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Possible laryngeal paralysis?

Species: Dog
Breed: Golden Retriever
Age: 11-15 years
Repeat Customer:

Hi Dr,
I spoke to you last Friday (through email) week regarding my Golden Retriever Callie. She still is not better. She still has “fits” of panting where it almost seems that she is short of breath. Every once in a while she does take a deep breath but it seems forced. She is on Rymadl and Tramadol (per the vet) and it does not seem to be doing much or anything. She sleeps with very shallow and short breaths. She is very lethargic – just getting up to pee and poop plus a little more. She will on occasion run around a little bit but it is a big difference from 2 weeks ago . When I take her for a walk she just comes and stands by me and wants me to pet her and lays down. No whining moaning or obvious signs of pain. Still No cough, gagging or anything else. Pooping, eating drinking all well and normal. No other signs or symptoms at all.

She has seen my vet, the doctor saw her hearts enlarged size (which I knew and has had since she has been age 2) but the Vet said Callie’s heartbeat is strong and her heart does not show anything that would be a concern. There is no fluid around the heart in the “sac” (the Vet did an x- ray and ultrasound and found no tumors cancer or obstructions.)
The Vet said it could be fatty deposits around her neck that is making her sound like she is breathing hard -(she is not that big - 70 pounds and spent most of her life at 53 pounds until 2 years ago) I don’t think that could be it at all. Is a shallow breath and panting thing, not a noise thing.

No blood work has been done – yet. Is heartworm a possibility? A lung infection? Pain of another sort?
Could she be lethargic because she is exhausted from breathing so hard all day long?
Please help as to what I should do next and what you think is going on – I am leaving town for 4 days and I am freaking out about leaving her!
Here is the summary for our conversations last week:
_________________________________________________________________________
My 12 year old golden retriever was diagnosed with an enlarged heart and a "5" grade murmur at the age 2 and is still alive and has had no symptoms until maybe now. (she has been very athletic and still runs around sometimes) . 4 days ago all of a sudden she started panting (it was hot here so i did not think much of it) she also has short breaths most of the day and seems uncomfortable and not at all normal. No cough, gagging or anything else. Pooping, eating drinking all well and normal.

Questions: Do you think this is the beginging of heart failure?
Is there medication that will slow it down?
Do you think she is in pain?
What will my local vet do for her?
How long can I expect her to live if it is the start of her heart failing?

Thanks,

Hi Marc and thanks for your question.

The answer here has a lot of "what ifs" as there are several possibilities for what could be happening to Callie.

There are many things that can cause a heart murmur in a Golden and while many heart murmurs are completely innocent it is certainly possible that this problem is related to Callie's heart. She may possibly have a condition called dilated cardiomyopathy where the heart muscle is not as strong as it should be. Sometimes these dogs can live for quite some time with no problems and then suddenly have heart issues. If this were the case, then the panting could be either because the heart muscle is struggling or possibly because of fluid in the chest (which is produced by a sick heart.)

While most dogs with significant heart disease do cough, not all of them do.

It's also possible that this is totally unrelated to her heart. She could have an issue with pain somewhere that is causing her to pant.

At 12, another possibility is hypothyroidism which is really common in Goldens. Goldens with hypothyroidism will definitely pant more. However, the symptoms usually come on very gradually.

The other thing we worry about, especially in Golden Retrievers is cancer. If there is cancer in her chest then this will definitely affect her breathing.

And there are many other possibilities such as an infection in the chest, laryngeal paralysis and even something totally unrelated to her chest such as liver disease or a bleeding spleen tumor.

Your vet will have a good listen to her heart and determine whether the murmur is worse. (However, the scale only goes up to 6, so it can't be much worse.) They will also listen for signs of fluid on her lungs. They will likely want to take an xray. The xray really should tell us if this is heart disease or if it is cancer. If the xray is inconclusive, however, they may want to do some bloodwork.

The rest of your questions are hard to answer without knowing what the diagnosis is. If this is heart disease then we do have medications that can help. Some dogs can live for another year or more with heart medications, but others do not do well and continue to decline. If there is cancer that is throughout the chest then her prognosis would be very poor.

It's very hard to say whether she is in pain, but if she is having trouble breathing then she is definitely uncomfortable. I would recommend you have her seen as soon as possible.

I really hope everything is ok!

Dr. Marie
______________

Thanks Dr.!


Online vet, Dr. Marie

Dr. Marie replied:

Ugh...so sorry to hear that things are not improving.

Another possibility jumped into my mind though. You may want to ask your vet about the possibility that Callie has something called laryngeal paralysis. Dogs with this problem will have issues with getting enough air into their lungs because the larynx does not open properly. They tend to pant and have very loud breathing.

The way we diagnose it is to administer a very very light anesthetic and then watch down her airway to see if the arytenoids (part of the larynx) are opening properly. This problem is usually seen in older dogs and labs and Goldens can be prone to it. There is a surgery that can be done to fix it but unfortunately it is fairly expensive. (It usually requires a specialist to do it.)

If the ultrasound is normal then heartworm is unlikely - there should have been changes visible on ultrasound. It's not a bad idea to have some blood tests done though as this could possibly give us a clue of other things that could be going on.

Being a Golden, another thing that I might consider if this were my case is to do a fine needle aspirate of her submandibular lymph nodes (the nodes in her neck) to see if there is any evidence of cancer as unfortunately cancer is relatively common in Goldens.

I'm guessing laryngeal paralysis is the culprit though. I have had some dogs with laryngeal paralysis get a little bit better on a bronchodilator called theophylline but most don't have a great improvement. If it is laryngeal paralysis, your vet can advise you on whether surgery is possible. If not, unfortunately, euthanasia is something that needs to be considered as things get worse.

Dr. Marie.



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Disclaimer: Although Dr. Marie is a qualified veterinarian, the information found on this site is not meant to replace the advice of your own veterinarian. AskAVetQuestion.com and Dr. Marie do not accept any responsibility for any loss, damage, injury, death, or disease which may arise from reliance on information contained on this site. Do not use information found on this site for diagnosing or treating your pet. Anything you read here is for information only.

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Dr. MarieDr. Marie is a veterinarian who practices in a busy animal hospital in Ottawa, Ontario. She created Ask A Vet Question as a resource for good, accurate veterinary advice online. Dr. Marie treats dogs, cats, hamsters, guinea pigs, and rats. She has been a vet since 1999.

Is an online vet visit just as good as a trip to your veterinarian? No! But, many times, asking an online veterinarian a question can help save you money. While Dr. Marie can't officially diagnose your pet or prescribe medications, she can often advise you on whether a vet visit is necessary. You can also ask Dr. Marie for a second opinion on your pet's condition.