Laryngeal Paralysis

Question 1

Pets show INSPIRATORY STRIDOR. T /F

Answer 1

T

A high/squeaky noise

Question 2

Laryngeal paralysis can be a part of bigger neurologic problem . T/F

Answer 2

T

Owners should be given the option of referral to a neurologist

Question 3

________ is a common complication of laryngeal paralysis which can be diagnosed via XRAY

Answer 3

Aspiration pneumonia ~15% cases

Non-cardiogenic pulmonary edema can also be seen

Question 4

Some patients will need INTUBATION as soon as they are evaluated. T/F

Answer 4

TRUE

give IV propofol (4 mg/kg) → intubate → keep sedated long enough

Question 5

How long to keep pet sedated?

Answer 5

Depends on two factors

• Until the temperature is normal
• if steroids given, then 1-2 hours (as it can take that long for them to work)

Question 6

On what basis do you decide that pet needs steroid injection

Answer 6

If marked swelling on intubation or laryngeal evaluation

Single dose of DEX SP can be given (0.1-0.2 mg/kg )

Otherwise, STEROID USE IS CONTROVERSIAL

Question 7

For patients with milder signs who donot warrant immediate intubation, author prefers sedation. T/F

Answer 7

T

Combination of Acepromazine and butorphanol

Ace = 0.025 mg/kg IV,IM
butorphanol = 0.2-0.4 mg/kg IM,SC (0.1 mg/kg IV )

Question 8

What initial diagnostics are recommended in a case suspected of laryngeal paralysis (excluding laryngeal exam)?

Answer 8

• CBC/Chem/UA as these are older pets

- XRAY (r/o aspiration pneumonia, non-cardiogenic pulmonary edema )

Question 9

________ is the most common Sx for laryngeal paralysis

Answer 9

Laryngeal tie back

Question 10

LARYNGEAL EVALUATION IS IMPORTANT PART OF DIAGNOSIS. How do we do it ?

Answer 10

• Position in VENTRAL recumbency
• Light anesthesia (2-6 mg/kg IV propofol): just enough to open and look

When in doubt, DOXAPRAM IV can be given to stimulate respiratory effort