Thought I'd note the journey my boy Luke and I are about to take through his LARPAR surgery, as it may help others to make the decision whether to tie-back or not. Luke is 12. Sometime in August 2022 I noticed him coughing after drinking water. Then I noticed him coughing while I/he were trying to sleep. There's also been some reverse sneezing going on, which seems to be initiated by events that might cause him anxiety or excitement. His panting is raspier than it used to be. He's breathing harder while on walks, I've had to cut our walks short. He sleeps a lot more, probably from poor quality of sleep due to the coughing or just lack of oxygen in general. Snoring has begun this week, he never snored before. At an unrelated Vet visit in early September I mentioned the coughing and we started discussing LARPAR. They did a sedated exam, thought that his flaps weren't moving as well as they should. My Vet consulted with a Surgeon at the specialist and the Surgeon recommended trying a 3 week cycle of Doxycycline, Benadryl & switching to a raised food/water bowl citing that he often ran across an infection that mimics larpar. That had no effect. Now we've moved on to the Specialist. Luke had a consultation with the specialist last week. A sedated exam with the Surgeon there is scheduled for the day after tomorrow. During that exam if he confirms that Luke has Larpar he will do the tie-back right then and there. Surgery is quoted to be about $4000-$5000. Thank goodness for dog insurance. Sounds like they will keep him in the hospital for at least a day and a half, maybe longer. As I understand it, pneumonia is one of the biggest risks after this surgery with a 20% chance of occurrence within 3 months after the procedure and will always be a concern. And since it is a nerve condition, other problems related to this condition will eventually show up, like the hindlimb weakness. I'll take others' advice and start physical therapy with him at home to delay that. I'm willing to cross those bridges once we get to them. His respiratory situation from the larpar (coughing/raspy panting) has progressed much quicker than I thought it would, and I am anxious to have the tie-back operation ASAP. He's in VERY good physical shape so I think the risks are worth it. I think my ole boy has at least one/maybe two good year(s) left in him. I'll update this after the surgery.