Simini Boards Cast
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Simini Boards Cast
Chapter 101 - Part C: When the Gate Won’t Open: Laryngeal Paralysis
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In this BoardsCast episode, we continue Tobias Chapter 101 — Larynx with one of the most terrifying presentations in small animal practice:
The lungs are fine, the airway isn’t blocked, and the dog still can’t breathe.
That’s because laryngeal paralysis isn’t a lung disease, it’s a mechanical failure of the airway gate.
If you remember one model from this episode, make it this:
Laryngeal paralysis = failure of the airway gate to open during inspiration.
You’ll learn:
- Why does normal breathing requires active arytenoid abduction (the doors must be pulled open)
- The single point of failure: cricoarytenoideus dorsalis (CAD) is the only opener
- What happens when CAD is offline: arytenoids sit paramedian, leaving a narrow rima glottidis slit
- Why the crisis accelerates with effort/heat: negative pressure sucks flaccid cartilages inward + Poiseuille’s law (radius ↓ → resistance explodes)
- The true cause in most cases: recurrent laryngeal nerve dysfunction, often as part of geriatric-onset polyneuropathy
- The classic patient: older large-breed dogs (Labs/Goldens), males overrepresented
- The surgical paradox: tieback fixes airflow, but permanently increases aspiration pneumonia risk
Key takeaway: this dog isn’t failing to breathe because the lungs can’t work — it’s failing because the gate won’t open.
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