What Is Brachycephalic Airway Syndrome in Dogs?
Brachycephalic Airway Syndrome in dogs is a condition found in breeds with shortened snouts and flat faces, known as brachycephalic breeds. The term “brachycephalic” originates from the Greek words “brachy,” meaning short, and “cephalic,” meaning head.
This syndrome encompasses a range of abnormalities affecting a dog’s airway and breathing, stemming from selective breeding practices aimed at achieving the characteristic flattened facial appearance. The shortened skull, facial, and nasal bones contribute to the distinctive “smooshed” face of these breeds. Consequently, these structural alterations also affect the throat and airways, culminating in the development of brachycephalic airway syndrome.
The condition of Brachycephalic Airway Syndrome in dogs encompasses a combination of three functional abnormalities:
- Stenotic nares: This refers to narrow or small nostril openings, diminishing the dog’s ability to breathe through the nose and causing restricted airflow. Consequently, affected dogs experience increased panting and a heightened risk of overheating.
- Elongated soft palate: The soft palate, which separates the nasal passage from the oral cavity, is often too long for the shortened snout of brachycephalic dogs. This excess tissue flaps into the throat, resulting in snoring sounds and obstructing airflow into the windpipe and lungs.
- Everted laryngeal saccules: Normally, there are two small pockets (saccules) in the back of the throat. In brachycephalic dogs, increased breathing effort due to stenotic nares and elongated soft palate can cause these saccules to turn inside out, further blocking the airway.
Additional airway-related conditions associated with brachycephalic airway syndrome include:
- Hypoplastic trachea: The windpipe is congenitally smaller in diameter than normal, making it challenging for dogs to breathe in sufficient air with each breath, akin to breathing through a straw.
- Laryngeal collapse: Chronic stress on the larynx from exerting excessive effort to breathe can damage the cartilage, leading to laryngeal collapse. This condition exacerbates airway blockage and may result in breathing difficulties for affected dogs.
The following dog breeds are considered brachycephalic:
- Affenpinscher
- Boston Terrier
- Boxer
- Bullmastiff
- Brussels Griffon
- Cane Corso
- Chow Chow
- Dogue de Bordeaux
- English Bulldog
- English Toy Spaniel
- French Bulldog
- Japanese Chin
- Lhasa Apso
- Pekingese
- Pug
- Shih Tzu
Symptoms
Symptoms of Brachycephalic Airway Syndrome manifest as clinical signs typically related to upper airway blockage caused by congenital anatomical conditions associated with the syndrome. These symptoms may vary in severity and include:
- Noisy breathing
- Snoring
- Gagging or retching
- Coughing
- Difficulty breathing or increased effort to breathe
- Increased panting
- Exercise intolerance (tiring easily with exercise)
- Distended abdomen or vomiting from swallowing excess air while struggling to breathe
- Overheating
- Pale or blue gums
- Collapse
Causes
Brachycephalic Airway Syndrome arises from genetic factors due to deliberate breeding practices aimed at achieving a desired cosmetic appearance of dogs with short snouts and flat faces. The intentional breeding for such characteristics results in anatomical alterations in the dogs’ throats and airways. These structural changes can lead to respiratory difficulties and increase the susceptibility of these dogs to overheating.
Diagnosis
Veterinarians typically diagnose Brachycephalic Airway Syndrome by considering the dog’s breed, clinical symptoms, and findings from a physical examination, which may reveal stenotic nares (narrowed nostrils). Dogs with this syndrome often exhibit a distinctive low-pitched, snoring-like sound known as stertor during breathing.
To further assess the condition, your veterinarian may opt for a sedated oral examination to check for elongated soft palate and everted laryngeal saccules. Additionally, an x-ray of the neck and chest can provide visualization of the trachea (windpipe) while assessing the heart and lungs. For a comprehensive evaluation, a complete blood count, serum blood chemistry, and urinalysis are typically recommended to establish a baseline assessment of the dog’s health.
Treatment
Treatment options for Brachycephalic Airway Syndrome may involve medical management, especially if the clinical signs are mild or infrequent. Addressing excessive weight is crucial as it exacerbates symptoms; thus, weight loss is recommended for overweight or obese dogs. Care should be taken to minimize exposure to heat and humidity, as these can worsen clinical signs, necessitating limited outdoor activities during hot summer days. Excessive exercise should also be avoided as it can strain breathing and worsen the syndrome.
During veterinary visits, if your dog experiences difficulty breathing, mild sedatives may be administered to alleviate distress and facilitate easier breathing. Additional therapeutic measures may include the use of steroids, oxygen therapy, and cooling measures to relieve acute respiratory distress. Medications may also be prescribed to manage gastrointestinal symptoms such as vomiting.
Surgical intervention may be considered if the structural abnormalities cause significant distress, worsen over time, or pose life-threatening breathing difficulties due to upper airway blockage. Life-threatening scenarios include multiple episodes of breathing difficulty requiring medical intervention. Surgical procedures typically involve:
- Stenotic nares resection: Surgically widening the nostrils.
- Soft palate resection (staphylectomy): Surgical trimming of the soft palate to reduce its length.
- Laryngeal saccule removal: Elimination of everted saccules.
These procedures are often performed concurrently, with early intervention possible as early as 4 months of age, although most diagnoses occur by 4 years old. Early detection and surgical correction may help mitigate complications associated with chronic upper airway disease, such as laryngeal collapse. It’s advisable for owners of brachycephalic breeds to discuss Brachycephalic Airway Syndrome with their veterinarians to determine if surgical intervention is warranted for their dogs.
Living and Management
Following brachycephalic airway surgery, dogs are closely monitored due to the potential for inflammation and bleeding post-operation. Typically, they will be kept under observation in a 24-hour ICU for 1-2 days after surgery.
The prognosis for young dogs is generally favorable, with most pet owners observing significant improvements in their breathing and exercise tolerance. However, prognosis may be more uncertain for older dogs with a history of chronic breathing difficulties, especially if they show signs of developing laryngeal collapse. In cases of advanced laryngeal collapse, inserting a tube in the neck (permanent tracheostomy) may be necessary to facilitate improved breathing.
For long-term management, maintaining brachycephalic dogs at a lean and appropriate weight is crucial. Collaborating with your veterinarian to establish weight goals and, if necessary, a weight loss regimen can be highly beneficial. Using a harness collar instead of a traditional neck collar helps alleviate pressure on the neck.
It is essential to take extreme caution to prevent brachycephalic dogs from overheating. It is advisable to limit their activity and outdoor exposure during hot and humid weather, ensuring they always have access to fresh water and shade.