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Chronic cough in post-op laryngeal tie-back

Customer Question

My 12 year old male Brittany had surgery six months ago (Dec. 16, 2004) for laryngeal paralysis. Since then he has had a chornic cough, plus he coughs and gags whenever he eats or drinks. He has been on antibotics (Clavamox) three different times for congested lungs. He coughs more in the morning and with exercise. The cough is frequently productive. He is about 5 lbs overweight, he weighs 55 lbs. When he had his surgery, the surgeon thought there was also some weakness of his intercostal muscles. April 13, 2005 he had a bronchoscopy, the results are as follows: "Left arytenoid is pulled quite open and is in a fixed position, while the right fold is paralyzed (even after 1mg/lb Dopram IV). Rima glottis is quite open. Trachea normal. Bronchi: mainstem bronchi, especially on left collapse markedly with expiration and with cough. Diffuse erythema and mucoid exudate in all airways." His meds are: Loratadine 10 mg qd. If he doesn't get this for a day or two his coughing increases. Hydrocodone 5mg or Butorphanol 5mg when his coughing increases above his baseline coughing. He also gets Chinese herbs every day to help strengthen his lungs (prescribed by a holistic vet) and accupunture every two weeks. On June 24, 2005 his lungs were congested again. This time he had a chest X-ray, CBC and chemistries. The chest x-ray showed "old dog lungs", no change since last December. The blood work was normal except for an elevated Alk. Phos. which he has also had in the past. We did not put him on antibotics this time, just a little chest physio-therapy, and he was back to his baseline coughing in a couple of days. Three days ago he was started on Flovent inhalation aerosol (no improvement yet). The coughing affects much of his daily activities. Is there any more I can do?
Submitted: 11 years ago.
Category: Pet
Expert:  Tammy F. replied 11 years ago.
If your dog is coughing, you probably need to return to the vet because this is a sign that he has aspiration pneumonia.

You should also keep in mind that:



  • The feeding and water bowls should be elevated about 8 to 10 inches off of the floor.
  • Dusty environments should be avoided.
  • Swimming will no longer be permitted. If your pet’s head would go under water, the larynx would not be able to close and drowning could occur.
  • Excercise should be limited
  • You should use a harness instead of a collar for the pet
  • During heavy panting your pet could still have increased respiratory noise, as only one side of the larynx has been tied open and the other vocal cord may flutter as air moves in and out.

If only one side was tied back, you might consider having the other done as well. This can often help with a chronic cough.


I hope that this helps some! Let me know if you still have specific questions. I will be happy to tell you what I know.

Customer: replied 11 years ago.
Reply to Tammy Falkner's Post: Thank you, XXXXX XXXXX already aware of this information. It was part of his post-op instructions. Actually I put his food and water dishes back on the floor about a month ago because he gags less when his head is lower. I know aspiration pneumonia will be a constant threat and that is why he has had three courses of antibotics and the chest x-ray. Having surgery on the other side is interesting. Would this help with the opening to his trachea already on the large side? I should add that he has been seen by five different vets for this problem: the surgeon, the internist who did his bronchoscopy, his holistic vet, and the two vets at our regular office. I'm probably grasping for straws here, but I thought there might be something that we have not thought of yet. Thanks again
Expert:  Tammy F. replied 11 years ago.

Take a look at this website that describes the procedure and complication, treatement, etc, in detail.


http://www.vetsurgerycentral.com/laryngeal.htm

Customer: replied 11 years ago.
Reply to Tammy Falkner's Post: I have already looked at everything I could find on the internet and in books. It looks like there is really nothing more that can help my dog. Thanks for trying.

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