Brachycephalic Airway Syndrome in Dogs
Causes, Symptoms, and Treatment of Brachycephalic Airway Syndrome
What is Brachycephalic Syndrome?
Brachycephalic syndrome refers to a group of airway problems that occur in dogs with flat faces and short noses (brachycephalic breeds). These are breeds such as English bulldog, French bulldog, Boston terrier, pug, Pekingese, shih tzu, and boxer. In rare cases, it can also affect certain brachycephalic cats, such as the Himalayan and Persian. These anatomical and acquired abnormalities in the upper respiratory tract can result in a partial airway obstruction, making it difficult for the dog to breathe properly. In that situation these breeds may find themselves in a crisis state, which warranted immediate veterinary intervention.
Causes of Brachycephalic Syndrome
This syndrome is caused by one or more of the following abnormalities in the upper airway:
Stenotic Nares: Narrow nostrils that limit airflow.
Elongated Soft Palate: The soft palate is too long and obstructs the airway.
Everted Laryngeal Saccules: The saccules (small soft pouches) of the voice box prolapse into the trachea, blocking airflow.
Narrow or Collapsed Trachea: Especially common in English bulldogs.
Enlarged Tonsils: Can contribute to airway obstruction in some cases.
Obesity: Many affected dogs are overweight, which exacerbates breathing problems.
Clinical Signs
Breathing Noises: Due to difficulty breathing, affected dogs often make loud noises, especially when inhaling.
Coughing and Gagging: Many affected dogs cough or gag, sometimes even vomiting.
Panting: Panting is common due to trouble breathing.
Snoring: Loud snoring occurs when the dog is relaxed or asleep.
Cyanosis: Severe difficulty breathing can lead to blue-colored gums or tongue and overheating.
Exercise Intolerance: Dogs with brachycephalic syndrome may collapse during exercise or show extreme fatigue.
Diagnostic Tests
Tentative Diagnosis: If a dog shows clinical signs and belongs to a brachycephalic breed, a tentative diagnosis can be made.
Sedation/Anesthesia: To diagnose structural issues like elongated soft palates or everted saccules, the dog may need to be sedated or anesthetized.
X-rays: X-rays of the chest can help assess the trachea for narrowing or collapse and check for any lung or hiatal hernia issues.
Treatment Options
Emergency Therapy: In severe cases, immediate treatment may be necessary, including sedation, oxygen therapy, and lowering the body temperature if the dog is overheated. The dogs many need to be intubated until inflammation subsides. In extreme cases, a temporary tracheostomy (a breathing tube in the trachea) may be required until corrective surgery can be performed.
Conservative Management: In less severe cases, management includes weight loss, exercise restriction, and avoiding triggers like heat or excitement.
Surgical Correction: Surgical intervention is typically needed for long-term relief.
This can be done at any point, before your pet experiences an emergency, if your veterinarian identified that your pet is predisposed to brachycephalic airway syndrome.
Procedures can include:
Shortening the Soft Palate
Widening the Nares (Nostril Openings)
Correcting Laryngeal Issues: If there are secondary problems in the laryngeal area, they should be corrected as well.
Follow-up Care
Monitoring: Close monitoring is essential after surgery, as aspiration pneumonia can develop. Chest X-rays may be done to check for this.
Recovery: Post-surgery, dogs may experience coughing and gagging for several days. Food is typically withheld for 18-24 hours, but water is allowed.
Weight Management: Maintaining a healthy weight is critical for long-term management.
Prognosis
If a severe respiratory crisis develops, the prognosis is guarded. Even with emergency intervention, some animals may not survive
Surgical intervention in advance of a crisis is always ideal and helps reduce the likelihood of a serious life-threatening event from occurring
