My 2.5 year old newfie is dying. Pharyngeal paralysis. Any help?

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My 2.5 year old newfie is dying. Pharyngeal paralysis. Any help?

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Old 01-04-2018, 04:04 PM
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My 2.5 year old newfie is dying. Pharyngeal paralysis. Any help?

Hi everyone,

Our troubles began about a year ago when she started to cough/snort and have some difficulty eating. Since then, my entire family has been in a whirlwind of vet visits and expensive bills, getting referred to university vet programs for further testing and subjected to slowly watching the sweetest goofiest pup starve to death.

They diagnosed her with Pharyngeal paralysis, which as far as I understand is an inability for her swallowing muscles to relax after tightening. We have tried every kind of food, vets have been recommending home recipes we cook. All for nought, she has just been weighed and has lost an additional 2kg in two weeks, and is quite skinny.

Our vet has told us there is no surgery option as you can't remove the dead muscle as it is needed to regulate breathing vs swallowing. She has also told us that we need to prepare for her death.

I trust this vet, she has always been kind to us, and has even taken Luna (the newf) home with her to monitor her herself, but my desperate side is here searching for any kind of answer or solution from someone who may have had experience.

Thank you for reading.
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Old 01-04-2018, 04:34 PM
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I actually watched a story about a dog who couldnt swallow its food, not sure if it was the same reason or not, but either way, they build this "high chair" for there dog, so the dog would eat in a almost standing position and the food bowl was elevated. It was all liquidated food so he would just lap it up and be able to "drink" the food and let gravity do all of the work for him, wait a little bit so the food has gone into the tummy and then let him out.
You could build a feeding station like that for under $50, you would just have to train the dog to get in the station and learn how to eat that way.
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Old 01-04-2018, 05:32 PM
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I am by no means an expert, but I did find the following link which provides some information. Certainly wish you the best.

Laryngeal Paralysis Is Not a Death Sentence

Not positive this is exactly the same disease.
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Old 01-04-2018, 05:48 PM
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Question Maybe?...

Quote:
Originally Posted by Ratchet7117 View Post

I actually watched a story about a dog who couldn't swallow... food, not sure if it was the same reason or not, but either way, they build this "high chair" for their dog, so the dog would eat in a almost standing position ...
.

those chairs are for megaesophagus - a different medical issue.


Quoting from the article linked above,
Laryngeal Paralysis Is Not a Death Sentence

"What happens in surgery, what is the prognosis, and are there any complications?
The goal of surgery is to permanently open up the larynx to allow more air to get in. These days, most surgeons will do a “tie-back” procedure. Typically, surgery involves placing two heavy nylon sutures (i.e. permanent) to open up the left side of the larynx. Only one side is opened up to minimize the risk of aspiration pneumonia.

In experienced hands, the outcome is typically good. Theoretically, surgery provides instant relief: with an open larynx, the patient can finally breathe. Then, of course, the pet needs to recover and heal after surgery.

Clients routinely worry about doing this surgery in their older dog. My standard replies are:
Age is not a disease.
Lar Par is not a death sentence.

It’s a bump along the road, which shouldn’t significantly affect the patient’s life expectancy as long as they don’t get aspiration pneumonia.

Coughing is expected after surgery, typically after eating and mostly after drinking. That’s a good thing, as it will hopefully prevent the dog from 'swallowing the wrong way'. The voice will change, and barking disappears. However, failure of the sutures & a disease in the cartilage of the larynx is a rare but severe complication, which is why we insist on confinement, peace, and quiet after surgery.
Another serious complication is aspiration pneumonia (also known as AP). This is a type of pneumonia due to aspiration, or inhalation, of food, water, saliva or vomit into the lungs. Thankfully it, like suture failure, is an uncommon complication.

What if my pet gets aspiration pneumonia? Then what?
It's crucial that aspiration pneumonia is caught early. We look for 4 criteria: coughing, lethargy, poor appetite and a fever. If you ever suspect AP, time is of the essence. A vet should see the patient ASAP, listen to the lungs and take chest X-rays to confirm the diagnosis. Treatment involves hospitalization, IV fluids, strong antibiotics, nebulization and a type of physical therapy called coupage.

What’s new with Laryngeal Paralysis?
We now give patients an anti-vomiting drug (metoclopramide) for life, after surgery. The hope is to decrease the risk of vomiting by helping move food downward. It is cheap, with very few side effects, though one effect is hyperactivity. Ironically, Labs are the number one breed affected by Lar Par, and many of them are rather hyper to begin with! So far, we have not heard many complaints about using metoclopramide, though contra-indication is patients with seizures, so another anti-vomiting drug should be used. It is important to note that not all surgeons will prescribe this drug, so please don’t be surprised if it is not suggested. It is certainly not mandatory.

These days, we don’t make the opening in the larynx as big as we used to, just enough for the patient to breathe comfortably. This is clearly art more than science, and you can see how experience comes into play. What’s the downside? The patient will likely have a noisier breathing, as air goes through a smaller opening. But again, as long as the patient can breathe comfortably, we don’t mind. As I now tell my clients, “I don’t treat noise, I treat dogs.”

What do I need to do at home after surgery?
This will depends on your surgeon’s recommendations. In our practice, we recommend:
- Strict rest for two months to allow healing with scar tissue
- Soft food ('meat balls') for two weeks
- Not too much water intake at once
- Pain killers for seven days
- Metoclopramide for life (again, not all surgeons do that)
- Weight loss (these patients are often chubby), or weight control as needed
- Long term, we recommend using a harness instead of a neck collar

The only restriction is swimming: your dog will have a permanently open larynx, with no possibility of closing it off, should (s)he swallow water. There is therefore a risk of aspiration at best, and drowning at worst.

Overall, Lar Par is a stressful condition for the dog and a stressful situation for the guardian. Fortunately, in most cases, results of Laryngeal Paralysis surgery are good to excellent.


If you have any questions or concerns, you should always visit or call your veterinarian – they are your best resource to ensure the health and well-being of your pets.

Last edited by leashedForLife; 01-04-2018 at 05:51 PM.
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Old 01-04-2018, 05:57 PM
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Lightbulb Another DVM article

.

Pharynx, as opposed to larynx:

Overview of Pharyngeal Paralysis - Digestive System - Merck Veterinary Manual

QUOTE,
"Treatment:
[PHOTO]
caption:
Equine esophagosotomy tube - Courtesy of Dr. Jan Hawkins, Purdue University.

Treatment protocols for pharyngeal paralysis vary, depending on the underlying cause. Treatment generally includes the administration of antimicrobial and anti-inflammatory medications. Because of the inability to swallow normally, IV administration is preferred.
Animals with hemoconcentration should be administered IV fluids. If the animal is unable to eat without aspiration, extraoral or parenteral nutrition should be strongly considered.
Extraoral alimentation with pharyngostomy, esophagostomy, or nasogastric tubes or temporary rumenostomy in ruminants can be an economical and effective way to provide nutritional support. Other treatments include local therapy for pharyngeal abscesses.

The prognosis for pharyngeal paralysis varies with the instigating cause. The prognosis for pharyngeal abscessation can be favorable, whereas the prognosis [in equine] for guttural pouch disease can be guarded.
If affected animals do not improve after 4–6 wk of symptomatic therapy, the prognosis is poor and euthanasia should be considered."



HTH,
- terry

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Old 01-04-2018, 06:46 PM
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I have no solutions or suggestions, but reading your post and seeing her sweet face broke my heart and I hope you can find a solution that gives you the years with her you both deserve ♥ You two are in my thoughts!
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Old 01-04-2018, 06:55 PM
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I am sorry for your dogs health troubles. I was wondering if there was a reason that a stomach tube was ruled out? I know they are usually short term i.e. a few months as opposed to a few years. These tubes go directly into the stomach and can be a pain to maintain, but it would bypass the area that is a problem for your pet.
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Old 01-04-2018, 07:18 PM
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Question

.

nasogastric can be long-term, so can direct gastric, in humans. // I see no particular reason that it couldn't be long-term in a dog, as they live one-sixth or less our lifespan.

JMO - i don't know the general medical opinion on this.

- terry

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