Laryngeal Paralysis in Dogs: Treatment options and how to know when it’s time

Laryngeal paralysis is a progressive and often distressing condition that affects many dogs, particularly older, large-breed dogs such as Labrador Retrievers. This condition impairs a dog’s ability to breathe normally, leading to respiratory distress that can significantly impact their quality of life. It is particularly exacerbated by excitement and heat. For some dogs, laryngeal paralysis can be part of a syndrome called GOLPP (Geriatric onset laryngeal paralysis and polyneuropathy) in which they also develop progressive hind end weakness.

While there are treatment options available, it can become scary to watch your beloved companion struggle to breathe, and eventually euthanasia often becomes the most compassionate decision to prevent a breathing crisis. Hopefully this article will help you decide how and when to elect treatment and when to let go.

What Is Laryngeal Paralysis?

Laryngeal paralysis occurs when the muscles that control the opening and closing of the larynx (voice box) become weak or completely stop functioning. In a healthy dog, the larynx opens wide during inhalation, allowing air to flow freely into the lungs. When a dog has laryngeal paralysis, the muscles do not function properly, causing the airway to remain partially closed and restricting airflow.

Symptoms of Laryngeal Paralysis
The first symptom is often noisy panting. Common signs include:

• Noisy or labored breathing (especially during exercise or excitement)
• A change in bark (often becoming hoarse or weak)
• Coughing, particularly after eating or drinking
• Panting excessively, even in mild temperatures
• Exercise intolerance
• Episodes of choking or gagging
• Cyanosis (bluish gums) in severe cases
• Collapse or respiratory crisis in extreme cases

How Is It Diagnosed?
Most of the time, your veterinarian can diagnose laryngeal paralysis on clinical signs, breed, and physical exam. Sometimes a sedated laryngeal exam will be performed to rule out other conditions, but often of the time this is not necessary.

Treatment Options

Treatment for laryngeal paralysis varies based on the severity of the condition. While mild cases can sometimes be managed with lifestyle changes, more severe cases often require surgical intervention.

Surgical Treatment: Laryngeal Tie-Back (Unilateral Arytenoid Lateralization)

The most common surgical treatment for laryngeal paralysis is a procedure called a laryngeal tie-back. This surgery involves permanently suturing one side of the larynx in an open position to improve airflow.

Pros:

• Can significantly improve breathing and quality of life
• Reduces risk of respiratory distress and collapse
• Often provides long-term relief for dogs with severe symptoms

Cons:

• Does not restore normal function—dogs must still be carefully monitored
• Increased risk of aspiration pneumonia (food or water entering the lungs)
• Requires anesthesia, which may be risky for older dogs
• Post-surgical complications, such as persistent coughing, may occur

Surgery can be an amazing option for some with laryngeal paralysis, but not all dogs are good candidates. A dog that is a younger senior and otherwise healthy is a great candidate. A dog that is very geriatric and/or has other major issues affecting their quality of life or a dog that is unable to handle anesthesia may not be a good candidate.

Palliative Care

When surgery is not an option—palliative care can help keep a dog comfortable for as long as possible. While laryngeal paralysis is a progressive condition, there are several ways to manage symptoms and enhance quality of life:

• Environmental Modifications: Heat, stress, and activity are the biggest triggers. Avoid hot and humid weather, limit strenuous exercise (or any exercise a the condition progresses) and stressful situations.
• Weight Management: Keeping a dog at a healthy weight reduces respiratory strain and improves breathing efficiency.
• Harness Use: Replacing a collar with a harness can prevent additional pressure on the throat and improve airflow.
• Sedatives and Anti-Anxiety Medications: These can help reduce stress-induced breathing difficulties.
• Cough Suppressants: If a dog experiences chronic coughing, medication may help reduce discomfort and irritation.

While these measures can provide relief, they are not curative, and laryngeal paralysis will continue to progress over time.

When to Consider Euthanasia

Deciding when to say goodbye to a beloved dog is one of the hardest choices a pet parent will ever face. For dogs with laryngeal paralysis, the disease often progresses to a point where any activity, heat, or excitement can set them into a crisis, causing a poor quality of life. In addition, no one wants to have their pet pass away from not being able to breathe, so I generally recommend electing euthanasia before the risk of a respiratory crisis is high.

• Frequent respiratory distress: If your dog is frequently having episodes where their breathing becomes loud and labored, and it cannot be controlled with environmental modifications and sedatives, I recommend considering euthanasia.
• Repeated emergencies: If the condition progresses to the point where your dog experiences respiratory crises that require emergency intervention, they are at risk of this happening again and potentially even dying of asphyxiation. If your dog is in this situation, it is better to help them pass peacefully rather than in respiratory distress.
• Aspiration pneumonia: If a dog has recurrent pneumonia due to difficulty swallowing, this can be a sign that their condition is becoming unmanageable.
• Severe anxiety or distress: Some dogs become highly anxious due to their breathing difficulties, leading to a cycle of worsening symptoms.
• Lack of joy in daily life: If a dog can no longer enjoy walks, eating, or socializing without significant struggle, euthanasia may be the kindest option.

Final thoughts

Letting go of a cherished pet is never easy, but ensuring they do not suffer needlessly is one of the greatest gifts we can give them. Remember that choosing euthanasia does not mean giving up—it means prioritizing love and compassion over prolonged suffering.

It is important to have open and honest conversations with a veterinarian about prognosis and quality of life. If you would like more guidance and support, schedule a 45 minute teleconsult with one of our compassionate veterinarians who can review your pet’s medical records and history and help you formulate the most compassionate and loving plan for your family.