Brachycephalic Obstructive Airway Syndrome commonly occurs in dog breeds which have those adorable squished up faces. Bulldogs and Pugs are the most commonly affected breeds, however other breeds such as Staffies, Mastiffs, Cavalier King Charles Spaniels, Boxers and some cat breeds may also suffer from upper airway disease.

Brachycephalic Syndrome refers to interference with the air flow at the back of the throat and nose.  This causes an obstructive breathing pattern and occurs due to a combination of things:

  • overly long soft palate
  • very narrow nostrils
  • inflammation of other structures in the back of the throat (tonsils and saccules) from the breathing turbulence, which narrows the airway even more.

The long soft palate prevents the normal passage of air to the wind pipe.  This makes it harder to get air flow and inflames the back of the throat.  Patients ususally present with breathing difficulties, noisy breathing, snoring, and in severe cases can turn blue and collapse.

These pets worsen during periods of hot and humid weather (spring and summer) and during exercise, when the demand on breathing is highest. Signs will get worse with age, as the tissues at the back of the throat and wind pipe deteriorate.

​For optimal quality of life long-term, surgical correction of the airway issues if often necessary.  ​Surgery involves shortening the soft palate (palatoplasty), opening the nasal passages (rhinoplasty), and occasionally removing the tonsils and laryngeal saccules.  Surgical repair relieves the breathing difficulty and the risk of fatal respiratory problems is greatly decreased.

The benefits of surgery performed early out-weigh the risks.  The main complication associated with surgery is in the immediate post-surgery period, where there may be swelling and obstruction of the airway.  Should this occur, a temporary breathing hole in the base of the neck may be required until the swelling subsides and the patient is able to breath normally again.

Occasionally the sutures used to shorten the soft palate may require removal if they cause irritation, which involves a brief sedation.

Brachycephalic patients are also at risk of chronic gastric reflux and heart-burn (oesophagitis) due to the breathing issues.  This may cause long-term regurgitation and require medication to limit the symptoms.

The prognosis following surgery is good, with an improvement in the airway passage and reduced risk of severe breathing diffculty.  Some noise whilst breathing and snoring may persist, but should be better than pre-surgery.

The prognosis for patients with longer term breathing difficulty is not as good due to degeneration of the cartilages at the back of the throat and wind-pipe.  In pateints where the cartilages of the larynx or trachea have collapsed, a laryngeal tie-back surgery or tracheal stent may be required.