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Brachycephalic Airway Syndrome in Dogs

Dogs with shorter heads and noses have a higher risk of developing brachycephalic airway syndrome. Today, our Pleasant Hill vets explain what brachycephalic airway syndrome is and how this condition can be treated.

What is Dog Brachycephalic Airway Syndrome

To understand brachycephalic airway syndrome, you must first understand what brachycephalic means. Brachy means "small" and cephalic means "head," so brachycephalic means "small head." Brachycephalic dogs are those with small heads and noses, such as:

  • French and English Bulldogs
  • Boxers
  • Boston Terriers
  • Shih Tzus
  • Chinese Pugs
  • Pekingese

These breeds are at a higher risk of developing brachycephalic airway syndrome which refers to abnormalities in the upper airways of brachycephalic dogs. 

Both males and females are equally likely to develop this condition, and most dogs are diagnosed when they are between 1 and 4 years old. However, dogs that have multiple abnormalities can start developing issues at a younger age.

Abnormalities Associated With Brachycephalic Airway Syndrome

Dogs with this syndrome can develop one or more of these abnormalities:

Stenotic Nares

This refers to abnormally small or narrowed nostrils, restricting the amount of air that is able to flow through the nostrils.

Elongated Soft Palate

The soft palate is the soft top part of a dog's mouth, and when it becomes elongated, it partially blocks the entrance to the windpipe (trachea) at the back of the throat.

Everted Laryngeal Saccules

Laryngeal saccules are small pouches or sacs in the larynx that turn outward (evert) or are sucked into the airways by the pressure from increased respiratory efforts caused by stenotic nares or an elongated soft palate. These everted saccules will then obstruct airway flow even more.

Hypoplastic Trachea

This is when the diameter of the trachea is smaller than normal.

Laryngeal Collapse

This happens when other brachycephalic airway syndrome abnormalities add chronic stress to the cartilage of the larynx box. As a result, the voice box (larynx) cannot open as widely as it should, further impeding airflow.

Extended Nasopharyngeal Turbinates

Nasopharyngeal turbinates are bone ridges covered by tissues that help to warm and humidify the air inhaled. When these spread beyond the nose and into the pharynx (the area behind the nose and mouth), they cause varying degrees of airway obstruction.

Other problems Caused by Dog Brachycephalic Airway Syndrome

This syndrome can also cause changes in the dog's lungs as well as the gastrointestinal tract including:

  • Chronic Gastritis
  • Gastroesophageal Reflux
  • Bronchial collapse

When dogs suffer from bronchial collapse the airways connecting the trachea to deeper airways of the lungs (bronchi) become weaker and collapse leading to additional airway obstruction.

Signs of Brachycephalic Airway Syndrome in Dogs

If you own a brachycephalic breed of dog, such as the ones listed above, you should be aware of and keep an eye out for the following signs of brachycephalic airway syndrome. The type of signs and severity of your dog's symptoms are determined by the abnormalities he or she has; generally, the more abnormalities a dog has, the worse the symptoms.

  • Noisy Breathing (can increase with exercise)
  • Snorting
  • Snoring
  • Tires easily 
  • Collapse/fainting after exercise
  • Coughing
  • Gaging
  • Retching
  • Vomiting 
  • Cyanosis (blue tongue and gums from lack of oxygen)

If you notice your dog exhibiting any of these symptoms and you believe they may have brachycephalic airway syndrome call your vet immediately.

Diagnosing Brachycephalic Airway Syndrome

When diagnosing brachycephalic airway syndrome in dogs your vet will start by performing a comprehensive physical examination and will make their diagnosis based on your dog's breed, and the symptoms they are exhibiting.

Veterinarians can diagnose stenotic nares just by looking at your pooch however, abnormalities such as elongated soft palate, everted laryngeal saccules, and others will require your dog to be heavily sedated or fully anesthetized in order to make a diagnosis.

Because dogs with this syndrome have a higher risk of anesthesia-related complications, your vet may recommend blood tests and chest X-rays to evaluate your dog's overall health and ensure that your pup is safe to be sedated while minimizing any potential risks.

If your dog requires anesthesia to make a diagnosis your vet might suggest having any required surgical treatments conducted at the same time.

Treating Dog Brachycephalic Airway Syndrome

If your dog only has a minor case of brachycephalic airway syndrome their condition might be manageable by avoiding humid or hot environments, controlling exercise levels, and avoiding stress. 

Obesity can also make symptoms worse, so managing your dog's weight and weight loss could also play a large factor in treating your pup.

Nonsteroidal anti-inflammatory drugs (NSAIDs), corticosteroids, and oxygen therapy could also be very helpful in helping to manage your dog's brachycephalic airway syndrome.

However, while these methods can be helpful in managing your dog's condition, they may still need to be treated. Surgery is always the first choice treatment when it comes to abnormalities interfering with a dog's breathing. And the type of surgery used will depend on your dog's abnormalities.

Sometimes dogs will require more than one kind of surgical operation if they have more than one abnormality, in order to treat their condition.

The general rule of thumb for surgery success is that the sooner it is completed, the better the outcomes are. Airflow will be greatly improved and everted laryngeal saccules may be avoided if abnormalities such as stenotic nares and/or an elongated soft palate are corrected early.

Surgery After Care

Because the surgical site may swell or bleed early after your dog's brachycephalic airway syndrome surgery, affecting your dog's ability to breathe, your vet will closely monitor your dog's condition once the surgery is complete. The level of monitoring required for your dog following surgery will depend on the type of surgery used, but dogs generally need to stay at the hospital for 24 hours for monitoring. To help the dog breathe, a tube is occasionally placed in the incision site in the throat.

It's normal for there to be some coughing and gagging after the surgery.

It's very important for you to carefully follow any post-operative care instructions your vet provides you with to ensure your dog recovers as safely and quickly as possible.

Prognosis For Dogs With Brachycephalic Airway Syndrome

Your dog's prognosis will depend on a few factors including their age at the time of diagnosis and treatment, as well as, how many abnormalities they have.

Younger dogs, less than 2 years old, typically have a better prognosis after surgery and can return to a higher level of activity while breathing easier. However, older dogs may not recover as quickly, especially if laryngeal collapse has already begun; if the laryngeal collapse has progressed to an advanced stage, the prognosis is usually not good.

Also, dogs that only require surgical treatments for elongated soft palate or/and stenotic nares, generally have better outcomes than dogs that have more brachycephalic airway syndrome abnormalities that need to be treated.

Note: The advice provided in this post is intended for informational purposes and does not constitute medical advice regarding pets. For an accurate diagnosis of your pet's condition, please make an appointment with your vet.

Contact our Pleasant Hill vets immediately if you believe your dog has brachycephalic airway syndrome.

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