A successful cricoarytenoid laryngoplasty will immediately alleviate signs of upper respiratory obstruction and significantly improve quality of life.4 Because knowledge of laryngeal anatomy and experience with cricoarytenoid laryngoplasty technique are essential, this procedure should be performed by a board-certified surgeon. Some throat-clearing may persist for several months or may be permanent.
The most common postoperative complication is aspiration pneumonia, which occurs in ≈18% of cases without cisapride treatment.1,6,12,13 Most cases of aspiration pneumonia respond well to medical management with antibiotics, thoracic coupage, and, if indicated, oxygen supplementation. When patients are discharged following surgery, owners must be educated to watch for the earliest signs of aspiration pneumonia (ie, inappetence, lethargy, fever) followed by soft coughing.
In patients with GOLPP, neurodegeneration typically progresses insidiously over several years, with dogs developing muscle atrophy around the pelvic limbs, torso, and temporal musculature and becoming weaker with decreased proprioceptive responses. Strength (eg, water treadmill, sit-to-stand), balancing, and coordination exercises are recommended as long-term therapy for all affected dogs, with a goal of maintaining muscle mass and increasing awareness of limb placement. Daily walks are also recommended. Dogs may show no signs of pain and can survive for several years postoperatively with an excellent quality of life. Helping harnesses may be used by owners when their dogs begin to have difficulty standing and walking. Some owners may use a cart. Owners typically request euthanasia when their dog becomes nonambulatory or has repeated episodes of aspiration pneumonia.
At the author’s clinic, the average age of dogs presented with GOLPP is 11.3 years, with an expected survival time of 2 to 4 years following surgical intervention. Many dogs die from conditions unrelated to GOLPP. A 2016 study demonstrated a 7-year postoperative survival rate of 75% in affected dogs.6 Dogs with GOLPP should be evaluated for neurodegenerative signs every 6 months. Regular communication between owners and veterinarians, including owner education on GOLPP management, is key to a successful long-term outcome.
Bruce responded well to treatment. Two-and-a-half years after undergoing left-sided cricoarytenoid laryngoplasty, his respiratory rate and effort were normal at rest, with mild stridor on exertion from untreated right-sided flaccid laryngeal paralysis. He was continuing to receive cisapride and had not had any episodes of aspiration pneumonia. He underwent regular physical therapy twice weekly (see Video) and enjoyed wading in a lake. Bruce had mild to moderate muscle wasting of the pelvic limbs, needed assistance getting into the car, and had difficulty ascending stairs; his owners used a harness to help him with these activities.