One of the rewarding aspects of arytenoid lateralization surgery is the obviation for intraluminal manipulations or dissections,
which usually translates into rapid, pain-free recoveries after surgery. Most dogs can be discharged the day after such surgery
and require minimal special care.
Most dogs can eat and drink fairly normally after tie back surgery. It may be beneficial to initially divide their daily food
intake into smaller meals and, likewise, to limit gulping of water in large volumes. Dusty food should be avoided since it
may induce coughing. Each dog requires some individual titration to determine the characteristics and frequency of feeding
to best reduce signs of dysphagia and cough, but with time most can resume the same feeding regimen that had been used before
Many of these dogs will feel well enough after surgery to start barking incessantly. Although they will usually lose their
resonance and have a hoarse sound to their barking, this violent activity places the maximal strain on the tie back and, therefore,
should be prevented. This is another reason to discharge these dogs from the hospital as soon as practical (as most dogs will
be more relaxed, less stimulated and quieter at home) and to continue the use of tranquilizers as needed.
Dissection in the neck may result in mild seroma formation in some dogs, which can be treated conservatively as needed. Neither
corticosteroids nor antibiotics are routinely required in the perioperative or postoperative periods with this operation.
Long-term, warn clients that their dogs' voices, even if still preserved before surgery (often they have already had a change
in phonation), will be permanently altered. I also counsel clients not to allow their dogs to swim any longer, since dogs—particularly
retrievers—tend to skim the surface of the water with their mouths open, which would put their minimally protected airways
at undue risk for aspiration.
While published reports suggest a significant incidence of postoperative aspiration pneumonia, my experience has been that
this is an infrequent complication and that many of these already older dogs can enjoy a significant increase in longevity
(often years) with good qualities of life. In dogs in which laryngeal paralysis is part of a more systemic neuromuscular disorder,
the prognosis may be more limited because of progressive esophageal or appendicular dysfunction.
Dr. Fingeroth is senior staff surgeon at the Orchard Park Veterinary Medical Center in New York. He is also a consultant to
the Veterinary Information Network in the areas of orthopedics and general soft tissue surgery, as well as oncologic, endocrine
and neurosurgery. He has been ACVS board-certified since 1988.