Brachycephalic dogs have conformational changes due to foreshortening of the facial and skull bones due to years of selective breeding.

CT scans of dog heads
CT is used to assess the structures within the head. The top right is a CT of a Labrador, the main image is a CT of a French Bulldog

The shortening of the soft tissues of the face have not been reduced in size at the same rate as the skeletal tissue. This mismatch has led narrowed airways which has resulted in a condition called brachycephalic obstructive airway syndrome (BOAS).

BOAS leads to a reduced ability to exercise, collapse, increased respiratory noise and difficulties sleeping. BOAS can compromise welfare.

The anatomic changes that contribute to this include narrowed and inflexible nostrils; redundant and excessive pharyngeal tissue; overly long and thick soft palates; excessive laryngeal mucosa (laryngeal saccules); laryngeal collapse (voice box changes) and hypoplastic trachea (narrowed windpipe).

Corrective airway surgery aims to reduce the impact of some of these anatomic components.

Surgery usually consists of procedures to widen the nostrils (resection rhinoplasty), to reduce the length and thickness of the soft palate (partial staphylectomy) as well as surgery to remove the excess laryngeal mucosa.

French bulldog
French Bulldog after surgery to widen the nostrils

These procedures allow increased airflow and improve how an individual patient breathes. This allows an increased ability to exercise, play and sleep, therefore improving their quality of life.

Some brachycephalic dogs are prone to regurgitation, this is passive bringing up of stomach contents. This can be related to BOAS as increased inspiratory pressure results in fluid from the stomach traveling back up the oesophagus (food pipe).

Corrective airway surgery can also improve regurgitation, particularly in French Bulldogs. In some dogs regurgitation is due to an abnormal position of the stomach, the stomach slides in and out of the chest cavity. This is called a hiatal hernia.

This condition can improve after airway surgery as well as concurrent medical management. However, in some individuals further surgery to secure the stomach in an abdominal position is needed.

We are very fortunate to have an excellent team of anaesthetists and surgery ward nurses who give the brachycephalic dogs individual care and attention. We have a dedicated recovery room for the patients to wake up after their procedures.

English bulldog
English Bulldog recovering from corrective airway surgery

Our Soft Tissue surgery team at the Queen Mother Hospital for Animals, Royal Veterinary College are experts in operating on brachycephalic dog airways.

We operate on approximately 200 BOAS patients every year and have very successful outcomes.

The RVC Soft Tissue surgery team has authored and contributed several studies and international conferences. This has resulted in a better understanding about the clinical presentation, diagnosis and treatment of dogs with BOAS. We have transferred this knowledge into treating your pets.

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