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Brachycephalic Syndrome

By: Dr. David Diamond

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Treatment In-depth

Treatment for upper respiratory obstruction may include one or more of the following:

  • Many brachycephalic breeds of dogs have stenotic nares and overlong soft palates that cause stridulous breathing but never cause more serious clinical signs. These mild cases ("normal" for their breed) are usually managed conservatively without surgery. Conservative management is directed at preventing excessive respiratory effort requiring the dog to move air faster than the airways will allow.

  • Obesity makes it more difficult for the dog to move air in and out of the lungs due to compression on the diaphragm and chest wall. Excess fat in the tissues around the airways impedes airflow through the airways. Obese dogs also have trouble eliminating excess heat and are forced to pant more than usual. These all cause the dog to have an increased respiratory effort and exacerbate the problem.

  • Excessively stressful situations increase the tissues' oxygen demands and will cause the dog to increase his respiratory effort. Hot, humid weather is very difficult for these dogs to deal with and they should be kept quiet in an air-conditioned environment whenever possible.

  • A very important management technique, to prevent breathing becoming more difficult than it already is, is for these dogs to avoid the use of a neck collar. When the dog pulls of the collar it compresses part of the trachea, further exacerbating the airway obstruction. An over the shoulders-type harness should be used instead.

  • Although mild cases are often managed conservatively, the risk for progression of severe airway disease exists. Months and years of increased inspiratory effort can lead to severe problems with the larynx. Close monitoring of the dog for worsening of clinical signs is imperative.

  • The surgical corrections for stenotic nares and overlong soft palate are relatively easy and carry excellent prognoses when performed early in the course of the disease. Surgical management later in the course of the disorder is less successful and may not be possible if the larynx has become weakened.

    Surgical corrections include:

  • Stenotic nares resection is widening of the size of the opening through the nostrils by removal of a small piece of the wall of each nostril. It can be performed with a scalpel or a surgical laser.

  • Resection of overlong soft palate is removal of the excess length of the soft palate that is hanging into the airway. It is carefully trimmed with a scalpel and scissors and then sutured closed, or a surgical laser can be used to minimize hemorrhage and requires no sutures.

  • Resection of everted laryngeal saccules is removal of the swollen tissues protruding from the walls of the larynx at their bases. Occasionally, a tracheotomy tube is needed to allow an unobstructed view of the larynx to allow this procedure.

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