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.