Does Your Big Buddy Have GOLPP? What Everyone With an Aging Large Dog Needs to Know
Gerka the Giant Schnauzer came in for an initial evaluation for progressive neuromuscular weakness. He’s wearing his goggles for laser treatment, which will come after his acupuncture treatment.
GOLPP stands for Geriatric Onset Laryngeal Paralysis & Polyneuropathy and is a common problem among older large and giant breed dogs. It is a disease of the nervous system, characterized by the slow but progressive degeneration of some of the longer nerves in the body. It results in partial paralysis of the larynx (voice box), esophagus, and hind limbs. Geriatric Onset Laryngeal Paralysis is due to the degeneration of nerves that control the muscles that move the laryngeal cartilages, located in the throat. Polyneuropathy means that many nerves are affected, not just the nerves responsible for laryngeal movement.
We do not know the cause of GOLPP, and there is no cure for it. However, there are many things you can do to reduce the problems associated with this disease.
What Are the Signs of GOLPP?
Dogs affected by GOLPP will slowly lose thigh and back muscle mass, scuff the tops of their paws as they walk, have trouble pushing off from their hind end as they climb stairs or try to get into the car or up on furniture, and become easily unbalanced in their back end. They will also develop noisy breathing from the throat (stridor), sometimes called “roaring,” most noticeable when panting. Distressed breathing is commonly observed when the dog is excited or stressed. A bark change or hoarse bark is seen in many cases, along with throat clearing, hacking, or coughing. Pronounced/repeated swallowing or coughing/hacking after eating, as well as increased drooling and lip licking may be signs related to partial paralysis of the muscles responsible for moving food from the throat to the stomach, causing esophageal dysfunction. As a result, food, liquids, and saliva are regurgitated back into the throat where they may be coughed out or inhaled into the lungs.
Who is Most Commonly Affected by GOLPP?
Geriatric medium to large breed dogs, anywhere from 8 to 13 years old, are most likely to be affected by GOLPP. The disease is commonly seen in Labrador Retrievers, but it has also been documented in Newfoundlands, Borzois, Golden Retrievers, Greyhounds, German Shepherds, Great Danes, and even mixed breed dogs.
How is GOLPP Diagnosed?
Your veterinarian will likely use multiple tests to diagnose GOLPP. First, a careful physical examination and palpation of the larynx and thyroid region of the neck can help to rule out other causes of laryngeal paralysis including thyroid cancer, trauma with swelling, or even a foreign body in the throat. Chest & neck x-rays will generally require three views for your vet to maximally evaluate the heart, lungs, trachea, and esophagus to ensure no signs of aspiration (inhalation) pneumonia or cancer are present. Laryngoscopy is the diagnostic tool of choice to rule out a tumor in the throat and to confirm laryngeal paralysis. Sedation is required to conduct this test properly; a short-acting anesthetic allows the veterinarian to fully evaluate the back of the throat and the laryngeal movements during breathing without causing the gagging reflexes that would occur with an awake dog. Baseline lab tests should also be run to assess the dog’s basic health.
Because Hypothyroidism (low thyroid) can contribute to neuromuscular weakness, including problems with swallowing and facial muscles, it is important to have your veterinarian run a comprehensive Thyroid Panel, in addition to the standard T4, which is commonly included in a senior blood panel. This comprehensive check should include not only a T4, but also a FreeT4 and an Endogenous TSH level (thyroid-stimulating hormone). Treating undiagnosed hypothyroidism can really help to improve neuro-muscle function, including swallowing, in any senior dog, not just those with GOLPP.
Finally, a thorough neurological exam by a veterinary neurologist in collaboration with a veterinary rehabilitation specialist will be very important to evaluate the dog’s current function, posture, gait, muscle tone, and awareness of leg position (also called proprioception). This type of comprehensive exam will allow you to plan the best treatment options to keep your dog functioning independently for as long as possible.
How is GOLPP Treated?
A surgery commonly referred to as a “tie-back” can help prevent airway obstruction from the paralyzed laryngeal muscles. In this procedure, the surgeon will make an incision on the side of the dog’s neck to approach the larynx, then permanently fix one of the laryngeal cartilages in an open position. Dogs experience immediate and marked improvement in breathing after this surgery. However, this procedure may lead to increased risk of inhaling food and water, which may cause pneumonia.
Non-surgical management may also be applied using a combination of medications and physical rehabilitation therapies that have been shown to improve swallowing and breathing as well as hind end nerve and muscle function. Acupuncture can help improve neuromuscular function, as does LASER therapy, neuromuscular electrostimulation (NMES), and Pulsed Electromagnetic Field (PEMF) therapy. In dogs with more severe swallowing problems, medications such as Reglan or Cisapride may be prescribed to improve motility and tighten the lower esophageal sphincter muscles to reduce the risks for reflux.
Feeding and sleeping habits may also be modified. Using raised food and water bowls, feeding smaller meals, keeping the dog sitting upright for at least 30 minutes after eating, and propping the head up when sleeping may all help to decrease the risk of aspiration pneumonia. However, in some cases, treatment with ongoing preventative antibiotics is necessary to prevent recurrent episodes of severe, life-threatening, inhalation pneumonia.
It’s always sad to see our older friends slowing down with age. But with proper diagnosis and treatment, you can help make your large breed buddy’s golden years as happy and comfortable as possible.