Sound signature for identification of tracheal collapse and laryngeal paralysis in dogs

The aims of this study were to investigate whether upper airway sounds of dogs with laryngeal paralysis and tracheal collapse have distinct sound characteristics, compared with unaffected dogs. The sounds of 5 dogs with laryngeal paralysis and 5 dogs with tracheal collapse were recorded. Honking sound appeared as predominant clinical signs in dogs with tracheal collapse. Laryngeal stridors appeared as predominant clinical signs in dogs with experimentally produced laryngeal paralysis by resection of laryngeal nerve, in which two types of stridor, I and II, were recorded. All these sounds were analyzed using sound spectrogam analysis. There were significant differences in duration (sec), intensity (dB), pitch (Hz), first formant (Hz), second formant (Hz), third formant (Hz), fourth formant (Hz) of sounds between the normal bark and two types of stridor or honking sound, indicating that the sound analysis might be a useful diagnostic modality for dogs with tracheal collapse and laryngeal paralysis.     

Upper airway obstruction in canine laryngeal paralysis

The type and the severity of airway obstruction in 30 dogs with bilateral laryngeal paralysis was assessed, using tidal breathing flow-volume loop (TBFVL) analysis. The dogs had clinical evidence of mild-to-severe upper airway obstruction (ie, respiratory distress, exercise intolerance, stridor). Seventeen dogs had TBFVL consistent with a nonfixed (inspiratory) obstruction, 10 had TBFVL indicative of a fixed (inspiratory/expiratory) obstruction, and 3 had normal TBFVL. Analysis of TBFVL confirmed that dogs with laryngeal paralysis have upper airway obstruction that differs in type and severity. Use of TBFVL provided a quantitative evaluation of airway obstruction and demonstrated the effects of bilateral laryngeal paralysis on the breathing patterns of dogs.     

Comparison of Three Clinical Techniques for the Diagnosis of Laryngeal Paralysis in Dogs

Objectives— To evaluate laryngeal function using 3 diagnostic techniques: echolaryngography (EL), transnasal laryngoscopy (TNL), and laryngoscopy per os (LPO).
Study Design— Prospective clinical study.
Animals— Dogs with laryngeal paralysis (n=5) and control dogs (n=10); 5 age- and breed-matched dogs and 5 young, breed-matched dogs.
Methods— Laryngeal function was evaluated in conscious dogs using EL. All examinations were recorded and evaluated by separate, blinded observers upon completion of the study. The methods were compared with a standard evaluation incorporating all clinical knowledge of the case (STD) using sensitivity, specificity, positive, and negative predictive values.
Results— Three dogs with bilateral laryngeal paralysis requiring surgery were diagnosed as unilaterally affected or normal on EL. Three dogs had paradoxic motion on TNL and LPO, 2 of those were considered normal on EL, and 1 had no motion on EL. Paralysis was diagnosed in 1 age-matched and 3 young control dogs on EL. LPO and TNL falsely diagnosed lack of arytenoid movement in 2 age-matched controls and 1 young control. Two age-matched and 1 young control dog were misdiagnosed as paralyzed with TNL and LPO.
Discussion— Direct observation of the larynx allowed better evaluation of laryngeal function compared with EL. TNL did not require induction of anesthesia, but did not improve the ability to assess laryngeal function compared with LPO.
Conclusions— EL was not as effective as direct observation of the larynx. TNL did not improve the evaluation of laryngeal function compared with LPO.
Clinical Relevance— We use LPO combined with knowledge of the clinical history and physical examination to diagnose laryngeal paralysis in preference to EL and TNL.     

Assessment of survey radiography as a method of diagnosing bilateral laryngeal paralysis in dogs

The gold standard for diagnosis of laryngeal paralysis is laryngoscopy under light anesthesia. This prospective analytical cross-sectional study aimed to determine whether a radiographic assessment of the larynx could be used as a non-invasive screening tool for diagnosing laryngeal paralysis in non-sedated animals, as the laryngeal ventricles may appear wider in affected animals. The laryngeal ventricles of 18 dogs with bilateral laryngeal paralysis composing the affected group and 25 non-sedated dogs presenting no respiratory abnormality composing the control group were evaluated using right lateral radiography of the larynx. Three observers measured the ratios of the maximal ventricular length and surface to the body length of the third cervical vertebra (MVL/LC3 and VS/LC3, respectively). They also subjectively assessed the ventricular shape as either normal or rounded. The most accurate criterion was found to be MVL/LC3, as the respective areas under the ROC curves were 0.96 (95% confidence interval [CI]: 0.95–0.97), 0.89 (95% CI: 0.87–0.91), 0.80 (95% CI: 0.65–0.95) for MVL/LC3, VS/LC3, and ventricular shape evaluation, respectively. Based on ROC curve analysis, two thresholds of clinical interest were set for the MVL/LC3; bilateral laryngeal paralysis was very unlikely for values < 0.3 and very likely for values > 0.5. The findings of this study support the use of lateral laryngeal radiography as a screening tool for diagnosing bilateral laryngeal paralysis. However, further diagnostic tests remain required if MVL/LC3 lies between these threshold values or if clinically indicated. Further studies are warranted to explore the use of laryngeal radiography in unilateral paralysis and other laryngeal or oropharyngeal diseases.     

EVALUATION OF DIAPHRAGMATIC MOTION IN NORMAL AND DIAPHRAGMATIC PARALYZED DOGS USING M‐MODE ULTRASONOGRAPHY

Diagnosis of unilateral diaphragmatic paralysis in dogs is currently based on fluoroscopic detection of unequal movement between the crura. Bilateral paralysis may be more difficult to confirm with fluoroscopy because diaphragmatic movement is sometimes produced by compensatory abdominal muscle contractions. The purpose of this study was to develop a new method to evaluate diaphragmatic movement using M‐mode ultrasonography and to describe findings for normal and diaphragmatic paralyzed dogs. Fifty‐five clinically normal dogs and two dogs with diaphragmatic paralysis were recruited. Thoracic radiographs were acquired for all dogs and fluoroscopy studies were also acquired for clinically affected dogs. Two observers independently measured diaphragmatic direction of motion and amplitude of excursion using M‐mode ultrasonography for dogs meeting study inclusion criteria. Eight of the clinically normal dogs were excluded due to abnormal thoracic radiographic findings. For the remaining normal dogs, the lower limit values of diaphragmatic excursion were 2.85–2.98 mm during normal breathing. One dog with bilateral diaphragmatic paralysis showed paradoxical movement of both crura at the end of inspiration. One dog with unilateral diaphragmatic paralysis had diaphragmatic excursion values of 2.00 ± 0.42 mm on the left side and 4.05 ± 1.48 mm on the right side. The difference between left and right diaphragmatic excursion values was 55%. Findings indicated that M‐mode ultrasonography is a relatively simple and objective method for measuring diaphragmatic movement in dogs. Future studies are needed in a larger number of dogs with diaphragmatic paralysis to determine the diagnostic sensitivity of this promising new technique.     

Bilateral thyroarytenoid cartilage lateralization and vocal fold excision with mucosoplasty for treatment of idiopathic laryngeal paralysis: 67 dogs (1998-2005)

Objective— To evaluate combined bilateral thyroarytenoid cartilage lateralization, vocal fold excision, and mucosoplasty technique (BTAL) through ventral median laryngotomy for treatment of laryngeal paralysis in dogs.
Design— Retrospective study.
Animals— Dogs (n=67) with laryngeal paralysis.
Methods— Medical records were reviewed for dogs with idiopathic laryngeal paralysis that had BTAL between January 1998 and March 2005. Retrieved data included signalment, history, physical and laryngoscopic examination findings, clinicopathologic tests, and results of recheck examination findings.
Results— BTAL was performed by a single surgeon. Short-term (<6 months) follow-up information was available for 67 dogs and long-term (>12 months) for 40 dogs. Major postoperative complications were surgical failures (13; 7 short term, 6 long term) and aspiration pneumonia (1). Mean recurrence of clinical signs was at 19 weeks (range, 2–30 weeks). Minor complications occurred in 22 (33%) dogs including occasional coughing or gagging, stridorous breathing during exercise, panting, noisy or heavy breathing, and aspiration pneumonia (3 dogs) that did not require hospitalization. All owners reported an improved quality of life and had no regrets with surgical outcome.
Conclusions— BTAL is seemingly an effective procedure for treatment of laryngeal paralysis.
Clinical Relevance— BTAL is associated with a low incidence of aspiration pneumonia; however, there is substantial risk of recurrence of clinical signs associated with narrowing of the glottis. Consequently, unilateral arytenoid lateralization currently represents the accepted approach to the treatment of laryngeal paralysis.     

Complications and Long-term Results after Partial Laryngectomy for the Treatment of Idiopathic Laryngeal Paralysis in 45 Dogs

Forty-five dogs with severe respiratory signs caused by idiopathic, acquired laryngeal paralysis were treated by partial laryngectomy. The predominant postoperative complications were coughing in 28 dogs and pneumonia in 15 dogs. Eight dogs required a second operation to alleviate persistent or recurrent upper airway obstruction. Results of surgery were considered excellent in 11 dogs (25%), good in 18 dogs (40%), fair in 6 dogs (13%), and poor in 10 dogs (22%). Poorer results were obtained by surgical residents than by more experienced surgeons. Death in the immediate postoperative period was related to pneumonia (8 dogs) and laryngeal collapse (1 dog). Nine dogs died later of respiratory disease. Although partial laryngectomy is effective for the treatment of laryngeal paralysis, it is not recommended because of the high incidence of postoperative complications.     

MAGNETIC RESONANCE IMAGING OF THE INTRATEMPORAL FACIAL NERVE IN IDIOPATHIC FACIAL PARALYSIS IN THE DOG

The most common cause of peripheral facial nerve paralysis in dogs, in the absence of otitis media, is thought to be idiopathic. Gadolinium-enhanced (Gd) magnetic resonance (MR) imaging has been used to study peripheral facial weakness in humans with a wide variety of disorders, including Bell's palsy, the clinical equivalent of idiopathic facial nerve paralysis in dogs. Gd-MR imaging may be useful to demonstrate abnormal enhancement of the intratemporal facial nerve. The aim of this study was to define the role of the Gd-MR imaging in dogs with idiopathic facial nerve paralysis, with regard to pattern of enhancement, and to search for prognostic information. Six dogs with peripheral facial nerve paralysis, followed between 2003 and 2005, were studied. Physical and neurologic examinations, as well as clinical tests, were performed, including routine hematology, serum biochemistry, thyroid screening, cerebrospinal fluid analysis, and MR imaging. The time interval between the onset of the clinical signs, the progress of the disease, and the final recovery was noted in each dog. The following four intratemporal segments of the facial nerve were analyzed: internal acoustic meatus, labyrinthine segment/geniculate ganglion, tympanic segment, and mastoid segment. Along its length, contrast enhancement was found in four dogs. In this group, contrast enhancement of the facial nerve was found in all segments of two dogs, in three segments of one dog, and in one segment of the other dog. In the four dogs with enhancement, one recovered completely in 8 weeks and three have not recovered completely. The two dogs without evidence of enhancement recovered completely in an average time of 4 weeks.     

Effects of doxapram HCl on laryngeal function of normal dogs and dogs with naturally occurring laryngeal paralysis

OBJECTIVES: To compare the effects of IV doxapram on glottic size and arytenoid motion in normal dogs and in dogs with laryngeal paralysis. STUDY DESIGN: Prospective experimental and clinical trials. ANIMALS: Six healthy dogs weighing 24.5 +/- 3.9 kg and six dogs weighing 27.4 +/- 11.5 kg suspected of having laryngeal paralysis. METHODS: Dogs were pre-medicated with acepromazine and butorphanol, and a light plane of anesthesia was induced with isoflurane by mask. Videoendoscopic examination of laryngeal function was recorded before (baseline) and after IV doxapram administration. Normalized glottal gap area (NGGA) at maximal inspiration and expiration, and percentage change in height, width, area, and NGGA were calculated with measurements from digitized images of the glottal gap. RESULTS: Active arytenoid motion was present in all normal dogs at baseline. After doxapram administration, depth of respiration appeared greater, but arytenoid motion, as measured by percentage change in NGGA, and in area and width, did not significantly increase in normal dogs. No arytenoid motion was detected in dogs with laryngeal paralysis at baseline; however, rima glottidis NGGA of dogs with laryngeal paralysis was greater at inspiration and expiration than normal dogs. After doxapram administration, dogs with laryngeal paralysis developed paradoxical arytenoid motion and significant, negative percentage change in area (-61%) and NGGA (-145%) because of inward collapse of the arytenoids during inspiration. CONCLUSIONS AND CLINICAL RELEVANCE: Administration of doxapram during laryngeal examination is useful for differentiating normal dogs from dogs with laryngeal paralysis. Dogs with laryngeal paralysis may suffer extreme glottic constriction with vigorous respirations, and may require intubation during examination.     

Neurological Manifestations of Hypothyroidism: A Retrospective Study of 29 Dogs

Neuromuscular signs in association with hypothyroidism are described in 29 dogs. Eleven dogs had lower motor neuron signs, 9 had peripheral vestibular deficits, 4 had megaesophagus, and 5 had laryngeal paralysis. Primarily older (mean = 9.5 years), large-breed dogs were affected, and there was no sex or breed predisposition. Duration of clinical signs before presentation ranged from 2 to 8 weeks (mean = 5 weeks). The diagnosis was based on (1) results of neurological examination (29 dogs); (2) electromyographic abnormalities (18 dogs), including fibrillation potentials (n = 18), positive sharp waves (n = 15), and complex repetitive discharges (n = 4); (3) high serum cholesterol concentration (10 dogs; mean = 335 mg/dL); (4) low response to thyroid-stimulating hormone (29 dogs; mean T₄ prestimulation concentration = 0.8 μg/dL; mean T₄ poststimulation = 1.2 μg/dL); and (5) good response to thyroxine supplementation (26 dogs). Dogs with vestibular deficits had abnormal brainstem auditory-evoked responses (BAER), including increased latencies of P₁-P₆ and decreased amplitude of P_4,5-N₅. Seven other dogs had similar BAER abnormalities without manifesting clinical signs of vestibular involvement. Three dogs with vestibular signs had fibrillation potentials and positive sharp waves without exhibiting lower motor neuron signs. All dogs were supplemented with levothyroxine (0.02 mg/kg P0 bid). The follow-up period ranged between 6 and 30 months (mean, 14 months). Serum T₄ concentrations were measured at least 3 times for each dog every 2 months (mean T₄ concentration = 2.6 μg/dL). All but 1 dog with lower motor neuron signs and 1 dog with vestibular signs recovered after 2 months (mean, 57 days). Signs of megaesophagus became progressively less severe over 4 months. Dogs with laryngeal paralysis improved partially after 5 months. We suggest that either vestibular or lower motor neuron signs, megaesophagus, or laryngeal paralysis may be the only clinical signs of an underlying, more generalized polyneuropathy associated with hypothyroidism. Electro-diagnostic abnormalities may be detected before clinical disease develops.     

DIAGNOSTIC SENSITIVITY OF SUBJECTIVE AND QUANTITATIVE LARYNGEAL ULTRASONOGRAPHY FOR RECURRENT LARYNGEAL NEUROPATHY IN HORSES

Recurrent laryngeal neuropathy (RLN) is the most common cause of laryngeal hemiplegia in horses and causes neurogenic atrophy of the intrinsic laryngeal muscles, including the cricoarytenoideus lateralis muscle. Recurrent laryngeal neuropathy results in paresis to paralysis of the vocal fold and arytenoid cartilage, which limits performance through respiratory compromise. Ultrasound has previously been reported to be a useful diagnostic technique in horses with RLN. In this report, the diagnostic sensitivity of subjective and quantitative laryngeal ultrasonography was evaluated in 154 horses presented for poor performance due to suspected upper airway disease. Ultrasonographic parameters recorded were: cricoarytenoideus lateralis echogenicity (subjective and quantitative), cricoarytenoideus lateralis thickness, vocal fold movement, and arytenoid cartilage movement. Ultrasonographic parameters were then compared with laryngeal grades based on resting and exercising upper airway endoscopy. Subjectively increased left cricoarytenoideus lateralis echogenicity yielded a sensitivity of 94.59% and specificity of 94.54% for detecting RLN, based on the reference standard of exercising laryngeal endoscopy. Quantitative left cricoarytenoideus lateralis echogenicity values differed among resting laryngeal grades I–IV. Findings from this study support previously published findings and the utility of subjective and quantitative laryngeal ultrasound as diagnostic tools for horses with poor performance.     

Laryngeal Paralysis-Polyneuropathy Complex in Young Rottweilers

Five Rottweiler puppies from 3 unrelated litters developed inspiratory stridor at 11–13 weeks of age. Physical examination disclosed tetraparesis in all dogs, and bilateral lenticular cataracts in 4 dogs. Laryngeal examination under light anesthesia showed laryngeal paralysis in all dogs. Electrodiagnostic testing revealed denervation potentials in the distal appendicular muscles of 4 dogs tested and in the intrinsic laryngeal muscles of 2 dogs tested. Motor nerve conduction velocity was slightly low in 1 dog. Neurogenic muscular atrophy was found in distal appendicular muscles (n = 3) and intrinsic laryngeal muscles (n = 2), and degenerative changes were found in peripheral nerves (n = 3) and recurrent laryngeal nerves (n = 2). No abnormalities were detected in the spinal cord, spinal nerve roots, or ganglia of 3 dogs autopsied. The clinical, electrophysiologic, and histopathologic findings support a diagnosis of polyneuropathy and resemble the finding reported in young Dalmatians. Young dogs with laryngeal paralysis should be evaluated neurologically to rule out a more generalized polyneuropathy. The condition is suspected to be hereditary in nature and the prognosis is poor.     

Laryngeal paralysis in immature and mature dogs as one sign of a more diffuse polyneuropathy

Six dogs with laryngeal paralysis had clinical, electrophysiologic, and pathologic evidence of a more generalized polyneuropathy. Three of the dogs were young Dalmatians, one was a young Bouvier des Flandres, and two were older, large-breed dogs. The results of this study suggest that laryngeal paralysis in dogs may frequently be one clinical sign of an underlying, more generalized polyneuropathy. Two forms of this generalized polyneuropathy may exist: an early form, as seen in young dogs with congenital or hereditary disease, and a delayed-onset form that is usually found in older dogs with so-called idiopathic laryngeal paralysis, some of which may have hypothyroidism.     

Transnasal laryngoscopy for the diagnosis of laryngeal paralysis in dogs

Four dogs with clinical signs of laryngeal paralysis and three normal dogs were evaluated with transnasal laryngoscopy. Six of these dogs subsequently underwent standard laryngoscopy. For transnasal laryngoscopy, a video endoscope was passed through the left nasal passage after intramuscular sedation and topical anesthesia. The laryngeal opening was observed during spontaneous ventilation. Laryngeal paralysis was diagnosed in four dogs and was confirmed with traditional laryngoscopy in three dogs. Normal motion of the arytenoid cartilages was present in the other three dogs; however, two required mechanical stimulation of the laryngeal mucosa for full evaluation. Transnasal laryngoscopy provided a means for diagnosing laryngeal paralysis in dogs without general anesthesia.     

Spontaneous laryngeal paralysis in four white-coated German shepherd dogs

Four cases of spontaneous laryngeal paralysis in juvenile white-coated German shepherd dogs are described. The presenting signs were typical for laryngeal paralysis, with stridor present in all four cases. Laryngoscopy revealed bilateral laryngeal paralysis in three cases, and unilateral paralysis in one. Concurrent megaoesophagus was also identified in one dog. All dogs underwent surgical treatment for laryngeal paralysis. Euthanasia was performed in one case due to intractable regurgitation and aspiration pneumonia. A possible association with white coat colour is discussed.     

The effect of two modifications of unilateral arytenoid lateralization on rima glottidis area in dogs

OBJECTIVES: To evaluate the clinical outcome and percentage increase in rima glottidis area achieved using a combined technique of cricoarytenoid and thyroarytenoid cartilage lateralization compared with cricoarytenoid cartilage lateralization alone in live anesthetized dogs clinically affected with bilateral laryngeal paralysis. STUDY DESIGN: Randomized prospective clinical study. ANIMALS: Twenty dogs with bilateral laryngeal paralysis. Methods-Bilateral laryngeal paralysis was diagnosed by direct laryngoscopy. Each dog was allocated randomly to 1 of 2 surgical groups: CAL (cricoarytenoid lateralization) and CTAL (cricoarytenoid and thyroarytenoid lateralization). Photographs were taken of each larynx before and after surgery, the images were digitized, and the preoperative and postoperative areas of each rima glottidis were measured. The percentage increase in rima glottidis area produced by each of the arytenoid lateralization procedures was compared. Follow-up was obtained by telephone survey of owners and referring veterinarians. RESULTS: There was no significant difference in mean (+/- SD) percentage increase in rima glottidis area for the CAL group (241.5 +/- 42.9%) or the CTAL group (236.4 +/- 44.5%). Clinical follow-up (median, 18 months postoperatively) indicated 60% of the dogs were still alive and only 1 dog had died as a result of complications related to surgery. CONCLUSIONS: CTAL for the treatment of canine laryngeal paralysis does not significantly increase rima glottidis area compared with CAL alone. The mean percentage increase in rima glottidis area obtained with both procedures was comparable to previously reported mean increases with CAL in live anesthetized dogs. Both procedures resulted in good long-term clinical outcome. CLINICAL RELEVANCE: CTAL is as effective as CAL in providing an increased rima glottidis for the treatment of bilateral laryngeal paralysis in dogs.     

Unilateral arytenoid lateralisation: An assessment of technique and long term results in 62 dogs with laryngeal paralysis

Sixty-two dogs with laryngeal paralysis were presented over a three year period. Presenting clinical signs included inspiratory stridor (100 per cent), exercise intolerance or syncopal episodes (81 per cent), loss or alteration in phonation (48 per cent) and coughing or gagging when eating (29 per cent). Causes of the paralysis were determined as traumatic (two dogs), neoplastic (two dogs), iatrogenic (two dogs), congenital (one dog) and idiopathic (55 dogs). Unilateral arytenoid lateralisation was performed in all dogs. The perioperative complication rate was approximately 10 per cent, while the success rate as judged by owners one year postoperatively was greater than 90 per cent. The technique avoided many of the recorded complications of intralaryngeal surgery. Operative times were short and the requirement for postoperative monitoring was minimal. Increasing familiarity with the technique favourably influenced the incidence of complications and the success rate.     

The assessment of corrective surgery for canine laryngeal paralysis by blood gas analysis: a review of thirty-five cases

Arterial blood samples were collected under sedation, from the femoral artery of 35 dogs suffering from laryngeal paralysis. Pre-operatively, the dogs showed a moderate degree of arterial hypoxaemia (mean PaO₂ 77 mmHg), with the worst affected clinically showing the most severe hypoxia. Following corrective surgery there was a significant improvement in PaO₂ tensions (90 mmHg). A group of 20 control dogs were also sedated and sampled. Their mean arterial oxygen tension was 91 mmHg, indicating that the pre-operative hypoxaemia found in the dogs with laryngeal paralysis was not the result of sedation.     

Evaluation of a modified castellated laryngofissure for alleviation of upper airway obstruction in dogs with laryngeal paralysis

A modified castellated laryngofissure procedure (castellated laryngofissure, vocal fold resection, and bilateral arytenoid lateralization) was performed on 12 dogs with bilateral laryngeal paralysis. Clinical signs of airway obstruction were assessed and a pulmonary function test (tidal breathing flow volume loop) was used to evaluate the severity of obstruction. The dogs were evaluated before surgery and at various periods from 4 days to 15 months after surgery. One dog died immediately after surgery and 3 dogs died due to nonrelated or unknown causes 1, 9, and 11 months after surgery. Clinical signs of upper airway obstruction disappeared or decreased in severity in the 11 dogs that recovered from surgery. Tidal breathing flow volume loop values were normal in 7 of 10 dogs evaluated within 5 to 189 days after surgery. The modified castellated laryngofissure procedure provided successful long-term relief of upper airway obstruction associated with bilateral laryngeal paralysis.     

Postoperative results of unilateral arytenoid lateralization for treatment of idiopathic laryngeal paralysis in dogs: 39 cases (1996-2002)

OBJECTIVE: To evaluate postoperative results for dogs with idiopathic laryngeal paralysis that underwent unilateral arytenoid lateralization (UAL). DESIGN: Retrospective case series. ANIMALS: 39 dogs with idiopathic laryngeal paralysis. PROCEDURE: Medical records were reviewed, and information on surgical technique, hospitalization time, postoperative treatment, and complications was obtained. Owners were contacted by telephone for additional information if necessary. RESULTS: In all dogs, UAL had been performed by a single surgeon who used a standard surgical technique. Long-term follow-up information was available for all 39 dogs; mean follow-up time was 29.6 months (range, 3 to 61 months). Seven (18%) dogs developed postoperative pneumonia, and 6 of the 7 recovered with treatment. Twenty-two of the 39 (56%) dogs had minor complications, including unresolved coughing or gagging, continued exercise intolerance, vomiting, and seroma formation. Owners of 35 of the 39 (90%) dogs reported an improvement in postoperative quality-of-life score. Median survival time was 12 months; only 1 dog was euthanized because of respiratory tract disease following surgery. CONCLUSIONS AND CLINICAL RELEVANCE: Results suggest that UAL will improve quality of life in most dogs with idiopathic laryngeal paralysis. However, the complication rate is high, with postoperative pneumonia being the most important major complication. Minor complications were common but did not adversely affect owner-assigned quality-of-life scores in most dogs.