Brachycephalic Syndrome In Dogs
Brachycephalic syndrome is typically a result of our need to breed short, little, flat-faced dogs. This has in turn, caused some severe “abnormalities” which can affect the quality of life of the dog. Dogs with brachycephalic syndrome may have one or more of the following congenital components: Elongated soft palate, stenotic nares, and hypoplastic trachea. Cats can get elongated soft palates and stenotic nares too—typically, Himalayans and Persians.
Pathophysiology
Congenital components:
- Elongated soft palate
o Normal soft palate extends to caudal aspect of tonsil and tip of palate barely touches the epiglottis
o Elongated soft palate typically extends into laryngeal opening, blocking air flow
- Stenotic nares
- Severe narrowing of nasal lumen
- Hypoplastic trachea
- Narrowing of trachea
- prevalent in English Bulldogs
Acquired components-as a result of increased airway resistance:
- Everted laryngeal saccules
o This is the mucosal lining of the laryngeal These can evert into the lumen of the larynx, compounding the problem
- Laryngeal edema
- Laryngeal collapse
- Redundant (edematous) pharyngeal folds
Clinical Presentation
Breed:
Small breed
- Bulldog, Boston Terrier, Pug, Pekingese
- Boxer, Shar-Pei, Lhasa Apso
Signs:
- Exercise intolerance
- Respiratory distress
- Gagging and dysphagia
- Open mouth and loud, stertorous breathing
- Collapse/cyanosis
- Aspiration pneumonia
Diagnosis
- Physical Exam
- Thoracic Radiographs
- Evaluate for hypoplastic trachea
- Oral exam under anesthesia
Treatment
Elongated Soft Palate:
- Resect to normal size. Be very careful as over-resection can predispose to aspiration pneumonia
- Monitor very carefully for excessive post-op swelling resulting in life-threatening airway obstruction
Stenotic Nares:
- Wedge resection of nasal fold
Hypoplastic Trachea:
- There is no effective treatment
- As long as you fix the other problems, animals can typically live with this
- If you have other underlying diseases such as heart failure, it may become a problem
Laryngeal Collapse:
- Make sure this diagnosis is accurate and that it is not laryngeal paralysis
- Occurs with very advanced brachycephalic syndrome
- Permanent tracheostomy is probably the best treatment option
Everted Laryngeal Saccules:
- Can grab saccule at the base with long pair of hemostats or Allis tissue forceps and remove with traction
