Overview
French Bulldogs, Pugs, Shih Tzus, and Boxers and other breeds of dogs all have something in common: that familiar, endearing, smooshed-in face. There’s a name for that adorable face: brachycephalic.
Unfortunately, because of this peculiar anatomy, brachycephalic dogs often have a hard time breathing and have respiratory abnormalities. This condition is known as Brachycephalic Obstructive Airway Syndrome, or “BOAS”.

BOAS is characterized by one or more of the following:

  • An elongated soft palate
  • Stenotic nares
  • Everted Laryngeal Saccules
  • A narrow trachea

Elongated soft palate
Ever notice that Bulldogs do a lot of snorting? That’s probably due to an elongated soft palate. The soft palate is the soft part at the back of the roof of the mouth that separates the nasal passages from the mouth. In brachycephalic breeds, the soft palate often extends down into the airway and may partially block the trachea, or windpipe.

Stenotic nares
Stenotic nares is the medical term referring to narrowing of the nostrils. This can limit the airflow, making breathing through the nose difficult. If the nostrils are extremely narrow and cause significant breathing problems, corrective surgery is possible.

Everted Laryngeal Saccules
Laryngeal Saccules are small pouches that are located behind the larynx, or vocal chords. Over time, due to the increased respiratory effort, the pouches will turn inside out and stick out into the trachea, further obstructing the airways. These are often surgically corrected at the same time as the elongated soft palate.

Narrow Trachea
The trachea, or windpipe, can often be very narrow in
brachycephalic breeds, making breathing difficult.

Symptoms and Complications
Symptoms of brachycephalic syndrome really vary with the severity of the abnormalities, and can range anywhere from noisy breathing, snorting, snoring, and coughing to exercise intolerance and even collapsing or fainting after exertion.

Continuously having to suck against all that excess tissue to breathe causes increased pressures in the airways, all the way down to the lungs. This leads to pulmonary hypertension, which leads to heart disease over time.  The chronic stresses in the lungs also leads to increased scarring and fibrosis of the lungs, creating chronic pulmonary obstructive disease (yes, your adorable pup can get COPD, too!) which further increases the risk of pulmonary hypertension and heart failure. In the brachycephalic breeds, this form of heart failure can happen in the middle aged dog!

 Additional Risk factors
Hot and humid weather can cause symptoms to get worse – because of their abnormal airway anatomy, brachycephalic dogs have a harder time cooling down, markedly increasing their risk for heat stroke!

Obesity, vigorous exercise, excitement and anxiety all further increase the chances of sudden-onset, life-threatening respiratory distress.

Brachycephalic dogs are also at a higher risk of problems during sedation and anesthesia.  If your brachycephalic dog needs surgery or any other procedure requiring sedation, your veterinarian will recommend the best course of action and take extra steps to protect your pup’s sensitive airways.

Diagnosis
Some brachycephalic conditions, such as stenotic nares, can be diagnosed through a simple physical. Others, such as the elongated soft palate, usually require general anesthesia. Since most brachycephalic dogs have one or more of these abnormalities, it’s really a matter of determining how severe the problems are and whether treatment is necessary.

Treatment
Emergency Treatment of an acute respiratory crisis can range from oxygen therapy and steroids to decrease inflammation to hospitalization for heat stroke or heart failure.
The best treatment is proactive Prevention

Prevention
The best way to prevent acute life-threatening respiratory crises or the chronic health concerns of COPD and heart failure, not to mention just the decrease in quality of life (not being able to play for very long or go on a walk with your people) is surgical correction.

Your veterinarian can help you decide if your pup’s BOAS is significant enough to warrant surgery. Or, you can proactively just have the surgery done. The sooner it is done, the less severe symptoms will be, the less impact on you dog’s quality of life and often, the less involved the surgery. For instance, if a young puppy has stenotic nares, you can have those repaired early (a good time is at the time of spay or neuter – 6-8 months of age). If the soft palate elongation is not too bad (which can be evaluated at the time of the spay/ neuter, too!), that may be all that will be needed. If the soft palate IS quite elongated, but the laryngeal saccules are not yet everted, then only the nares and soft palate will need surgery. The longer surgery is delayed, the more likely the laryngeal saccules WILL be everted and all three abnormalities will require surgical correction.  Of course, more surgery means more time under anesthesia, more risk of complications and more expense.

Care of your Brachycephalic Breed

  • Discuss your brachycephalic baby’s airway challenges early on with your vet.
  • Consider proactive surgical intervention so your pup can get the most out of life!
  • Consider health insurance that helps to cover BOAS surgery as soon as you purchase your puppy– before the vet makes the diagnosis (because they most likely will!).
  • Keep your dog lean– excess weight is one of the leading contributors to the worsening of respiratory distress. Lean dogs with mild anatomical issues can avoid surgery altogether!
  • Keep your pet fit– daily walks are imperative to help with weight management and overall health, but avoid exercising in the heat and especially humid days.
  • Avoid strenuous activity if your dog pants excessively or starts “honking” or coughing. Talk to your vet!
  • Avoid collars/ harnesses that cross your pup’s throat– we don’t need any more airway constriction!

Adapted from  www.pethealthnetwork.com