Brachycephalic Airway Syndrome

Posted on June 12, 2015

Brachycephalic airway syndrome affects breeds of dogs with abnormal skull conformation, resulting in proneness to upper respiratory problems of the nose, mouth, and throat.  Early diagnosis is important when noisy breathing or other abnormalities occur. Most dogs are 2 to 4 years old when brought to a veterinarian.

The syndrome has three primary physical abnormalities affecting dogs in varying degrees, and if left untreated will result in swelling and inflammation of all upper airway structures.

1.       Stenotic nares are nostils with a congenital defect in the cartilage causing them to be excessively narrow.  This results in difficulty breathing and noisy breathing.

2.       Elongated Soft Palate is a palate that is elongated more than normal.  The soft structure at the back of the mouth behind the hard palate hangs down and interferes with airflow to the trachea causing labored breathing.

3.       Everted laryngeal saccules tissues become swollen protruding into the main airway from turbulent flow of air in the trachea.

Secondary airway problems may exist.

1.       Weakened cartilage supporting the larynx causes collapse.

2.       Trachea loses structural support resulting in chronic cough. A collapsing larynx cannot be corrected surgically.

Common dog breeds affected by brachycephalic airway syndrome.

1.       Pugs

2.       Shih Tzus

3.       Boston terriors

4.       Boxers

5.       Pekingese

6.       French bulldogs

7.       English bulldogs

Symptoms of brachycephalic  airway syndrome can be mild or severe.  Stress, excitement and heat can result in more difficulty breathing.

1.        Snorting

2.       Excessive panting

3.       Exercise intolerance

4.       Noisy breathing

5.       Difficulty breathing during sleep

6.       Unable to sleep for long periods

7.       Turns blue and passes out from lack of oxygen

Needed Testing

1.       Chest x-rays to eliminate possibility of heart and lung disease.

Treatments

1.       Surgical correction usually results in good to excellent results.

A.      Stenotic nares can be widened for better air flow.

B.      The elongated soft palate trimmed for a more appropriate length, as to not interfere with normal air flow.

C.      The everted laryngeal saccules removed for better flow.

Surgery on the structures can worsen swelling, making breathing difficult and oxygen support necessary during a post-operative period.  All dogs require a minimum of 24-hour supervision monitoring respiratory rate and effort monitored.  Steroids may be given to help reduce inflammation.  A temporary tracheostomy tube can be placed into the main windpipe until swelling resolves.

An experienced veterinary surgeon is an absolute requirement because of serious complications occurring.

Prognosis

Dogs less than four years generally have positive outcomes. Older dogs have more guarded outcomes.  Keeping animals at a good weight and avoiding stress may help.  Severe cases may require a permanent tracheostomy to prevent life threatening distress.