Brachycephalic airway syndrome in dogs affects breeds with shorter skulls than normal, resulting in soft tissue abnormalities in the respiratory tract. Breeds commonly affected include French and English Bulldogs, Pugs, Shih Tzus, and Boston Terriers. These dogs typically have overly narrow nostrils (stenosis) and an elongated soft palate, causing noisy breathing, swallowing difficulties, and increased risk of aspiration pneumonia.
How Does This Syndrome Affect Breathing?
In affected dogs, the reduced diameter of the upper airways increases airway resistance. The body compensates by creating higher negative pressure, progressively worsening abnormalities such as:
- Elongated soft palate
- Everted laryngeal saccules (partially obstructing the trachea)
- Tonsil inflammation and swelling
- Collapse of laryngeal cartilage
This vicious cycle progressively worsens breathing, with symptoms intensifying over time.
Clinical Signs of Brachycephalic Airway Syndrome
Symptoms generally appear between ages 2 and 4, intensifying with stress, heat, and exertion. Common signs include:
- Snoring and abnormal respiratory noises
- Shortness of breath, especially after exercise
- Gagging, coughing, and swallowing difficulties
- Bluish mucous membranes (cyanosis)
- Episodes of acute respiratory distress
Diagnosis and Examinations
An accurate diagnosis requires airway visualization under anesthesia, as well as chest radiographs to detect:
- Aspiration pneumonia
- Pulmonary edema due to respiratory distress
- Possible associated cardiac malformations
Management and Treatments
During an acute respiratory crisis, rapid intervention is essential:
- Resting in a cool environment
- Administration of oxygen and anti-inflammatory drugs
- Fever management and intravenous catheter placement
In severe cases, a temporary (or permanent in extreme cases) tracheostomy may be required to maintain respiration.
Surgery: A Preventive Solution
Early surgical intervention, particularly correction of stenotic nostrils from 3-4 months old, can significantly slow syndrome progression. Correction of the soft palate and laryngeal abnormalities should be performed in specialized facilities with careful postoperative monitoring.
Prognosis and Follow-Up
Although surgical success rates exceed 88%, complications such as postoperative edema, regurgitation, infections, and sometimes voice loss may occur. Mortality rates range from 3.2% to 6.8%, reaching up to 12.5% in English Bulldogs.
Rigorous follow-up, weight control, limiting intense exercise, and using a harness rather than a collar greatly improve these dogs’ quality of life.
