Tuesday, July 5, 2011

A Deep Breath of Relief

This spring, we started to notice that our 11-year old Lab mix, Jade, was developing a hoarse sound to his bark, and was beginning to pant heavily upon exertion. The panting eventually grew to have a very rough sound to it (what I learned is called “respiratory stridor”), and he was getting tired faster and faster with any exercise. After losing Milo to a heart condition, I was growing afraid that Jade may have developed congestive heart failure, and so we took him in for an exam with our regular veterinarian.

Since we were preparing ourselves for the worst, we were a bit relieved when our vet told us that his heart sounded fine, but that she suspected laryngeal paralysis. This is a neurologic condition, common in Labradors especially, where they can no longer control the nerves in the larynx, and so are unable to control the cartilage that closes and opens in their trachea, thereby controlling their airway. She described it as constantly breathing through a straw – they struggle to take in a full breath of air. Sometimes the condition goes undiagnosed until a dog is in an acute respiratory crisis, so we were glad that we had addressed this early on.

268100_2048743189982_1586533506_32027987_7844879_n There isn’t a cure for the condition, but there is a treatment, known as a unilateral tie-back surgery. The cartilage on one side of the trachea is tied back, keeping the airway partially open at all times. The surgery is highly successful, and owners report extremely high levels of satisfaction after having it performed. The dogs immediately can breathe better, and return to a much higher quality of life.

Last week, we took Jade to see Dr. Bryden Stanley at Michigan State University. Dr. Stanley is a veterinary surgeon and leading researcher in laryngeal paralysis. She explained that they are finding that this is actually part of a larger neurologic condition, which they have termed Geriatric Onset Laryngeal Paralysis Polyneuropathy (GOLPP). Oftentimes, the disease will progress to involve lack of function in the rear legs and eventually rear end paralysis. It is not painful, and dogs are reported to be bright and active the entire time. With a tie-back surgery performed, the respiratory symptoms will be alleviated, and she gives a prognosis of 2-5 more years.

Jade stayed for tests at MSU and then underwent surgery on Thursday. All went fine. Dr. Stanley, who has done the surgery many times, told us this was the easiest and fastest one she has ever done because Jade is so lean and healthy – she said it was like looking at an anatomy textbook. We picked him up Friday, and he is doing great. He has been comfortable and pain free the entire time, his incisions are healing nicely, his attitude and appetite are great, and he can take a deep breath again! He will no longer be able to bark - another side effect of the surgery - which is weird and kind of sad, but again, there are much worse side effects.

So, the bad news – we are awaiting nerve biopsy results from his rear legs, but it is likely that the neuropathy has started to and will continue to spread. He has lost muscle mass in his rear, and there have been a few instances recently that seem to indicate a slight lack of coordination in his rear. His neurologic exam at MSU was clear, but we suspect something may be beginning. Hopefully the onset will be slow though, and overall Jade is in excellent health, so we are quite optimistic.

The procedure and condition also put him at increased risk of aspiration pneumonia, as his airway is partially open. He underwent swallowing tests at MSU also, and his esophageal function was good, so that reduces his risk a bit. Some of the GOLPP dogs already have swallowing issues which complicates matters more. For a while he will have to be hand-fed “meatballs” of soft food, and he has to eat in an elevated position from now on. He can only be walked on harness, and he can’t retrieve in water anymore, though we were told it is OK for him to swim as long as he keeps his head well above water.

So, we’re all adjusting to the diagnosis, but doing just fine. He’s going on 12 years old, and inevitably something was going to catch up with him eventually, so we can take this. We have every reason to hope for quite a bit more time with him, and that he will be able to be his active, crazy self again now that he can breathe better.

If you aren’t familiar with GOLPP, please check out the MSU website. Since learning about this, I have heard of so many dogs who were misdiagnosed for years until they were in acute crisis or it was too late. Untreated, it is an awful disorder that can continually restrict the dog’s airway and potentially cause asphyxiation. But, there are good options once identified, and it is definitely something to learn about and be aware of if your dog starts to change behavior, tire faster, pant louder, etc. I am grateful, as always, that we have access to such wonderful veterinary care here in Michigan, and have taken much comfort in these past weeks knowing Jade is in good hands.

It is hard seeing my first dog get older, but I’m treasuring these senior years with him as well. As I sat petting him this weekend, an old Grateful Dead song came on the radio, and I caught one of the lyrics for the first time:

“Oh well, a touch of grey kind of suits you anyway . . .”

Your golden years do suit you well, Jade. We will get by.



patty marsh said...

Your blog just came up on a google search I did. My golden has the surgery about the same time your dog did. She is now 12 1/2 and has recently been diagnosed with lymphoma. On top of that the GOLPP has progressed to hind leg weakness. I think that may end up being the reason we put her down when the time comes-it just seems worse than the lymphoma right now. Dare I ask how your dog is?

reddog said...

I am very grateful to say that Jade celebrated his 14th birthday last month, and is doing very well. The neuropathy has progressed a bit to his rear legs - he has lost muscle mass and is a little weaker and a little wobbly - but he still gets around fine so far. Walks are shorter and slower these days, but I'm happy he is still mobile and having a good quality of life. He hasn't had any other complications from the GOLPP or the surgery - no aspiration pneumonia or anything. We feel very fortunate. :-) I'm very sorry to hear about your golden's diagnosis, and hope that you are still able to have many good days together.

Sal Cuciti said...

My dog has LP - can you tell me how much the tie back surgery cost? Thanks


Enelradsedir said...

hi there. I just ran across your blog as I put my chow/retriever mix, Sunny, down on Monday. He was 14/15 yo. He was diagnosed with LarPar about 4 years ago - and had the tie-back procedure done promptly. It gave him 4 more years with me. I was instructed to have him eat and drink from the floor (bowls placed at floor level) and he never had any aspiration episodes.

Unfortunately, Sunny had several other issues such as Cushings disease, Hypothyroidism and 2 vestibular events. one resolved after about 72 hours - but left him with a head tilt. The second one he never quite completely recovered from (2 years ago).

I should have started him on rehab but never did although he was being treated by a neurologist and had an MRI done last year. All was well - no tumors etc.

What I'm most curious about is whether you experienced more hind leg weakness with your dog-or other neuropathy symptoms? Sunny had rear leg weakness mostly on one side - but his muscle wasting really became bad. He dropped half his weight in two years. In the past month, he started carrying his head low and the weakness seemed to be moving to his front legs. On tops of it all, there was incontinence (fecal and urinary) and likely some cognitive decline. He was just a shell most of the time - showing no interest in being outdoors or riding the car. Some of this favorite things. He ate up until the very end though - gaining 4 lbs back.

I am all over the place wondering if the rehab would have helped or if i would have had him tracked by a program like you had at MSU maybe his outcomes would have been better. 14/15 is a good age of course, but I just feel like I let my boy down not fully understanding the progression of disease and exactly what was bothering him. I know he just wasn't happy.

Thank you.