Brachycephalic Syndrome in Dogs

Causes of Brachycephalic Syndrome

The term Brachycephalic Syndrome refers to the combination of an elongated soft palate, stenotic nares, and everted laryngeal saccules, all of which are commonly seen in brachycephalic breeds.

• Elongated soft palate is a condition where the soft palate is too long so that the tip of it protrudes into the airway and interferes with the movement of air into the lungs.
• Stenotic Nares are malformed nostrils that are narrow or collapse inward during inhalation, making it difficult for the dog to breathe through its nose.
• Everted Laryngeal Saccules is a condition in which tissue within the airway, just in front of the vocal cords, is pulled into the trachea (windpipe) and partially obstructs airflow.

Many dogs will only have one or two of the above conditions, but they cause enough breathing trouble that they still need to be addressed. In some cases, dogs with brachycephalic syndrome also have a narrowing of the trachea or laryngeal paralysis.

The cause of brachycephalic syndrome typically comes down to genetics. Certain dogs have been bred in such a way that they have flat faces, short noses/muzzles, and small or misshapen nostrils. In producing this cosmetic appearance, we have compromised these animals in many important ways, and you as an owner must be familiar with the needs of your pet.

Clinical Signs/Symptoms of Brachycephalic Syndrome

Dogs with one or more of the conditions associated with brachycephalic syndrome typically exhibit specific signs that are easily detected:

• Noisy breathing, especially upon inhalation (snorting)
• Snoring while asleep
• Difficulty breathing (increased effort)
• Exercise intolerance (tiring easily)
• Retching or gagging, especially while swallowing
• Nasal discharge (in the case of stenotic nares)
• Blue tongue and gums aka cyanosis (from lack of oxygen)
• Fainting or collapse episodes (loss of consciousness)

These signs generally become worse after exercise, excitement, or excessive heat or humidity exposure. Obesity tends to make signs worse.

How is brachycephalic syndrome diagnosed?

If you suspect that your dog has brachycephalic syndrome, you must visit your vet for an evaluation. Your vet can diagnose stenotic nares during the exam by simply looking at the nostrils.

Based upon the dog's history and by listening to breathing, your vet may suspect elongated soft palate and/or everted laryngeal saccules. However, it’s very difficult to see the upper airway in an awake dog (the tongue is typically too large and the dog rarely allows a good look). Therefore, the only way to definitively diagnose these is with an upper airway exam while the dog is under sedation. During a sedated upper airway exam, your vet can take the time to look closely at the soft palate and laryngeal saccules to see if there is an obstruction of the airway and determine how severe it is.

Your vet may refer you to a veterinary specialist (usually a surgeon or internist) for further evaluation or treatment.

Treatment Options for Brachycephalic Syndrome

At-Home Management:

• Limit your dog's exposure to heat and humidity.
• Make sure exercise is not too strenuous and is done indoors or only during cooler times of the day.
• Use a harness instead of a neck collar to avoid pressure on your dog's airway.
• Teach your dog to have self-control, keep him calm, and train him to settle down. Excitement can worsen symptoms.
• Avoid overfeeding to maintain a lean body condition.

In general, there are no medications deemed effective in treating brachycephalic syndrome.

Surgical Treatment:

• Soft palate resection (staphylectomy): If your dog has an elongated soft palate, this surgical procedure may be recommended. During a soft palate resection, the surgeon stretches the excess tissue of the soft palate, then trims it away surgically using a scalpel blade, scissors, or CO2 laser. Of course, all of this is done under general anesthesia.
• Laryngeal Sacculectomy: If your dog has everted laryngeal saccules, they can be surgically removed. Often, this is performed at the same time as the soft palate resection. The surgeon may opt to leave the saccules in place and allow them to return to their normal position now that the palate has been repaired.
• Stenotic Nares Repair: Surgery can correct stenotic nares. The procedure involves the surgical reshaping of the nostrils to create a larger opening, making it easier for the dog to breathe. Excess tissue may be trimmed away and the remaining tissue tacked with sutures so the nostrils can heal more openly. This may also be done at the same time as the above procedures.

After surgery, your dog must be watched closely. Dogs generally stay in the hospital postoperatively to be monitored for bleeding or inflammation as it can lead to major airway obstruction.

Preventing Brachycephalic Syndrome in Dogs

This syndrome is directly related to the conformation or breed standard for brachycephalic dogs. Dogs with pronounced breathing difficulty or dogs that require surgery to correct airway obstruction should not be used for breeding. It is usually recommended that these dogs be spayed or neutered at the same time that the surgical correction is performed.

Read more:

Collapsing Trachea in Dogs

Reverse Sneezing in Dogs

Caring for Pets with Pneumonia

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