Pulse - August 2023 - 17

PULSE SPECIAL SECTION
Blanca is a 15-year-old Labrador Retriever that originally presented
to CROC for generalized weakness and osteoarthritis, but
further evaluation revealed early signs of GOLPP. She now participates
in twice weekly therapy sessions to treat both her arthritis
and GOLPP symptoms.
in any medium to large breed. I like to describe GOLPP as " LarPar
Plus - the Neuropathy Edition " . Patients present with owners noting
increasing peripheral nerve neuropathy symptoms starting in
the limbs in addition to louder respiration and general decrease in
energy and mobility.
As GOLPP advances, delay and then loss of conscious proprioception
in the pes occur. Since these are senior or geriatric patients,
usually with reduced muscle mass to begin with, atrophic
changes are accelerated. As Laryngeal Paralysis sets in, patients
may develop a cough, have a change in their bark, increased panting,
and regurgitation of food or water. Exercise intolerance and
difficulty thermoregulating, especially in stressful or exciting conditions,
is common. Further along the disease process, GOLPP
patients are at risk for developing Megaesophagus and therefore
have an increased risk of aspiration.
Stumbling and weakness from GOLPP are frequently confused
with osteoarthritic changes, however GOLPP is not a painful condition
and decreased range of motion in the joints is not a symptom.
That being said, as our senior patients frequently have some
level of DJD present, it's important not to rule out GOLPP too
quickly. Suspected GOLPP cases can be confirmed with cervical
radiographs to help rule out space occupying lesions and sedated
laryngoscopy to verify Laryngeal Paralysis. DNA testing for Degenerative
Myelopathy through OFA is also recommended.
Rehabilitation Therapy for the GOLPP patient focuses on improving,
or at least maintaining, balance, coordination, strength,
and stamina. Since their respiration is compromised, therapy
should be performed in a calm, quiet, and controlled environment
to avoid over excitement or stress. Free reign play or group activities
should be avoided. Because of their predisposition for aspiration,
swimming is never an appropriate activity for GOLPP patients.
Instead, use of an Underwater Treadmill in which the water can
be precisely controlled to a safe level allows the patient to benefit
from the muscle building resistance of hydrotherapy with reduced
PULSE
AUGUST 2023
Copper is an 11-year-old Vizsla that presented to CROC for pelvic
limb knuckling and incoordination. His family reported changes
in his voice and recently developed exercise intolerance but were
unaware that these were symptoms of undiagnosed GOLPP.
risk for aspiration. While this method of hydrotherapy is excellent
for addressing peripheral atrophy, gains in ability will only reach
what neurological function will allow, so it is recommended to begin
therapy as soon as possible.
Though GOLPP is not intrinsically painful, these patients typically
suffer from comorbidities and compensatory injuries. For this
reason, Rehab patients are treated as individuals for all of their
presenting symptoms and not for the diagnosed condition alone.
Electrostimulation therapy, Veterinary Medical Acupuncture, and
Class 3-4 LASER to the peripheral nerve sites have proved therapeutic.
Exercises to target anti-gravity muscles of the limbs and
erector muscles of the body are prescribed for owners to perform at
home in addition to in-clinic therapies and exercises.
Outside of Rehabilitation Therapy, Arytenoid Laryngoplasty,
also known as Laryngeal Tie-Back, can provide almost immediate
relief and marked increase in respiratory function. These patients
respond particularly well to Rehab post-op since they have gained
an increase in exercise tolerance. Owners of GOLPP dogs should
be instructed to take great care with feeding/watering and may
need to adjust their routine as Megaesophagus develops. They
must also be diligent in monitoring their dog's thermoregulation
and be careful not to overexert their pet. A place to cool off and
calm down must always be available and owners should form an
emergency plan in advance should their pet show signs of heatstroke
or dyspnea. Modifications at home include textured flooring
to help avoid falling injuries and use of a supportive harness
rather than a collar or " no-pull " device to make it easier to assist
their pet as the disease progresses.
With frequent and competent Rehabilitative therapy, GOLPP
patients can have delayed advancement of symptoms, improved
comfort, and mobility despite the progressive nature of the disease.
Many GOLPP patients, especially those who receive consistent rehabilitation
services, can expect months to several years of quality
time with their families. P
17
Pulse - August 2023

Table of Contents for the Digital Edition of Pulse - August 2023
