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Ask Dr. Michael Salkin Your Own Question
Dr. Michael Salkin
Dr. Michael Salkin, Veterinarian
Category: Dog Veterinary
Satisfied Customers: 28996
Experience:  University of California at Davis graduate veterinarian with 45 years of experience
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Salkin Only: my friend Lynn just texted me to ask if I could

Customer Question

For Dr. Michael Salkin Only: good evening, my friend Lynn just texted me to ask if I could get your opinion on something for Sprite. She knows that he has the paralyzed larynx. The lymph nodes have gone down/stayed down since you helped her adjust how she's doing the prednisone. She wants me to get your thoughts on him having surgery for the larynx. She said she would do it in a heartbeat if you thought it would be safe. If you thought it was worth pursuing and could make him more comfortable she was going to consult a surgeon.
Submitted: 1 year ago.
Category: Dog Veterinary
Expert:  Dr. Michael Salkin replied 1 year ago.

Here's what Lynn needs to know...

Unilateral arytenoid lateralization (UAL) is recommended because higher complication rates are seen with other surgical options (complications include the need for permanent tracheostomy, vocal fold excision, partial laryngectomy, castellated laryngofissure (I have no idea what that is.), or muscle-nerve pedicle transposition (sounds terrible). UAL is considered a referral procedure.

Possible complications:

Aspiration pneumonia reported in 8-33% of dogs after UAL.

Coughing/gagging in 10-16% after UAL.

Respiratory distress requiring temporary tracheostomy; postoperative megaesophagus; concurrent respiratory tract, esophageal, neurologic, or neoplastic disease. Laryngeal paralysis is now considered just one part of GOLPP - geriatric onset laryngeal paralysis polyneuropathy - and so if GOLPP worsens, surgery may not have been of value in the long run.

Prognosis and outcome:

Reduction of respiratory signs and improved exercise tolerance in 90% of dogs after UAL.

Poor with GOLPP; generalized signs commonly develop within 1 year of diagnosis of idiopathic laryngeal paralysis

Mortality rate 14%; higher complications noted in older dogs or those with concurrent respiratory, esophageal, or neurologic disease.


Customer: replied 1 year ago.
wow lots of info thanks!!! would you NOT do it because of the lymphoma?
Customer: replied 1 year ago.
she said he is waking up short of breath at night and had to stop twice today while eating to catch his breath so she has to make some decisions.
Expert:  Dr. Michael Salkin replied 1 year ago.

Ugh. I must admit that I'm not going to put my own lymphoma dog through such a surgery. I don't believe it would extend his life appreciably.

Customer: replied 1 year ago.
a big surgery for a compromised dog. he still seems to be so happy - this breathing just doesn't seem to bother him.
Expert:  Dr. Michael Salkin replied 1 year ago.

Then leave the poor guy alone.

Customer: replied 1 year ago.
she said she'd almost rather lose him on the OR table to try because the lymphoma doesn't seem to be getting him but she doesn't want to see him suffering with the breathing.
Expert:  Dr. Michael Salkin replied 1 year ago.

I would need to stage his lymphoma at this time, then. I want to know where it is now and what his prognosis is.

Customer: replied 1 year ago.
fair enough. our old vet is a surgeon. she may contact him. I copied and emailed all of this to her. i'll leave this open a bit in case she has other questions.
Expert:  Dr. Michael Salkin replied 1 year ago.

Sounds good.

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