Canine Laryngeal Paralysis – GOLPP is a condition therapist don’t typically treat but remain aware of in the event a dog needs to use water as a therapeutic medium
Then a dear friend called me to ask whether PT could help her 13-year-old greyhound Maybelline. She was hoping that PT could relieve stridor, or the respiratory effects of laryngeal paralysis. I wasn’t sure. “Let me think about this and get back to you,” I said.
Laryngeal paralysis is a condition therapist don’t typically treat but remain aware of in the event a dog needs to use water as a therapeutic medium.
This condition contraindicates canine swimming and a calls for precaution with underwater treadmill use.
Stridor is the unusual breathing sounds a dog makes when laryngeal paralysis is present.
It is a type of gasp, can be high-pitched and occurs during inhalation. Stridor also inhibits the ability to bark.
The larynx, positioned in the throat as part of the upper airway system, has a little valve at its opening.
This valve consists of 2 small articulated flaps, called arytenoid cartilage, which normally open and close as the larynx performs its function. In laryngeal paralysis, the flaps remain stationary in a neutral position and cease to open and close properly. This results in panting, inadequate ventilation during exercise and decreased protection when the dog swallows.
This condition occurs in older dogs, large breeds, smaller breeds with brachiocephalic head shapes (flattened face/nose), and is ‘idiopathic’ (no known cause) in many cases. Sometimes it can occur from trauma to the neck.
Treating laryngeal paralysis
Treatment for laryngeal paralysis is often surgical. The tie-back procedure allows proper opening at the opening of the larynx.
Some dogs are unable to have surgery for medical or other reasons. In such cases, treatment consists of
- weight management
- decreasing the activity level
- limiting exposure to heat and high temperatures to prevent excessive thermoregulatory panting
Veterinarians often prescribe the use of oxygen, sedatives, steroids, and antibiotics as other forms of treatment.
Can physical therapy help?
PT for animals, though nearly 15 years in existence, is still a very new field with lots of unfamiliar territory. When a therapist encounters something like this, there is little if any veterinary rehabilitation research to rely on. As a result, one must apply principles that have solid evidence-based results in humans.
Finally, a therapist must ensure that in trying these treatments will harm the dog and no known contraindications exist. Collaborating with the pet’s owner and veterinarian is also imperative.
Well, here is what I came up with for PT treatment of stridor in Maybelline:
1. Positioning for drainage:
in case of Maybelline aspirated any food or liquid, I positioned her flat, on her side to allow gravity to drain any congestion in the upper lung lobes. If her lower lung lobes were affected, I would have used pillows under her ribs and rump to incline her body further.
2. Percussion technique
I applied a technique called percussion, a rhythmical clapping directly on the chest and ribs, to mobilize lung fluids. This is performed with cupped hands, and the fingers held together.
3. Vibration technique
After a few minutes of percussion, I perform a shaking technique called “vibration” with compression on the ribs. This technique increases intra-thoracic pressure and helps elevate or lift the laryngeal flaps.
4. Manual cervical traction
I finish with manual cervical traction. This elongates the neck and throat to further relieve any mechanical pressure on the airway.
One hand is placed on the spinous process of the lower cervical vertebrae for stability and the other under the skull occipital bone, and then a traction force is applied.
This is an advanced technique with no margin for error. Do not attempt to do on your own until you have been thoroughly taught by your therapist or veterinarian. If in doubt, have a professional perform manual cervical traction.
When I’m through, sweet Maybelline always turns her head and looks up as if to say “I really like this”!
Maybelline’s owner Carol and her veterinarian feel that these techniques, combined with her total treatment plan, are helping provide temporary relief of stridor by giving her upper airway a short-term boost. This coincides well with the warm summer months behind us, heading into autumn and winter.
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