Section: Veterinary Care In-depth
Diagnosis In-depth
Diagnostic tests are needed in cases of upper respiratory obstruction, including:
Complete medical history and physical examination
The diagnosis of upper airway obstruction/brachycephalic syndrome is often simply made based on the breed of dog and the clinical signs. Although brachycephalic breeds of dog often make loud snorting noises while inhaling and are considered "normal," clinical signs of weakness, cyanosis or fainting are indications that the dog is unable to get enough oxygen through his airways and may need treatment. Other concurrent causes for the dog's clinical signs must be ruled-out to avoid missing the real problem.
The veterinarian should obtain a complete medical history and perform a thorough physical examination. It is especially important that auscultation (examination with a stethoscope) of the chest is performed to listen for abnormalities in the lungs or irregularities in the heartbeat.
Thoracic radiographs (chest X-rays) also may be taken, particularly if auscultation of the chest was questionable or abnormal, in order to confirm or refute heart or lung causes of the respiratory difficulty.
Visual inspection of the nostrils confirms the diagnosis of stenotic nares. Stenotic nares have reduced openings compared with those of a normal dog's nose.
In order to confirm the presence of overlong soft palate and/or everted laryngeal saccules, the dog must be sedated or lightly anesthetized and the veterinarian must examine the back part of the oral cavity and larynx.
An abnormally long soft palate will reach the base of the covering of the larynx and the epiglottis, and in severe cases it may be sucked into the laryngeal opening as the dog inhales. Normally the palate barely reaches the tip of this structure.
Everted laryngeal saccules are seen arising from normally hidden crypts in the walls of the larynx adjacent to the vocal folds. They are not visible in a normal dog, but can be sucked out of their crypts with excessive negative pressure during inspiration (when air is drawn into the lungs). The presence of everted laryngeal saccules indicates a more severe form of brachycephalic syndrome and is thought to represent an early stage of laryngeal collapse.
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