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Ask Dr. Michael Salkin Your Own Question
Dr. Michael Salkin
Dr. Michael Salkin, Veterinarian
Category: Dog
Satisfied Customers: 28554
Experience:  University of California at Davis graduate veterinarian with 45 years of experience.
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Our 13 year old yellow Labrador retriever has developed a condition

Customer Question

Our 13 year old yellow Labrador retriever has developed a condition of repetitive dry-retching and coughing. He has been to his registered vet had a course of anti-biotics, anti inflammatories and steroids; followed by throat, chest and stomach x-rays, which, after examination proved to reveal no obstructions or growths. He looks most uncomfortable and distressed by this dry retching which seems to strain his whole body and often causes him to pass wind as he displays this symptom, which is NOT a fit or a convulsion. In every other way he appears healthy. Any ideas?
Submitted: 3 years ago.
Category: Dog
Expert:  Dr. Michael Salkin replied 3 years ago.
Aloha! You're speaking to Dr. Michael Salkin
I'm sorry for the delay in responding to you. Any 13 year old Lab with the symptoms you've described and with normal X-rays of those areas should be suspected of suffering from GOLPP - geriatric onset laryngeal paralysis polyneuropathy - or acquired myasthenia gravis.

GOLPP is newly described. Laryngeal paralysis is well-known in the geriatric Lab and will cause coughing and retching but we've noticed that there is often esophageal dysfunction in these dogs as well; hence, the diagnosis of a polyneuropathy - a disorder of more than one nerve - not just the nerves innervating the larynx. Diagnosis of laryngeal paralysis is done by lightly sedating our patient and watching how the arytenoid cartilages of the larynx move while our patient breaths. One or both of the cartilages can be paralyzed in this disorder.

Myasthenia gravis is another neuromuscular disease. An acetylcholine receptor antibody blood test is the gold standard for identifying the presence of myasthenia gravis - a disease that can mimic the symptoms of GOLPP. Please feel free to share our conversation with Dougie's vet and please respond with further questions or concerns if you wish.
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Customer: replied 3 years ago.
Thank you so much for your prompt response.
Your reply confirms what our vet observed while
Dougie was under anasthetic, saying his larynx appeared to be
acting slower than expected. Have you any suggestions concerning
any possible treatment?
Expert:  Dr. Michael Salkin replied 3 years ago.

You're quite welcome. A surgical "tie back" procedure* is the standard of care for these dogs. Nonsurgical treatment is rarely sufficient long-term and simply involves weight loss, exercise restriction, stress reduction, and treatment of underlying diseases - such as myasthenia gravis which, if present, might be sufficient.

*Unilateral arytenoid lateralization is recommended because higher complication rates are seen with other surgical options such as permanent tracheostomy, vocal fold excision, partial laryngectomy, castellated laryngofissure (whatever that means - I'm a medicine guy not a surgeon...), and muscle-nerve pedicle transposition.

Please continue our conversation if you wish. Thank you for your kind accept. I appreciate it.

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