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Larynx: disease overview
Introduction
- Signs: laryngeal diseases usually result in inspiratory airflow obstruction:
- Dysphonia (abnormal voice).
- Stridor (ggg-sound).
- Noisy or loud breathing, panting.
- Exercise intolerance.
- Cyanosis.
- Dyspnea.
- Gagging/retching.
- Cough (may be paroxysmal).
- Causes:
- Paralysis Larynx: paralysis.
- Congenital malformation - disease associated with brachycephalic airway obstruction syndrome Brachycephalic airway obstruction syndrome , eg lateral ventricle eversion Larynx: laryngeal ventricle excision.
- Neoplasia Larynx: neoplasia.
- Spasm Larynx: miscellaneous conditions.
- Edema Larynx: miscellaneous conditions.
- Laryngitis.
- Trauma Larynx: miscellaneous conditions.
- See individual diseases for further information.
Geographic incidence
- Worldwide.
Breed/Species predisposition
- Older large breed dogs, eg Retrievers Retriever: Golden and Setters Gordon Setter are predisposed to the development of acquired laryngeal paralysis.
- Young dogs predisposed for congenital laryngeal paralysis (2-6 months):
- Dalmations Dalmatian
- Rottweilers Rottweiler
- Great Pyrenean Great Pyrennees
- Bouvier des Flandres Bouvier de Flandres
- Huskies Siberian Husky
- Bull Terriers Bull Terrier
- Brachycephalic breeds most commonly affected with brachycephalic airway obstruction syndrome:
- English Bulldog English Bulldog, French Bulldog French Bulldog.
Cost considerations
- Low to moderate expense incurred in diagnosis and treatment (may be high if surgery is required).
Special risks
- Any condition may induce acute laryngeal edema and obstruction which requires immediate medical/surgical management.
- Laryngeal disease results in an increased likelihood of aspiration pneumonia Lung: aspiration pneumonia due to the inability to effectively protect the airway.
Pathogenesis
Etiology
- Congenital malformation.
- Acquired paralysis in older dogs.
- Genetic.
- Infectious disease, eg infectious tracheobronchitis Acute infectious tracheobronchitis.
- Trauma (including post-surgical stenosis of glottis).
- Neoplasia (leiomyoma Leiomyoma / leiomyosarcoma , rhabdomyosarcoma Soft tissue sarcoma, squamous cell carcinoma Mouth: squamous cell carcinoma (gingival).
- Allergies/anaphylaxis (laryngeal involvement in dogs not as common as in cats).
Pathophysiology
- History and clinical signs of laryngeal disease reflect dysfunction of the larynx in its regulation of air flow or vocalization, its insufficiency in protecting the airway as a result of a decreased quality of the cough or the resulting irritation and stimulation of the cough receptors.
- In dysfunction of regulation of airflow, it is the inability of abduction that causes the predominant signs of dyspnea/stridor on exertion. Inability to adduct increases the likelihood of aspiration.
- Irritation of laryngeal mucosa → coughing (loud, dry and persistent) and occasional gagging after eating or drinking.
Timecourse
- Variable - minutes to days/weeks/months.
- Many dogs have progression of clinical signs over weeks to months prior to the development of an overt respiratory crisis.
Diagnosis
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Treatment
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Prevention
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Outcomes
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Further Reading
Publications
Refereed papers
- Recent references from PubMed and VetMedResource.
- Rutherford L, Beever L, Bruce M M, Haar ter G (2017) Assessment of computed tomography derived cricoid cartilage and tracheal dimensions to evaluate degree of cricoid narrowing in brachycephalic dogs. Vet Radiol Ultrasound 58 (6), 634-646 PubMed.
- Oechtering G U, Pohl S, Schlueter C, Lippert J P, Alef M, Kiefer I et al (2016) A Novel Approach to Brachycephalic Syndrome. 1. Evaluation of Anatomical Intranasal Airway Obstruction. Vet Surg 45 (2), 165-172 PubMed.
- Oechtering G U, Pohl S, Schlueter C, Schuenemann R (2016) A Novel Approach to Brachycephalic Syndrome. 2. Laser-Assisted Turbinectomy (LATE). Vet Surg 45 (2), 173-181 PubMed.
- Haimel G, Dupré G (2015) Brachycephalic airway syndrome: a comparative study between pugs and French bulldogs. JSAP 56 (12), 714-719 PubMed.
- Gabriel A, Poncelet L, Van Ham L, Clercx C, Braund KG, Bhatti S et al (2006) Laryngeal paralysis-polyneuropathy complex in young related Pyrenean mountain dogs. JSAP 47 (3), 144-149 PubMed.
- Snelling S R, Edwards G A (2003) A retrospective study of unilateral arytenoid lateralisation in the treatment of laryngeal paralysis in 100 dogs (1992-2000). Aust Vet J 81 (8), 464-468 PubMed.
Other sources of information
- Haar ter G (2016) Throat Anatomy and Physiology. In: Harvey RG, Haar ter G (eds) Ear, Nose and Throat Diseases of the Dog and Cat. 1st edn. London: CRC Press, Taylor & Francis Group; pp 345-56.
- Haar ter G (2016) Surgery of the Throat. In: Harvey RG, Haar ter G (eds) Ear, Nose and Throat Diseases of the Dog and Cat. 1st edn. London: CRC Press, Taylor & Francis Group; pp 475–-90.
- Venker-van Haagen A J (2000) Diseases of the throat. In: Textbook of Veterinary Internal Medicine. 5th edn. Eds S J Ettinger & E C Feldman. Philadelphia: W B Saunders. pp 1029-1031.