Brachycephalic Syndrome in Dogs and what we can do to help

Certain breeds of dogs are prone to difficult, obstructive breathing because of the shape of their head, muzzle and throat. The most common dogs affected are the “brachycephalic” or “short faced” breeds. Common examples of brachycephalic dog breeds include the English bulldog, French bulldog, Pug, Pekingese, and Boston terrier.

The term Brachycephalic Syndrome refers to the combination of:

  1. Elongated soft palate (tissue at the back of the throat which can protrude into the airways).
  2. Stenotic nares (narrow nostrils)
  3. Everted laryngeal saccules (tissue that protrudes into the airway of the voice box)
  4. Hypoplastic trachea (narrow windpipe)

The consequence of these challenges are:

  • Noisy breathing that is worse during exercise or stress.
  • Exercise intolerance and difficulty coping with hot temperatures
  • Choosing to sleep on their backs or excessive snoring
  • Gagging or retching when swallowing

One way to think about these challenges is to imagine having to breathe through a “straw” in comparison to a “snorkel”, as the airways are much more narrow.

In the long term, the excessive effort required for air intake during breathing can lead to airway collapse, reduced quality of life and death. The condition of elongated soft palate and everted laryngeal saccules can only be visualised by placing an animal under general anaesthesia and appear like the above images.

What can we do to help our pets?

There are two procedures that are now commonly performed to help relieve symptoms of brachycephalic syndrome AND PREVENT the long term consequences of airway collapse.

The simplest procedure is to widen the narrow nostrils (stenotic nares). The operation requires a wedge of tissue to be removed from the exterior of the nostril. As a result, the dog makes less snuffling noise as air moves more freely during breathing.

 

 

 

The second procedure we can perform is to shorten (resect) the elongated soft palate. For this procedure, the s

oft palate is evaluated when the dog is intubated for a general anaesthetic. In cases where the soft palate extends into the airways, the tissue can be trimmed and sutured closed. At this time, if the laryngeal saccules are everted, they are also trimmed.

 

                 

What are the risks and how can we minimise these?

Surgical correction of the stenotic nares and the elongated soft palate have the potential to improve a dogs quality of life and reduce serious life threatening respiratory events long term.

However, the resection of the soft palate can lead to some serious complications without proper care and attention before, during and after surgery. Possible complications include:

  • Coughing
  • Vomiting
  • Aspiration (breathing in of fluid or food)
  • Pneumonia (secondary to aspiration)
  • Swelling of airways
  • In rare cases, complications can lead to death

We minimise risks by taking the following measures:

  1. 14 days of gastroprotectant medications to start 7 days before surgery
  2. Use of anti-inflammatory medications to reduce risk of post operative swelling
  3. Introduce food in hospital 24 hours post operatively and monitor closely
  4. Feed soft food only in small meals for 2 weeks (ideally fed from hand)
  5. Use only harnesses for walking (no collars for 2 weeks minimum)
  6. Keep rested and confined at home for 2 weeks
  7. Monitor for cough and/or vomiting and treat as required

Complication rates are lower in young patients before signs of respiratory disease

In the ideal world, dogs would be monitored closely for the first 24-48 hours post operatively. Round the clock veterinary monitoring is available at specialist veterinary hospitals in Sydney and Canberra. Here at North Nowra Veterinary Hospital, our patients undergo surgery early in the day and are monitored closely until end of business at 6pm. At this time, dogs return home with their owners and are kept quiet and we ask owners to NOT offer food or water at this time. An after hours call service is available in cases of emergency.

The following day, patients return to hospital where they are offered small amounts of food and water and watched closely for normal swallowing and lack of coughing or vomiting. Weekly rechecks are recommended and after 2 weeks your dog can resume normal feeding and activity patterns.

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