Brachycephalic Syndrome in Dogs

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Overview of Brachycephalic Syndrome in Dogs

Brachycephalic syndrome is a group of conditions that cause resistance to airflow through the upper respiratory tract (nose, larynx) in short-nosed breeds of dogs. This syndrome is caused by anatomic abnormalities related to the shortened bones of these dogs’ compressed faces without the same proportionate shortening of the overlying soft tissues. The excess soft tissue leads to airway compromise.

Brachycephalic breeds of either sex, such as the English bulldog, Boston terrier, pug and Pekingese, are most commonly affected.

Stenotic nares (pinched nostrils), overlong soft palate and everted laryngeal saccules are the most common conditions encountered in dogs with this problem. Although the abnormalities are present at birth, clinical signs of respiratory difficulty often begin in early middle age.

Increased airway resistance from brachycephalic syndrome over a long period of time can lead to progressive respiratory difficulty. The larynx and trachea become weaker as the large negative pressure of the increased effort on inspiration continually draws them in. Eventually they may collapse causing critical airway obstruction, cyanosis (blueness to the color of the oral membranes), and possibly death.

What to Watch For

Signs of brachycephalic syndrome in dogs may include: 

  • Noisy breathing (especially on inspiration)
  • Exercise intolerance
  • Cyanosis (blue appearance of the gums due to lack of oxygen)
  • Syncope (fainting)
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    Diagnosis of Brachycephalic Syndrome in Dogs

    The diagnosis is often made based on the breed of dog and the clinical signs. Other diagnostic tests that may be performed include:

  • A complete physical examination, including auscultation (listening) of the chest with a stethoscope, to help exclude other causes of respiratory difficulty
  • Thoracic radiographs (x-rays) to determine if heart or lung disease is present
  • Visual inspection of the nostrils to determine the presence of pinched nostrils
  • Examination (under sedation) of the mouth and larynx to diagnose an overlong soft palate and/or laryngeal saccules that are turned outward
  • Treatment of Brachycephalic Syndrome in Dogs

    Mild cases are usually managed conservatively without surgery. Although mild cases or sudden bouts of airway obstruction may be managed medically (by tranquilization, administration of oxygen, hospital use of anti-inflammatory steroids), the risk for progression of severe airway disease exists. Close monitoring of your dog for worsening of clinical signs is imperative.

  • Surgical management before severe clinical signs develop is relatively easy and carries a much more favorable prognosis than attempted treatment later when the signs are more severe. Possible surgeries (depending on which abnormalities are present in your dog) include removal of a portion of the nostril to allow increased airflow, shortening the soft palate and removal of the everted laryngeal saccules.
  • Home Care

  • If medical management is pursued closely watch your dog for worsening of clinical signs.
  • Prevent your dog from becoming obese as this will make it more difficult for him to breathe easily.
  • Avoid excessively stressful situations, such as exercise during hot, humid weather.
  • Avoid using a neck collar – use a harness instead.
  • If your dog has trouble breathing, becomes cyanotic, or collapses, visit your veterinarian immediately.
  • If surgical therapy is done no special care may be required once healing is complete; however, you should continue to monitor your dog for recurrence of clinical signs.
  • In-depth Information on Brachycephalic Syndrome in Dogs

    Related diseases or disorders that mimic the signs of brachycephalic syndrome:

  • Laryngeal disease. Laryngeal paralysis is a relatively common neurologic disorder of dogs that lead to inability to open (abduct) the muscles of the larynx (voice box). Laryngeal collapse is a very severe, end-stage condition of the larynx caused by chronic increased inspiratory effort and subsequent weakening of the laryngeal cartilages that would normally hold the walls of the larynx out of the airway.
  • Upper respiratory cancer or mass lesions. Tumors, masses or foreign material lodged within the nasal cavity, pharynx, larynx or trachea (windpipe) can cause respiratory difficulty as the air passage is partially obstructed by the mass.
  • Tracheal collapse. Usually found in small breed dogs, tracheal collapse is caused by weakness of the cartilage rings that normally hold the trachea open during breathing leading to a severe “honking” cough and dyspnea (difficult breathing).
  • Bronchial obstructions. These are caused by primary bronchial collapse that compresses the left bronchus (airway).
  • Heart failure. Heart failure with development of fluid accumulation in the chest or lungs can lead to breathing difficulties.
  • Pulmonary (lung) disease. This is ineffective oxygenation of the blood caused by lung disease and can cause shortness of breath and difficulty breathing. Examples include bronchitis, pneumonia and lung cancer.
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