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It now seems such
a very long time ago that I wrote my original article about laryngeal
Paralysis in one of the club magazines, mid 1980s
SOAMES’ story has
gone around the world and back several times over and subsequently so many
elderly and not so elderly hounds, have benefited from the
surgical tie back procedure.
Whilst the
“BASICS” remain the same it seems opportune to bring this subject to some of
our new owners’ attention .This year has seen a number of hounds
encountering difficulties& requiring surgery.
I spent a most
interesting & informative morning in February with the Newfoundland
Activity Group who had arranged for Alasdair Hotston-Moore to
come up from Bristol Vet School to give a talk on LARYNGEAL PARALYSIS,
arranged by Brenda King who is doing the SAME within her breed’s
community as I have attempted to over these years, create an AWARENESS…LP
is now being recognized in a number of the giant breeds, including
Newfies & Leonbergers, as well as the well documented predisposed
breeds which are the Afghan Hound, Labrador Retriever; Golden Retriever:
Irish Setter.
Alasdair, who
took over much of the small animal surgery from Geoff Lane at Bristol, who
he described as his “Mentor”, said that if he was asked who proved the most
successful candidates for treatment, he would say Irish Setters and Afghans,
by virtue of their anatomy, and the slim Labradors!....Labradors present the
highest in representation, but that is probably because there are so many
Labs kept as pets.
There still
appears to be some misunderstanding, even with some members of the
profession, concerning the operation and the outcome.
Please let the
EXPERTS tell you if your dog is a candidate for surgery!
A survey
undertaken by Cambridge vet school indicated over 90 o/o owner satisfaction
with their dog's improvement following tie back surgery.
The immediate
post- op recovery care is VERY important and it is often unwise for a dog to
be anaesthetized just to inspect the larynx looking for a degree of
paralysis, if the vet performing this procedure is not skilled to go on
and perform the tie back operation immediately. Dogs with LP can get into
severe breathing difficulties following a general anaesthetic.
The
following comments are taken from this excellent presentation given by
ALASDAIR HOTSTEN- MOORE from Bristol Vet School on LP. His
presentation in full, can be read by logging on to the NEWFOUNDLAND
BREED CLUB WEB SITE & under their HEALTH & LONGEVITY SECTION.
It may take a bit of time for some in downloading & you will need adobe file
reader (the file is 750K).It was a great pity that few more AFGHAN HOUND
owners did NOT attend this lecture!!
LP
is the loss of movement of the VOCAL CORDS due to the loss of the NERVE
SUPPLY to the MUSCLES of the LARYNX. The function of the Larynx is to
control free air movement; cough/voice.
Difficulty in breathing (known as DYSPNOEA) results in
panting; the reluctance to exercise or a restricted ability in normal
exercise routine. In some instances dogs will collapse (varying degrees) and
ASPHYXIA can occur.
HYPERTHERMIA.
& associated LP.
Hyperthermia
is very feasible in any animal with a severe airway obstruction.
MANAGEMENT.....immediate
veterinary treatment... which should consist of the following
SEDATION; CONTROLLED
COOLING, eg: The environment, wet towels; fans etc AVOIDING
DRAMATIC MEASURES such has hoses, packing in ice, cold enemas etc.
OXYGEN
THERAPY may be required.
Cooling
& calming will have an immediate affect.
When
administrating oxygen therapy any stress factors must be avoided, many dogs
fight against the facial oxygen mask.
MANAGEMENT
OF THE CHRONIC CASE OF LP
following such a collapse.
Remember
that if the condition is chronic, the dog may have de-compensated but may be
stabilised and RETURNED TO THE CHRONIC STATE. Surgical tie
back can be performed at a later time.
With
the above medical treatment, cooling sedation etc, any emergency surgery
,either tie back or tracheotomy will rarely be required. The tie back
surgical procedure can be performed a.s.p. once the dog has been stabilised.
LARYNGEAL
PARALYSIS
represents 90o/o of the common laryngeal disorders.
It
is the commonest upper airway obstruction in the AFGHAN HOUND.
It
can occur in the elderly dog, over 9 yrs of age.
It
is a VERY COMMON CONDITION THAT IS FREQUENTLY MISSED BY OWNERS AND VETS
ALIKE.
The
onset can be gradual and it is frequently assumed that the older dog is
slowing up.
The
classic stridor may NOT always be apparent at REST.
It
severely inhibits lifestyle and ASPHYXIA can occasionally result from
this condition.
SURGERY CAN BE HIGHLY SUCCESSFUL, even in the more elderly animal. There are various surgical
procedures but the “TIE BACK” operation is the RECOMMENDED
PROCEDURE AS A PRIMARY TREATMENT.
The
surgery is successful in the RIGHT HANDS.
In
the hands of the INEXPERIENCED, the surgery is dangerous and
stressful.
If
anyone has an elderly dog who is experiencing even minor episodes of LP or
has been diagnosed with this condition, it is vital to ensure that the dog
is constantly monitored in hot humid weather conditions.
I
always
remember Geoff Lane (Bristol Vet School) saying to me that it was during the
SUMMER MONTHS that many of these dogs were presented for
surgery.
Given the
incidence and predisposition, in our breed, for this condition & the
publicity given to this particular talk, in the general canine press,
and the web forums, the location, at a central venue less than 15 minutes
drive from the major motorways M1 and M40 and just a short distance from Sky
Connection at Coventry, where so many of us can travel to for a dog show
event!! Yet only 4 Afghan Hound owners made the effort to go
along. I am sure we ALL learned much from Alasdair's excellent
presentation if we had experienced this condition with our dogs or
not.
This poor
representation from the Afghan Hound fraternity, possibly illustrates the
apparent general apathy within the breed when it comes to health interests!
Yes as a breed we
are relatively healthy (or are we?) compared to problems encountered in some
breeds, but we are ALL on a learning curve, or should be and an AWARENESS
of any medical condition that may raise its head always serve some use.
Laryngeal
Paralysis has been acknowledged in the breed for many years and thanks to a
greater awareness, particularly made during the mid-80s, a good many Afghans
have benefited from the surgical treatment available to correct this
particular condition.
Some of the
questions raised were "Should my dog have surgery?”...the answer
being that surgery is best suited where there is an obvious reduction in
exercise resulting from an obstructed airway, resulting in difficult &
laboured breathing and where the chance of asphyxia is probable given the
limited airway as a result of the paralysis.
If the cough is
the major symptom, rather than breathing difficulties, surgery may be
postponed. Contra-indications for surgery include those dogs who have a
concurrent swallowing/vomiting disorder such as megaoesophagus and dogs
with a proven severe heart disorder such as cardiomyopathy, but even these
dogs can be managed reasonably well given a lifestyle change and
medications to reduce their coughing such as the drugs known as
broncho-dilators...so
it is obvious from this information that any owner who is experiencing
difficulties in getting their dog assessed correctly should insist on a
referral to a specialist.
The following is
from Suzanne Ellis who is happy for this to be included with my update.
Dear
Sylvia,
It
seems ages since I have written to you and I thought that it may be
encouraging to many people pondering on the scary stories about the outcome
of laryngeal tie-backs to know that six months on from BIBi`s
operation, she is well and active, and that even in this hot weather she is
no longer panting or showing any signs of distress. It is so easy with more
mature dogs to think the symptoms which are in fact, those of laryngeal
paralysis, are those of `old age`, since they appeared so gradually at “that
time of life”. In our case, however, I would go through it ALL again, to see
my best friend restored to the vigour of a normal “Youngster”.
We
had, as you know, the most scary complication of pneumonia, but she was in
very good hands at the Royal Veterinary College at Potters Bar, cared for by
a team of experts led by James Grierson, giving her the best chance of
pulling through not only the tie-back, but the removal of a mammary lump at
the same time.
She
was in the hospital for several weeks, and remained on antibiotics for 6
weeks, until all symptoms subsided.
Following
several weeks of restriction in exercise and great care with her diet, she
has now adjusted to normal feeding, and daily gallops free-running on
Windsor Racecourse, chasing anything she can hunt with the vigour and
condition of a four year old. It seems to have turned back the clock, and
given her a completely new lease on life. I had worried for ages about
taking the steps towards this operation, and spoken to so many people to
gain information about her best chances, and whether we should go ahead. If
the same situation re-occurred I would go ahead unhesitatingly, but only if
the treatment was carried out by an expert, preferably at one of the
veterinary hospitals, and the most difficult obstacle I encountered was
getting that referral!
So
many vets seem keen to state that they are capable of performing tie-backs,
but I held out and insisted on the veterinary hospital to give her the best
possible chance, particularly the immediate post-operative care.
With
the current hot weather, I am so grateful to see BIBI laying relaxed,
healthy and happy--not struggling for breath even in the warmth of the sun.
I
must thank you, for your unstinting support, advice, encouragement and help
throughout.
The
other `star` to whom I will be eternally grateful is James Grierson at the
RVC, whose skill and care saved BIBI’s life. He spent a lot of time
explaining every step of the procedure, and telephoned BIBI`s progress to me
each night, even when he was operating until 10pm, I always had a courteous
explanatory call.
He
also said that Afghans were the best breed for this operation because of
their length of neck.
You
are welcome to use this letter Sylvia in any way you wish, as I imagine
there must be lots of worried people trying to decide about this operation.
James tells me he has never had a failure, or to re-do a tie-back!
Suzanne’s bitch
was turned 10 years of age at the time of her surgery & due to a long
delay in referral Suzanne had had a very worrying time, as an owner
she found that she had to be very assertive in insisting on a referral to a
specialist vet.
I have found it
rewarding and very encouraging to receive so much positive feed back from
owners of a number of other breeds who have found much help from the LP
information that has been disseminated through various lines of
communication within the Afghan fraternity, may such SHARING in ALL
HEALTH matters continue for the well being of ALL dogs.
SYLVIA
EVANS.SEPTEMBER 05.
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