What can you tell me about tieback surgery for laryngeal paralysis?

Thanks for sharing this picture of your 12-year-old boy with laryngeal paralysis. He’s lucky to have such a dedicated owner.


First, the disclaimer: I’m not a veterinarian, and only you can make the decision — in tandem with a qualified veterinary professional — about whether a procedure is right for you dog.


That said, laryngeal paralysis occurs occasionally in older Ridgebacks, and it’s important to know what your options are.


Sometimes called “LP” or “lar par” for short, laryngeal paralysis is just that: The nerve function of the vocal cords is impaired, causing the flaps of the layrnx to flop around, sometimes sticking together to restrict air flow. This often happens when the dog is exerting himself, or overheated, creating a sound called a “stridor,” which resembles snoring. Laryngeal paralysis is serious, because in some cases a dog can literally suffocate before you can get medical intervention.


Other than the distinctive stridor, exercise intolerance, coughing and gagging are symptoms of laryngeal paralysis, as is a change in the way a dog barks — or the inability to bark at all.


Laryngeal paralysis is definitively diagnosed via biopsy, which can reveal changes in the muscle fibers of the larynx. Some vets diagnose the disease by anesthetizing the dog and observing the larynx flaps, though experts recommend that the respiratory-stimulating drug Doxapram be administered in these cases, as shallow breathing caused by sedation can sometimes be incorrectly attributed to the disease.


Once laryngeal paralysis is diagnosed, the treatment is “tieback surgery,” or cricoarytenoid lateralization. In this specialized surgery, one flap of the larynx is “tied down,” or immobilized. (Even if both flaps are affected, only one is tied down, to minimize the risk of aspirating food, water or saliva into the lungs, which is life threatening in and of itself.) Be sure you know the experience level of the surgeon: Because the surgery is a Goldilocks proposition — the amount tied back has to be “just right,” to avoid aspiration while still freeing up breathing — your dog should be operated on by someone who has done the surgery dozens upon dozens of times.


That said, owners often struggle with the risk of putting elderly, often infirm dogs under anesthesia for this surgery. It is a very difficult decision, although owners who have lost — or almost lost — dogs to an episode of laryngeal paralysis cannot find words to describe how horrific the experience is.


While laryngeal paralysis is considered a disease of old age, there is a congenital form that is seen in young puppies. Though it is very rare, this early-onset form of the disease has been reported in a handful of Ridgebacks (as well as Rottweilers, Bouviers des Flandres, Bull Terriers, Dalmatians, German Shepherd Dogs, Afghan Hounds, Cocker Spaniels, Dachshunds, Miniature Pinschers and Siberian Huskies).

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