Brachycephalic Obstructive Airway Syndrome

Brachycephalic Obstructive Airway Syndrome in Dogs

What is Brachycephalic Obstructive Airway Syndrome?

Brachycephalic Obstructive Airway Syndrome (BOAS) is a common respiratory condition affecting certain breeds of dogs, characterized by anatomical abnormalities that make breathing difficult. Brachycephalic dogs are breeds with “short noses,” such as Bulldogs, Pugs, and Boston Terriers. The short muzzle and flattened face contribute to a host of breathing difficulties collectively known as BOAS.  Components of BOAS typically include combinations of the following:

• Stenotic Nares: Narrowed nostrils restrict airflow into the nasal passages.

• Elongated Soft Palate: A long soft palate can obstruct air movement into the larynx and trachea.
• Everted Laryngeal Saccules: Swollen tissue near the vocal cords can also limit airflow.
• Laryngeal collapse: This is where the larynx can collapse in on itself, and can occur in more severe cases and further restrict airflow
• Hypoplastic trachea- present in some cases, this involves an abnormally small trachea
• Redundant nasal turbinates– when present, these can protrude into the nasopharynx and further restrict airflow through the nose

Clinical Signs:

Clinical signs can vary depending on severity, but typically include a combination of the following:

• Noisy breathing or snoring, which may only be noted during exercise in mild cases
• Frequent panting
• Exercise intolerance
• Difficulty in eating or swallowing
• Cyanosis (bluish discoloration of the tongue and gums)
• Gagging
• Collapse in severe cases

Secondary clinical signs, such as lower airway disease and gastrointestinal problems, can develop in more chronic cases.  The narrowed airways increase resistance, putting additional stress on the respiratory and gastrointestinal systems. Over time, these issues can lead to more severe problems like laryngeal collapse, gastroesophageal reflux, hiatal hernias, and pyloric stenosis.

If your pet displays any of the clinical signs mentioned above, consult your veterinarian immediately. An early diagnosis will help in effective management and can prevent further complications.

Diagnosis

Clinical signs often give a strong indication of BOAS, but confirmation typically requires a thorough physical examination and a sedated upper airway examination. Diagnostic tests like thoracic radiography and fluoroscopy can also be beneficial in assessing the respiratory tract.

Treatment Options

The most effective treatment for BOAS is surgical correction of the anatomical abnormalities that can be corrected. These typically include:

• Alar fold resection to widen the nostrils and increase airflow into the nose

• Staphylectomy to shorten the soft palate and prevent occlusion of the larynx
• Laryngeal sacculectomy as needed to widen the laryngeal opening
• In more severe cases, treatment of laryngeal collapse may be necessary

Supportive care usually involves:

• Weight Control: Obesity greatly exacerbates BOAS symptoms.
• Environmental Management: Avoid heat and excessive exercise to decrease panting
• Sedatives may be used as needed to decrease stress
• Using a harness instead of a collar to decrease pressure on the neck and airways

Postoperative care usually involves close monitoring for the first 24 hours after surgery to observe for signs of breathing difficulty from surgical site swelling.  Patients should be fed only soft food in the postoperative period, and an Elizabethan collar should be maintained until the nares have healed.

Conclusion

Brachycephalic Obstructive Airway Syndrome is a complex condition that can significantly impair the quality of life for affected dogs and can be a constant concern for pet owners and veterinarians alike. Early diagnosis and appropriate treatment are crucial in managing this condition effectively and improving the quality of life for brachycephalic dogs. Whether you’re a seasoned veterinarian or a loving pet owner, staying informed and vigilant is the key to ensuring a better life for our brachycephalic furry friends.  If you would like to schedule an appointment with Apex Veterinary Surgery to have your pet evaluated for BOAS, please feel free to contact us here.