Thursday, November 5, 2015

The Pet PT Pit Stop: Relief for Laryngeal Paralysis using Physical Therapy

by Susan E. Davis, PT “pull in for a helpful refuel!”  

It’s all about guiding and empowering you to help your dog avoid injury, provide practical solutions and achieve rapid restoration of health and function!   

When a dear friend and Reiki practitioner, Carol Alan, called me to ask whether PT could help her 13 year-old greyhound Maybelline with stridor, or the respiratory effects of laryngeal paralysis, I wasn’t sure. “Let me think about this and get back to you, Carol”.

Laryngeal paralysis is a condition therapists don’t typically treat, but remain aware of in the event a dog needs to use water as a therapeutic medium.  

It is considered a contraindication for canine swimming and a precaution for underwater treadmill use.

Stridor is the unusual breathing sounds a dog makes when laryngeal paralysis is present. 

It is a type of gasp, can be high-pitched and occurs during inhalation. Stridor also inhibits the ability to bark.

The larynx, positioned in the throat as part of the upper airway system, has a little valve at its opening. This valve consists of 2 small articulated flaps, called arytenoid cartilage, which normally open and close as the larynx performs its function. In laryngeal paralysis, the flaps remain stationary in a neutral position and cease to open and close properly, resulting in panting, inadequate ventilation during exercise and decreased protection when the dog swallows.

This condition occurs in older dogs, large breeds, smaller breeds with brachiocephalic head shapes (flattened face/nose), and is ‘idiopathic’ (no known cause) in many cases.  Sometimes it can occur from trauma to the neck.

Treatment for laryngeal paralysis is often surgical, with a tie-back procedure, to allow proper opening at the opening of the larynx.

Some dogs are unable to have surgery for medical or other reasons, and treatment consists of body weight management, decreasing the activity level, limiting exposure to heat and high temperatures to prevent excessive thermoregulatory panting. Veterinarians often prescribe use of oxygen, sedatives, steroids and antibiotics as other forms of treatment.

So what about PT for this condition?

PT for animals, though nearly 15 years in existence, is still a very new field with lots of unfamiliar territory.  When a therapist encounters something like this, there is little if any veterinary rehabilitation research to rely on, so one must apply principles that have solid evidence-based results in humans.

Finally, a therapist must be certain that in trying these treatments for a pet, no harm will be done and no known contraindications exist. Collaborating with the pet’s owner and veterinarian is also imperative.

Well, here is what I came up with for PT treatment of stridor in Maybelline:


Positioning for drainage: in case Maybelline aspirated any food or liquid, I positioned her flat, on her side to allow gravity to drain any congestion in the upper lung lobes.  If her lower lung lobes were affected, I would have used pillows under her ribs and rump to incline her body further.

I applied a technique called percussion, a rhythmical clapping directly on the chest and ribs, to mobilize lung fluids. This is performed with cupped hands, and the fingers held together.



After a few minutes of percussion, I perform a shaking technique called “vibration” with compression on the ribs, to increase intra thoracic pressure and help elevate or lift the laryngeal flaps. 



I finish with manual cervical traction. This elongates the neck and throat to further relieve any mechanical pressure on the airway. One hand is placed on the spinous process of the lower cervical vertebrae for stability and the other under the skull occipital bone, and then a traction force is applied. This technique is advanced and must be done properly, so do not attempt to do on your own until you have been thoroughly taught by your therapist or veterinarian. If in doubt, have a professional perform manual cervical traction.


When I’m through, sweet Maybelline always turns her head and looks up as if to say “I really like this”!

Maybelline’s owner Carol and her veterinarian feel that these techniques, combined with her total treatment plan, are helping provide temporary relief of stridor by giving her upper airway a short-term boost. This coincides well with the warm summer months behind us, heading into autumn and winter.

***

Susan E. Davis (Sue) is a licensed Physical Therapist with over 30 years of practice in the human field, who transitioned into the animal world after taking courses at the UT Canine Rehabilitation program.  She is located in Red Bank, New Jersey.

She has been providing PT services to dogs and other animals through her entity Joycare Onsite, LLC in pet’s homes and in vet clinics since 2008.

She also provides pro bono services at the Monmouth County SPCA in Eatontown, NJ.  Sue is the proud “dog mommy” to Penelope, a miniature Dachshund with “attitude”.  For more information see her website www.joycareonsite.com , or follow on Twitter @animalPTsue.


Sue is also the author of a fantastic book on physical therapy, Physical Therapy And Rehabilitation For Animals: A Guide For The Consumer.  

Physical therapy can do so many great things for your dog. Understanding all the possibilities physical therapy can offer will change your dog's life. This book definitely belongs on the shelf of every dog lover.



Articles by Susan E. Davis:
Functional Strengthening Exercises: the What, Why and How
One Thing Leads To Another: Why The Second ACL Often Goes Too
Compensation: An Attempt To Restore Harmony
Paring Down to the Canine Core
Canine Massage: Every Dog ‘Kneads’ It”
Photon Power: Can Laser Therapy Help Your Dog?  
Physical Therapy in the Veterinary World  
Reiki: Is it real? 
Dog Lessons: Cooper  
The Essentials Of Canine Injury Prevention: 7 Tips For Keeping Your Dog Safer 
It's Not Just Walking, It's Therapy! 
Treatment And Prevention Of Canine Intervertebral Disc Disease (Part I)
Treatment And Prevention Of Canine Intervertebral Disc Disease (Part II Physical Therapy)
Range Of Motion: It’s A Matter Of Degree…
The Weight Of Water And How It Helps Dogs 
By Land or By Sea? A Comparison of Canine Treadmills 
Unraveling The Mystery Of Fascia And Myofascial Trigger Points (Part I)
Unraveling The Mystery Of Fascia And Myofascial Trigger Points (Part II) 
Scar Tissue: Is it Too Much of a Good Thing? 
Physical Therapy Tip Of The Month: Ramps! 
Physical Therapy Tip Of The Month: Indoor Duo Dog Exercises!
Physical Therapy Tip Of The Month: Best Practices After Your Dog’s Surgery 
Physical Therapy Tip Of The Month: Ideas to Chew on - Can Physical Therapy Help with my Dog’s Digestive Problems?
Wrap It Up: Using Soft Supports For Your Dog
When Do I Use Heat versus Cold? : A Tale (or Tail) Of Two Temps! (Part I) 
When Do I Use Heat versus Cold? : A Tale (or Tail) Of Two Temps! (Part II) 
Physical Therapy Tip Of The Month: Safe Summer Boating Tips for your Dog 
Physical Therapy Tip Of The Month: Hip Dysplasia - What’s a Dawg Mama to Do?
PT Pit Stop: Wheeled Carts Keep Them Doggies Rollin' (Part I)
PT Pit Stop: Wheeled Carts Keep Them Doggies Rollin' (Part II)
Staying in the Loop with Targeted Pulsed Electromagnetic Field Therapy
Addressing Frailty Syndrome in Geriatric Dogs 
The Pet PT Pit Stop: "Where's The Evidence?"
Physical Therapy is Great, Except When It Isn’t 
Top Dogs and their Toplines at the Westminster Kennel Club Dog Show (Part I)
Top Dogs and their Toplines at the Westminster Kennel Club Dog Show (Part II) 
What's in a Dog's Gait? 
A Practical Method to manage your Dog’s Care Plan 
Wound Care 101 (Part I The Basics) 
Wound Care 101 (Part II Wound Management)
Prevention and Management of Hip Dysplasia in Puppies: Attention all Breeders!
Support and Braces
Vaccinosis - A Vexing Conundrum 
The Pet PT Pit Stop: Blame it on the Weather, Really!

2 comments

  1. Interesting. I'd never heard of this condition. Thanks for the info.

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    Replies
    1. It's not a good condition to have. Particularly since lately they discovered that it's really a syndrome, which over time will affect other parts of the body as well - Geriatric Onset Laryngeal Paralysis Polyneuropathy (GOLPP).

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