Laryngeal paralysis in 72 cats: a multicenter study on epidemiology and treatment

Objective To describe the etiology, treatment, and outcomes of cats with laryngeal paralysis (LP) and identify factors associated with survival. Methods Retrospective, multicenter, observational study. Medical records from 7 referral hospitals (Italy, UK, US) were reviewed to identify cats with LP (2003 to 2024). Survival was assessed using Kaplan-Meier and Cox regression analyses. Results 72 cats were included. Primary idiopathic LP was diagnosed in 49 cats (68%) and secondary LP in 17 (24%), most commonly associated with pulmonary neoplasia, trauma, or surgery. Six cats (8%) had comorbidities without a confirmed causal relationship. Bilateral LP was diagnosed in 44 cats (61%), and unilateral LP was diagnosed in 26 cats (36%). Arytenoid lateralization was performed in 53 cats (74%); 93% of cats with bilateral LP and 38.5% of cats with unilateral LP underwent surgery. Complications occurred in 13 cats (24%), including 8 major complications (15%) and 3 deaths from aspiration pneumonia. Estimated 1-, 2-, and 3-year postoperative survival rates were 88%, 85%, and 85%, respectively. Major postoperative complications were the only independent predictor of decreased survival (hazard ratio, 99.42; 95% CI, 8.50 to 1,161.77). Conclusions Primary idiopathic LP was the most common diagnosis, although secondary causes, particularly neoplasia, were frequent. Unilateral LP may require surgical treatment. Arytenoid lateralization provided good long-term outcomes, although major complications markedly reduced survival. Clinical Relevance Thorough investigation should be considered in cats with LP to identify underlying neoplasia. Treatment decisions should be based on clinical severity rather than laterality, and owners should be informed of the risk of serious postoperative complications.