Brachycephalic Obstructive Airway Syndrome. It's a disease that many veterinarian will recognize, but still, few owners know about it, and even fewer recognizes it in their own pets.
Brachycephalic syndrome is a group of conditions often occurring in dogs wit
h short noses, such as Bulldogs, Pugs and Shih-Tzus. It causes the dogs to experience difficulties with breathing, due to the shape of their head, muzzle and throat.
Breeds with short noses will often have a compacted skeleton with excessive soft tissue - with an outward sign of this being the skin folds these dog-breeds often have.
On the inside, the anatomical signs in dogs with brachycephalic syndrome, is an elongated soft palate, malformed nostrils and a partly blocked trachea. Some dogs may even have a narrower trachea, collapse of the larynx or paralysis of the laryngeal cartilages. A dog with brachycephalic syndrome may be affected by one or more of the mentioned abnormalities.
But what causes the brachycephalic syndrome? Most often the compact and pushed in head, found in some of the mentioned and other breeds, are caused by breeding. Generations of breeding, controlled by an arbitrary cosmetic standard set by humans. A standard stating that the dogs were "better" with short muzzles, and noses. A standard of a "cute" appearance that have left dogs unable to breathe properly and struggling in their everyday life.
Generally, for many of the breeds that suffer from brachycephalic syndrome, it's now considered "normal" that they have breathing issues. It's seems as charming that they snore and pant - it's important to realise though, that although this may be normal for the breed; this is not physiologically normal. A healthy dog should not be struggling to breathe.
When it comes to symptoms, not being able to breathe normally is one of the main signs of brachycephalic syndrome, due to increased airway resistance, making it more difficult to inhale.
Dogs that are only mildly affected will have noisy breathing, and tend to snore when sleeping. Animals that are severely affected will, besides the noisy breathing, tend to retch or gag, experience cyanosis (blue gums from lack of oxygen) and even occasionally collapse when excited or active. The problem with this goes further than just struggling to breathe, it can develop into secondary problems which includes inflammation of the airways and heart issues.
The symptoms are all very distinctive, when combined; meaning Brachycephalic syndrome is often diagnosed primarily based on the clinical signs observed and a physical examination. However, it can be necessary to assess the soft palate, pharynx and larynx - often done under general anesthesia. Luckily, today, we're in a situation where brachycephalic syndrome, if not cured, can be helped.
(Picture credit BVA)
Obesity will significantly worsen the symptoms, and as many dogs with brachycephalic syndrome struggles with breathing, they dont run a lot, and tends to be overweight. Therefore, weight loss is an important part in treatment, especially if the symptoms are only mild. NSAIDs, non-steroidal anti-inflammatory drugs, may also be useful for short term relief of inflamed airways - it does however not correct the underlying anatomical causes, which is why a significant number of dogs are referred for surgery. The main focus of the surgery is to unblock the airways.
The classic approach to the surgerys is to "trim" the soft palate, and thereby remove what's blocking the airways. The palate is stretched and excess tissue is removed. Correction of stenotic nares can be done at the same time. In most instances, one surgery will improve the condition significantly, so the dog may never require additional surgical treatments for the airways. However, a few will require extra treatments. Generally, the prognosis is good for young animals, that will likely breathe much easier and with significantly reduced distress.
Nonetheless, surgery isn't a long term solution, not for the generations of pets to come. In 2017 the FECAVA-/WSAVA conference was held in Copenhagen, and concluded here: Urgent action must be taken, and "vets must dare to speak out". Experts from around the world discussed the animal welfare issues, and issued recommendations for veterinarians on how to handle the increasing no. Of cases of brachycephalic dogs. These includes recommending owners not to buy animals with extreme conformation, raise awareness amongst breeders and owners and share the data available on the health and welfare issues related to extreme breeding.
British Veterinary Association (BVA) is also campaigning to raise awareness and have adopted policies to try and ensure healthier future generations of dogs, and to help current generations struggling to breathe.
In the end, we all love the animals, whether they're our beloved pets or patients. No animal should struggle to breathe, and they certainly shouldn't struggle due to continuous breeding. With a combined effort from owners, breeders and veterinarians, we will have healthier and happier dogs, now, as well as in the future.
