Laryngeal paralysis in dogs: treatment of laryngeal paralysis using a silicone stent and alternatives to the tie-back procedure
- Mar 27
- 5 min read
Laryngeal paralysis in dogs, also known as LarPar, is a respiratory condition that can seriously compromise a dog’s quality of life and, in some cases, become a medical emergency. In recent years, alongside traditional surgical options, the silicone laryngeal stent has gained traction as a minimally invasive alternative for keeping the airway open in certain patients.
This article is based on a clinical review by Claire M. Lindo, DVM, shared by Charlestown Animal Hospital
What is laryngeal paralysis (LarPar) in dogs?
Canine laryngeal paralysis is a condition in which the laryngeal cartilages do not open properly during inhalation (Figure 1).
This occurs because the muscles responsible for moving them do not receive adequate nerve stimulation.
As a result, the dog has greater difficulty breathing, particularly during exercise, excitement or exposure to heat, and there is also an increased risk of bronchoaspiration and aspiration pneumonia.
Symptoms of canine laryngeal paralysis
Clinical signs may start off subtle and worsen over time. The most common include:
noisy breathing or stridor
heavier breathing than usual
exercise intolerance
coughing or retching after eating or drinking
breathing difficulties in hot or humid conditions,
episodes of respiratory distress
increased risk of aspiration
Why does it get worse with heat, exercise and excitement?
Many dogs with laryngeal paralysis appear relatively stable in cool environments. However, as the temperature rises, they need to pant more to regulate their body temperature. It is at this point that the mechanical restriction of the larynx becomes much more apparent.
If the dog becomes stressed and tries to breathe more forcefully through a narrowed opening, the situation can quickly escalate from breathing difficulties to a respiratory crisis.
Traditional treatments for laryngeal paralysis (LarPar) in dogs
In the early or moderate stages, part of the treatment involves reducing the factors that trigger breathing difficulties, such as avoiding heat, limiting strenuous exercise or reducing agitation.
According to clinical experience reported by Dr Claire M. Lindo, some patients may benefit from doxepin, laser therapy or nutritional support.
Nevertheless, in many cases the disease progresses and medical management proves insufficient.
Surgical treatment for laryngeal paralysis: tie-back
The best-known surgical procedure for treating laryngeal paralysis is the tie-back procedure, also known as arytenoid lateralisation. It involves securing one of the laryngeal cartilages in an open position to improve airflow.
When to consider tie-back surgery
A tie-back is usually considered when:
the patient is already experiencing respiratory crises or is on the verge of doing so
their quality of life is clearly compromised
conservative management is no longer sufficient
Silicone laryngeal stent for the treatment of laryngeal paralysis: a minimally invasive alternative
In recent years, the silicone laryngeal stent has emerged as a highly promising option for dogs with laryngeal paralysis, either as an alternative to the tie-back procedure or as a temporary solution whilst definitive surgery is being planned (Figure 2)
When to consider a laryngeal stent for a dog with laryngeal paralysis
A silicone laryngeal stent may be considered for patients:
with significant laryngeal obstruction
who require rapid stabilisation
who are not ideal candidates for immediate surgery,
whose carers are seeking a less invasive option.
Its function is to keep the laryngeal cartilages partially or mostly open, allowing for better ventilation.
From a clinical perspective, one of its greatest strengths is that it can provide noticeable improvement within minutes or upon waking from anaesthesia, making it a particularly valuable tool in unstable patients.
Benefits of the silicone laryngeal stent in dogs with laryngeal paralysis
The growing interest in the silicone laryngeal stent is due to a number of clinical and practical advantages. The most significant benefits include:
1. A minimally invasive technique: unlike the tie-back procedure, it does not require open surgery on the laryngeal structures.
2. Immediate airway opening. The effect is rapid and can be crucial in patients with significant respiratory compromise.
3. Temporary or bridging option. It can be used whilst a decision is made or definitive surgery is scheduled.
4. Can be placed by trained veterinarians. With the appropriate training and the correct instruments, it does not always require a specialist surgical centre.
5. Relatively lower cost compared to more complex surgical procedures This can facilitate access to treatment in certain clinical contexts.
6. Silicone is a flexible and atraumatic material In airway applications, medical-grade silicone offers an adaptable, removable solution designed to preserve lumen patency with a less aggressive approach.
From a therapeutic standpoint, the silicone laryngeal stent represents a particularly attractive alternative when a rapid, minimally invasive and potentially reversible solution is sought.
Possible limitations and clinical considerations
Like any treatment, the silicone laryngeal stent also requires careful case selection and a strict post-operative protocol. Key considerations include:
possibility of coughing
need to restrict activity
Possible speech impairment
Risk of aspiration, which is an inherent feature of the condition itself and must also be taken into account when considering other treatment options.
Another important factor is the experience of the treatment team. Choosing the right size, the correct insertion technique and proper follow-up care are essential for achieving better results.
There have also been reports of halitosis or bacterial colonisation of the implant, particularly in areas where organic material may accumulate. However, this does not affect the patient’s quality of life nor necessitate the removal of the device.
Is a silicone laryngeal stent in dogs with laryngeal paralysis a temporary or permanent solution?
One of the most frequently asked questions is whether a laryngeal stent should be regarded as a temporary measure or whether it can be left in place long-term.
Dr Claire M. Lindo’s experience with a silicone stent
The experience reported by Dr Claire M. Lindo and Charlestown Animal Hospital suggests that, in certain patients, the stent can remain stable for prolonged periods without the need for frequent replacement, provided that clinical follow-up is favourable.
Although some studies have suggested periodic replacement, actual clinical experience in certain cases indicates that, once stable, unnecessary manipulation of the stent may not be the best option. This reinforces the idea that the approach should be tailored to the individual based on:
implant stability
clinical signs
patient tolerance
quality of life.
Silicone laryngeal stent: an innovative option for treating laryngeal paralysis in dogs
Laryngeal paralysis in dogs is a progressive condition that may form part of a broader neurological syndrome such as GOLPP. Early diagnosis and appropriate management are key to preventing respiratory crises and improving the patient’s quality of life.
Although tie-back remains an important therapeutic option, the silicone laryngeal stent is establishing itself as an increasingly relevant alternative due to its minimally invasive nature, its ability to rapidly stabilise the airway, and its potential utility in both short-term and long-term scenarios.
Inspired by the clinical review by Claire M. Lindo, DVM, and the experience shared by Charlestown Animal Hospital, we can affirm that the development of strategies such as the silicone laryngeal stent broadens the range of treatment options available for patients with LarPar, allowing for a more flexible, practical approach tailored to each clinical case.
Would you like to know more about STENTS? You can visit our website www.abtvet.com
Comments