and cats, though it predominantly affects dogs, especially older, large-breed ones. It occurs when the **arytenoid cartilages** and **vocal folds** in the larynx fail to open during inspiration, causing **airway obstruction** and difficulty breathing. At the heart of this condition lies a primary failure in the **recurrent laryngeal nerves**, which control the muscles responsible for opening the airway.

Primary Cause of Laryngeal Paralysis: Nerve Dysfunction

The most frequent cause is damage or degeneration of the **recurrent laryngeal nerves**. These nerves play a crucial role in facilitating normal breathing by signaling the muscles to open the airways. When these nerves fail, the airway cannot function properly, resulting in the clinical signs associated with laryngeal paralysis. There are two primary classifications:
  • Congenital: Present from birth due to genetic or developmental abnormalities
  • Acquired: Develops later in life and is far more common, especially in dogs

Acquired Laryngeal Paralysis in Dogs

Acquired laryngeal paralysis is most commonly seen in **older, large-breed dogs**. Labrador Retrievers are particularly predisposed, but other breeds including **Siberian Huskies, Rottweilers, Dalmatians**, and **American Staffordshire Terriers** are also at risk. In many cases, the degeneration is part of a broader condition known as **Geriatric Onset Laryngeal Paralysis and Polyneuropathy (GOLPP)**, which also affects the animal’s limbs and swallowing ability. Other potential acquired causes in both cats and dogs include:
  • Trauma to the neck region
  • Tumors in the neck or upper chest
  • Previous neck surgery
  • Hypothyroidism
  • Systemic polyneuropathy
  • Idiopathic causes (no identifiable cause)

Clinical Signs of Laryngeal Paralysis

Symptoms tend to develop gradually and are often more visible during stress or warm weather. Common signs include:
  • Noisy, raspy breathing
  • Changes in bark or meow
  • Increased panting at rest
  • Difficulty during exercise
  • Gagging or coughing after eating or drinking
  • Regurgitation or vomiting
  • Blue gums or tongue (cyanosis)
  • Collapse due to respiratory failure
In severe cases, the airway can become completely obstructed, leading to suffocation if not promptly treated.

Diagnosis and Confirmation

Diagnosing laryngeal paralysis involves a combination of:
  1. Complete physical and neurological examination
  2. Owner-supplied history of observed symptoms
  3. Bloodwork and imaging (chest and neck radiographs)
  4. Endoscopic or laryngoscopic visualization of the larynx under light anesthesia
A definitive diagnosis is made when inward airflow fails to open the laryngeal cartilages during inspiration. In some cases, **CT scans or genetic testing** may assist in uncovering the root cause.

Treatment Options

Treatment depends on symptom severity and underlying cause. Conservative management may be sufficient for mild cases:
  • Weight control
  • Avoiding heat and stress
  • Using harnesses instead of collars
  • Limiting exercise
  • Physical rehabilitation (particularly for GOLPP cases)
Medical management can be used during acute episodes:
  • Oxygen therapy
  • Cooling and sedation
  • Anti-inflammatory medication (like corticosteroids)
Surgical intervention is often necessary in moderate to severe cases. The most common procedure is:
  • Unilateral Arytenoid Lateralization: Also known as "tie-back surgery," this technique permanently opens one side of the larynx to improve airflow.

Postoperative and Long-Term Care

Following surgery, pet owners must:
  • Restrict barking or meowing and physical activity for 6–8 weeks
  • Feed soft or blended food
  • Elevate food and water dishes
  • Avoid swimming or aspiration-prone activities
  • Maintain weight and monitor breathing

Potential Complications

Despite successful surgery, complications may arise:
  • Aspiration pneumonia
  • Local infections or seroma formation at the surgical site
  • Post-op coughing or gagging
  • Loss of bark or meow

Prognosis and Outlook

With proper intervention, the outlook is generally good for affected dogs. However, **ongoing veterinary supervision** is critical to managing complications and ensuring long-term comfort. For cats, prognosis remains guarded due to the rarity of the condition and limited treatment data.

Conclusion

Laryngeal paralysis is primarily caused by **recurrent laryngeal nerve dysfunction**, most often acquired in aging large-breed dogs. Understanding its causes, recognizing the symptoms, and ensuring prompt, appropriate treatment are essential for improving quality of life. While there’s no known prevention, early diagnosis and ongoing care can make a significant difference.

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