However most unilateral cases will eventually progress to include both sides of the larynx, a more serious problem with symptoms appearing more often. Signs are usually worse in hot and humid weather, during exercise, during times of stress or excitement, and in obese pets. Acute or late-stage symptoms are usually unmistakable and require immediate emergency treatment. Diagnosis
This condition is usually diagnosed by direct examination of the larynx under light sedation, which also allows checking for benign or malignant tumors. Tests, such as thoracic radiographs, CT-scans, or echocardiography, are sometimes needed to rule out heart, lung, or mediastinal diseases or other possible causes of the symptoms often seen with LP. Some vets may also recommend running a thyroid profile since LP can be a symptom or complication of hypothyroidism. Treatment
Mild cases are managed by limiting activity, keeping a healthy body weight, and avoiding exposure to high ambient temperatures. Mild sedatives can be used to decrease anxiety and panting and therefore improve respiration. Corticosteroids may also be administered in acute cases to decrease inflammation and edema of the larynx. Severe acute symptoms, such as difficulty breathing, hyperthermia, or aspiration pneumonia, must be stabilized with sedatives and oxygen therapy and may require steroid or antibiotic medications. Sometimes a tracheotomy is required to allow delivery of oxygen. Once the patient is stabilized, surgical treatment may be beneficial especially when paralysis occurs in both arytenoid cartilages (bilateral paralysis). The surgery (aretynoid lateralization, or a "laryngeal tieback") consists of suturing one of the aretynoid cartilages in a maximally abducted (open) position.
First known was to use Prussian blue, which is a solid ion exchange material, which absorbs thallium. Up to 20 g per day of Prussian blue is fed by mouth to the person, and it passes through their digestive system and comes out in the stool. Hemodialysis and hemoperfusion are also used to remove thallium from the blood stream. At later stage of the treatment additional potassium is used to mobilize thallium from the tissue. Notable cases
There are numerous recorded cases of fatal thallium poisoning. Because of its use for murder, thallium has gained the nicknames "The Poisoners Poison" and "Inheritance Powder" (alongside arsenic). Australias "Thallium Craze"
In Australia, in the early 1950s, there was a notable spate of cases of murder or attempted murder by thallium poisoning. At this time, due to the chronic rat infestation problems in overcrowded inner-city neighbourhoods (notably in Sydney), and thalliums effectiveness as a rat poison, it was still readily available over the counter in New South Wales, where thallium sulphate was marketed as a commercial rat bait, under the brand Thall-rat . In September 1952 Yvonne Gladys Fletcher, a housewife and mother of two from the inner Sydney suburb of Newtown, was charged and tried for the murders of both her first husband, Desmond Butler (who died in 1948), and her abusive second husband, Bertrand "Bluey" Fletcher, a rat-bait layer, from whom she had obtained the thallium poison that she used to kill him earlier that year.