"Flat faced brachycephalic dog breeds such
as bulldogs suffer from multiple medical problems due to preferences
for dogs with a flatter face and pushed-in noses. One of the most
prevalent problems are breathing issues
referred to as brachycephalic airway syndrome. Brachycephalic airway
syndrome (BAS) refers to several
respiratory problems that affect the dog's mouth, throat and nose.
One way to reduce or prevent breathing related problems is by keeping
flat faced breeds at a healthy
weight. This can ease breathing related difficulties and can help to
avoid surgery in mild cases.
Early diagnosis and treatment an result in a better outcome. Most dogs
have multiple breathing problems that need to be corrected. If there is
only one defect, such as a narrowing of the nostrils (called stenotic
nares), the better the prognosis. The prognosis for dogs under 2
is higher than for older dogs. Surgical correction can result in a much
better quality of life for the dog.
Brachycephalic dogs can be prone to eye problems, dry eye, eye
irritation and eyes that appear to pop out (proptosis). They are
also prone to panting due to heat stress.
Flat-faced Brachycephalic Breeds. The term brachycephalic is a Greek
term for "shortened head." These breeds are known for their shortened
facial bones that give the face a pushed-in appearance. The shorter
structure results in proportionately excessive amount of soft tissue in
and around their throats and noses, causing dog breathing problems such
as heavy breathing or panting.
Syndromes can lead to sudden death due to acute airway collapse that
results from airway obstruction due to many of the issues described
below (see bottom of page for free brochures on the condition).
Brachycephalic Dog Breeds
There are several breeds that are vulnerable to BAS. This includes:
Respiratory System Abnormalities
Structural abnormalities in the face and head of brachycephalic dog
Everted laryngeal saccules:
this is usually seen with other respiratory issues. Dogs with BAS and
labored breathing can cause small pouches to form inside the larynx
that are either sucked into the airway or turned outward.
Hypoplastic trachea: This
refers to a narrower-than-normal windpipe. This cannot be corrected
Elongated soft palate: in
this condition the soft part of the roof of the mouth is too long when
compared to mouth length. At the back of the throat the extra soft
palate tissue blocks the entrance to the windpipe (trachea). The
elongated palate can be shortened to remove excess tissue in surgery.
Brachycephalic Soft Palate
Stenotic nares: This
refers to narrow nostrils that restrict air that can enter into the
nose. Air flow can be improved by using surgery to remove tissue from
Dog with Stenotic Nares
Brachycephalic Airway Syndromes is based on the dog's facial shape,
physical examination, breed, and clinical symptoms. Abnormalities are
diagnosed by sedation or by putting the dog under anesthesia. Note that
in some cases sedation or anesthesia could
be dangerous given breathing abnormalities. Tests used are a
tracheoscopy or a laryngoscopy, where a fiber optic scope is inserted
through the mouth into the trachea and larynx.
The condition can be diagnosed as young as age 1, and usually some time
between age 1 year and 4 years.
BAS is scored on a five-point scale.
0 = No symptoms
4, 5 = Difficulty
breathing and could be life threatening
Additional tests such as
blood work and X-Rays can be used to determine the health of the
patient prior to initiating treatment. The veterinarian will also
want to rule other other causes of breathing difficulties such as an
upper respiratory infection or allergy that can cause a dog's airways
Keeping a bulldog at normal weight can reduce any breathing
discomfort and relieve symptoms such as snoring and labored breathing.
Symptoms associated with Brachycephalic airway syndrome include:
Infections in facial skin folds
Hunched body posture when inhaling
Susceptibility to heat stroke
Collapsing after significant activity
Fainting after rigorous activity
Gagging and Choking
Breathing with an open mouth
Cyanosis (blue-tinged color)
Intolerance for exercise
Video Example of Breathing Problems
If your dog is breathing heavy,
or the breathing seems
sure to visit your veterinarian for a checkup. Dogs with BAS tend to
have more than one breathing problem that needs to be corrected.
Slimming down a bulldog or other flat-faced breed will help to reduce
BAS symptoms such as snoring and labored breathing. Also consider
getting a harness that does not tug at the dog's neck. Breathing
problems often accompany issues such as gastric reflux, which pushes
gastric fluids into the esophagus, causing additional problems.
also avoid situations that cause labored heavy dog breathing
such as excessive physical exercise and stress, particularly on hot
Medications and Therapy
Oxygen therapy and anti-inflammatory medications are often used to
bring relief to dogs. Relief is short-term with surgery being the best
option for long-term relief.
For most dogs with BAS surgery is the recommended treatment in order to
correct any structural abnormalities in the throat or face. Many
bulldogs require respiratory surgery where the
elongated soft palate at the back of the throat is shortened, allowing
the dog to breath easily. New surgical techniques such as the use
of lasers can reduce recovery times and result in lower levels of
bleeding and swelling.
After Stenotic Nares
Surgery for Brachycephalic Dog Breeds
Post surgery brachycephalic dog breeds will need to be monitored
closely since the surgery
can cause airway swelling, resulting in an even narrower air passage
until the swelling subsides. In some patients it may be necessary for a
veterinarian to use a nasotracheal catheter where a tube is passed into
the trachea via the nasal passage. In chronic cases, a dog will require
a tracheotomy, which is a procedure where an incision is made in the
dog's wind pipe.
Post surgery medications can help to reduce any pain and antibiotics
are administered if there is a risk of infection. Dogs will need
to return to the veterinarian for two weeks after surgery and exercise
might be restricted over this time.
Cost of Surgery
The cost of surgery for brachycephalic dog breeds runs between $500 and
$3,000 (U.S. dollars)
depending on the extend and number of breathing problems that need to
Brachycephalic dog breeds that undergo surgery and that are under
age 2 have the best
prognosis. Having fewer defects that need to be corrected also results
in a better prognosis (e.g;; 1 defect has a better prognosis than 2).
Many dogs can experience a significantly better quality of life after
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