Environmental changes may be helpful for dogs who have developed GOLPP complex, which has been increasingly recognized in geriatric large-breed dogs (Labrador retrievers and associated breeds). This condition causes degeneration of long nerves in the body, particularly the laryngeal and sciatic nerves, causing laryngeal paralysis and weakness of the pelvic limbs with conscious proprioception deficits. Clinical signs include exercise intolerance, upper airway stridor, weakness, and sarcopenia. Comorbidities may include osteoarthritis and secondary musculoskeletal pain. Treatment may include maintaining QOL with laryngeal tie-back surgery and physical therapy to preserve muscle mass. Pain management should be included in the treatment plan.⁵⁶ Clients should be counseled that heat stroke may be a complication in this subgroup of patients.⁵⁷