LARYNGEAL PARALYSIS 

SYLVIA EVANS 2002

Over the years I have written a number of articles and several regional breed clubs, including the AHA, Southern Afghan, East/England Club & the NEAHS have given space in their annual magazines to Geoff Lane's original paper on Laryngeal Paralysis. This condition continues to raise inquiries and it would appear, from my OUR DOGS Breed Notes "Post Bag", that there remains much confusion and misunderstanding of the condition, commonly presenting in our aged, and some not so aged, hounds.

I continue to receive inquiries from as far away as New Zealand, Australia, mainland Europe and of course here within the UK Our breed continues to attract new enthusiasts, many of whom will have little awareness or background information on this condition (although I was very pleased when Lynda Race included the condition in the Health Section of her new book on the Breed) It is apparent that a good many hounds have benefited from information available to their owners resulting in appropriate treatments, long may this continue but....

Time does indeed "March On", I will not be active in the breed forever to continue to respond to referred inquiries from anxious owners, so I have taken up Pam's suggestion for this subject to be included within the HEALTH pages and to UPDATE and give this very significant & treatable disorder , further coverage.

I first approached Geoff Lane at Bristol Veterinary College for detailed information on this condition within our breed around the mid- 80's.At that time this establishment held excellent BRISTOL BREEDER's WEEKENDS, at their main campus at Langford. Armed with the relevant information received, which I took back to the Breed Council, we were then able to disseminate this through the regional club membership and a much greater awareness was made of the condition and the successful surgical correction treatments possible. Jim Huckbody, then the Council's Chairman, had a bitch at that time who his own vet was treating for a suspected cardiac disorder, due to her reluctance to exercise, albeit that she was not an OLD animal. Neither Jim ( a Medical Practitioner) or the Vet himself were too confident of the diagnosis! She was immediately referred to Geoff at Bristol where the condition was diagnosed and she subsequently enjoyed a much more ACTIVE life for her remaining year (S) following treatment! My own SOAMES (ALEXEIEV FROM AMSHURA): MAX (AMSHURA BRIGADIER GERARD) and indeed MANY other hounds, subsequently have proven how valuable this SHARING INFORMATION "Exercise" was!

Duncan Lascelles MRCVS who operated on MAX at Cambridge Vet School (himself a Bristol graduate) kindly re-read an article that I originally wrote for the Eastern Expression magazine in 1997 and up-dated one or two significant points particularly....

1.HARSH,RASP-LIKE breathing, sounds , a whistling / wheezy sound, especially on INSPIRATION.

2.PNEUMONIA, a further complication that MAY preclude a positive diagnosis (If you are lucky enough to find a vet who will recognise or suspect the significance of the underlying condition behind the presenting acute pneumonia symptoms!)

Those who know me are all too aware how strongly I feel about the need to SHARE any relevant information and experience in animal husbandry and the disease(s) process that may effect our breed. At times there appears to be a reluctance of attitude on such subject matter by some breeders/owners to participate.

The continuing advances in veterinary science and education provide further scope for the future health and well being of all our animals and we must ALL play a part in this .

"MAX" of the 1997 article, reprinted here, of course is no longer with me. For the record he lived for a further 12 months following his "tie back" surgery and the remainder of his "Autumn Days" were enjoyed to the full with him taking on a new lease of activity, enjoying regular exercise and generally having a quality life style until he finally succumbed to the inevitability of the ageing process at turned 13 years of age.

LARYNGEAL PARALYSIS...... MAX's STORY

I make NO EXCUSE for highlighting this subject once again, as it would appear, from phone calls and letters I continue to receive , that this condition still continues to cause concern, may go unrecognised by both owners and some vets in general practice, with the older dog frequently being treated, mistakenly, for a cardiac disorder. In other instances, IF the condition is diagnosed, owners may then be told that this condition is a terminal disorder, and their hound is too old, and too great the risk factor associated with a surgical procedure.

Many of you will be aware of "SOAMES STORY" and his legacy to our breed in highlighting the condition following his own "tie back" surgery at Bristol. In 1989. SOAMES (ALEXEIEV FROM AMSHURA) was 11 years of age at the time of his surgery and went on to live a further 18 months post surgery thanks to Geoff Lane & his excellent Bristol team.

MAX (BRIGADIER GERARD) later had his surgery performed at The Cambridge Veterinary School in June at turned 12 years and this resulted in a significant improvement in his breathing and life style.

Max's condition was apparent to me long before surgery became necessary. Once you have lived with a dog with LP you instinctively come to recognise that harsh rasp like breathing noise, even when the dog is at rest. I have recognised the sound in friend's dogs& have rarely been wrong! I always remember one of my vets at the practice, herself a Bristol graduate, telling me that she was always aware when SOAMES was in the waiting room by the NOISE of his BREATHING! she could hear & recognise through closed doors!...yet at that stage he was still fairly active for an older animal and continued to enjoyed his exercise...His nephew, MAX had become very ill in the January of 1995, with an aspiration pneumonia, a complication of LP. Many owners may not realise that a failure in the valve mechanism of the larynx can predispose to pneumonia. Sometimes the pneumonia is of most concern, and usually this will be treated BEFORE subjecting the dog to the stress of anaesthesia and surgery, which in itself could make the pneumonia worse and put the dog into a life threatening situation.

A brief word here must be mentioned on OESOPHAGEAL DYSFUNCTION, which can also be associated with this condition which is a contraindication for surgery.

A full veterinary examination is a good idea as soon as you suspect that your dog may be suffering from LP. I am now only too aware that when I lost MAX's dam, KALINKA,(co-incidently SOAME's litter sister), some years previously, with pneumonia, that her pneumonia resulted from an UNDIAGNOSED paralysis of her larynx. Several years on and armed with the wisdom of hindsight, I was able to be one step ahead with her son and of course I am very fortunate to have the expertise of CAMBRIDGE so close to my home here in Essex, who treated MAX's acute pneumonia condition and also confirmed the diagnosis of the underlying Laryngeal Paralysis which had caused the pneumonia, the primary consideration to be treated and any surgery postponed until he was fit enough to withstand the stress of general anaesthesia and tie-back surgery. I was told at the time that he was "PADDLING" and I would KNOW when he started getting into "DEEP WATERs"& would require tie-back corrective surgery.

Although we managed to get him through a subsequently very hot summer of '95, felt that he may not continue to cope so well, in a stressful situation and with the first hot & humid spell of June '96 it became all too apparent that he required update assessment with the specialists at Cambridge Veterinary School.

Whilst I am always reluctant to subject any AGED dog to any unnecessary surgical procedure, I knew we were now at a "Crossroads," With his increasing respiratory difficulties, which were becoming more pronounced at stress and any mild exertions, EUTHANASIA,ASPHYXIA,OR SURGICAL INTERVENTION...For me there could be only one option. I once again, reiterate the benefits here and would urge any one who thinks that their dog may have LP, to seek out SPECIALIST advice. Please let the EXPERTS tell YOU if your dog is a suitable candidate for surgical treatment.

Surgery for Laryngeal Paralysis within our breed is NOT new, I believe that one of the first Afghan Hounds that had corrective surgery performed by Geoff Lane was sometime in the mid 1970's.The advances in anaesthetic procedures over ensuing years have assisted in the many successful outcomes.

I will quote here the following from Geoff Lane at Bristol, in answer to my original inquiries made, which I took up following an article in a Southern Club magazine, on a male Afghan Hound that had been put to sleep at just 8 years, resulting from an increasing obstructive airway disorder.

QUOTE

1.Laryngeal Paralysis is a disease for which there is a specific surgical remedy.

2.There is absolutely NO need for ANY dog to be put to sleep because the condition is DIAGNOSED or SUSPECTED.

3.ADVANCED cases are suitable for surgery, indeed the surgical technique may be more simple than in EARLY diagnosis.

4.The AGE of the patient referred should be NO deterrent.

In a series of over 200 dogs that were treated at BRISTOL (1987/1989) not one died during, or as a result of the ANAESTHETIC; the eldest was 17 and over 160 dogs (including AFGHAN HOUNDS) have been over 10 years of age at the time of their surgery.........

UNQUOTE

Whilst there now may be many vets in general practice who will confidently perform the operation, I would suggest, from my own experience, that if you have an AGED dog, the specialist veterinary colleges, certainly here within the UK, may offer a greater variety in experience in anaesthesia in the OLDER animal, especially the HOUND, which may alleviate some of your anxieties.

I had NO post-anaesthetic problems with either SOAMES or MAX; both were detained in the hospital for under 36 hours, MAX, being older, just a little longer ,pre-surgery so that he could have a variety of tests to ensure that he received the appropriate pre-and post anaesthetic fluids to prevent any kidney or liver stress associated with surgery in the older animal.

Surgery will have been performed through a wound on the underside of the neck. The area is likely to remain swollen for a couple of weeks post-operation. Sutures are removed after about 10 days. Although an immediate improvement of the respiratory distress and obstruction of the airway may be evident, the full benefit of surgery may not become apparent for a further few weeks when the internal swelling subsides. Most dogs cough to clear their throats to begin with after the surgery, this may become more noticable, particularly after eating/drinking but the cough does subside thereafter, although some dogs do continue to cough intermittently.

Post-op Pneumonia may also be an associated risk factor but sensible post-op care, additional post-surgery antibiotics, supervised feeding of a soft diet greatly reduces the risk. The dog should ALWAYS be fed from a HEIGHT, viz: placing the bowl of food on a stool or chair and the meals should be small and spaced out at 3/4 times daily, again this will reduce stress to the liver of an older dog. Diet is modified during the first 6 weeks post surgery ,the consistency of the food is more important than what it actually contains, not too hard or too soft and NOT flaky A gradual return to normal can be made after this convalescent period.

The overall improvement in the quality of life, living out the remainder of their days with a greater degree of dignity, cannot be over emphasied and from my experiences I would suggest it is worth considering if you do think that your older canine friend and perhaps some not so old, (I know of two litter brothers who had successful surgery at Edinburgh Vet College, that were only just 7 years) is developing the condition.The operation may be costly (pet insurance does help!) but just think of the COSTs involved in doing just a FEW shows of the circuit in a year!

This will be money WELL SPENT!!

I will leave you with some additional comments in a letter sent to me by Geoff Lane, following my SOAMES death.....

"Laryngeal tie back surgery continues to be performed regularly on elderly dogs and AFGHAN HOUNDS are well represented. I am pleased to say that the results of surgery are consistently encouraging. Current research is being directed toward the nerve damage which seems to cause the paralysis in the first place, thus I was interested to note that SOAMES was begining to show the hind leg weakness which may well be a related neurological disorder in the breed."

I do urge you once again, if you think that you may have this condition in any of your dogs, to seek professional advice, take along this paper, written by Geoff Lane that is reproduced here, show it to your vet and seek a specialist referral if necessary. Likewise if I can be of assistance at anytime, please do feel that you can continue to contact me

SYLVIA EVANS (AMSHURA)