Generalized neuromuscular or muscular disease can also result in laryngeal paralysis. Most of these processes, with the exception of a traumatic episode, are slowly progressive, until an acute exacerbation causes a life-threatening crisis. A temporary tracheotomy may be necessary to bypass the compromised airway as an emergency procedure until definitive surgical correction can be performed. This predisposes the patient to a life-threatening collapse, asphyxia and death. The signs of laryngeal paralysis are often made worse by exercise, hot and humid weather, and obesity.
Aspiration pneumonia can also occur during violent gasping and gagging episodes.
The diagnosis of laryngeal paralysis involves direct observation of arytenoid function during respiration. This is usually performed under heavy sedation or light anesthesia. Dogs with compromised airflow through the larynx must work harder to fill their lungs with air. When collapsed, the paralyzed laryngeal wall closes in front of the opening to the trachea and blocks the flow of air. Thus, the paralyzed larynx is sucked closed when we need air the most, creating the anxious and terrifying noisy breathing, gagging and gasping for air with exercise or periods of excitement.