Brachycephalic Airway Syndrome

What is Brachycephalic Airway Syndrome?

Brachycephalic airway syndrome affects dog breeds with shortened snouts. Because of their abnormal skull conformation, these breeds are prone to upper respiratory problems of the nose, mouth, and throat.  Early diagnosis is important when noisy breathing or other abnormalities occur. Most dogs are between 2 and 4 years old when brought to a veterinarian.

The syndrome has three primary physical abnormalities affecting dogs in varying degrees:

1. Stenotic Nares - Stenotic nares are nostrils 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 - The soft palate is located at the back of the throat behind the hard palate. When the soft palate is elongated, it hangs down and interferes with airflow to the trachea causing labored breathing.
3. Everted Laryngeal Saccules - Difficulty breathing causes pouches in the larynx to become inflamed. Tissues become swollen and protrude into the main airway, disrupting turbulent flow of air in the trachea.

If left untreated, these abnormalities are likely to result in swelling and inflammation of all upper airway structures.

Secondary airway problems may exist, including:

• Weakened cartilage supporting the larynx resulting in collapse
• // Cartilage supporting the larynx becomes weakened, resulting in collapse.
• Trachea loses structural support resulting in chronic cough. A collapsing larynx cannot be corrected surgically.
• // The trachea loses structural support, resulting in chronic cough. A collapsing larynx cannot be corrected surgically.

Brachycephalic Breeds

Common dog breeds affected by brachycephalic airway syndrome:

• Pug
• Shih Tzu
• Boston Terrier
• Boxer
• Pekingese
• French Bulldog
• English Bulldog

What are the symptoms?

Symptoms include:

• Snorting
• Excessive panting
• Exercise intolerance
• Noisy breathing
• Difficulty breathing during sleep
• Unable to sleep for long periods of time
• Turning blue or passing out from lack of oxygen

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

Necessary Testing

It is important to have chest radiographs done to rule out heart and lung disease.

Treatment Options

Surgical correction usually results in good to excellent results.

Stenotic nares can be widened for better air flow.

The elongated soft palate can be trimmed to the correct length, as to not interfere with normal air flow.

The everted laryngeal saccules can be 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 old generally have a positive outcome. Older dogs have more guarded outcomes. 

Keeping your pet at a healthy weight and avoiding stressful situations may decrease difficulty breathing.  Severe cases may require a permanent tracheostomy to prevent life-threatening distress.