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“normally”. According to the results of a structured questionnaire, it appears that the extent and severity of clinical signs and their impact on quality of life greatly exceed our expectations (6).
Therefore, most dogs require careful attention for the whole duration of the visit to your clinic.
Widening of stenotic nares, surgical removal of excessive soft palate and everted laryngeal saccules are strongly advised surgical procedures (1), at least in the absence of severe laryngeal and tracheal hypoplasia, which would make any treatment less successful. Novel elegant approaches including removal of nasal conchae using laser-assisted turbinectomy (LATE) using a diode laser
as part of a multilevel surgery have more recently been described (7). Corrective surgical procedures should best be done as early in life as possible in order to decrease the consequences of long-termed negative pressure on the airway structures. Once severe laryngeal dysfunction occurs, successful management is much more dif cult.
If tracheal hypoplasia with its associated ventilator impairment is still severe after reaching adult size (at 1 year of age), there is nothing else that can be done to remedy the situation. Stress, excitement, and weight gain must be avoided in these animals.
Digestive tract medical treatment combined with upper respiratory surgery appears to decrease the complication rate and improve the prognosis of dogs presented for upper respiratory syndrome (8)(1). Those treatments
are widely used. In brachycephalic dogs, it is probable that regular microaspiration occurs, aggravating
the in ammation of the mucosa of the laryngeal/ nasopharyngeal areas. Accordingly, any possible cause of macro or microaspiration, as oesophagitis or sliding iatal hernia, should be addressed.
Prognosis depends on the severity of the abnormalities and the ability to surgically correct them.
A combination of primary and secondary changes can progress to life-threatening laryngeal collapse in many brachycephalic dogs. Early recognition of the primary anatomic abnormalities is essential since it allows the clinician to make early recommendations for medical and surgical management, which can improve the quality of life in affected animals. Factors that may increase the risk and further complicate the condition include obesity, overexcitement, and exercise.
Take home message
Some owners strongly underestimate the degree of breathing impairment in their pet. It is important to keep in mind that even apparently stable patients are susceptible to worsen suddenly in your practice.
The major impact that selective breeding for extreme brachycephalic features has on animal welfare should be emphasized.
1. Dupré G, Heidenreich D. Brachycephalic Syndrome. Vet Clin North Am Small Anim Pract. 2016 Jul;46(4):691–707.
2. Packer RMA, Hendricks A, Tivers MS, Burn CC. Impact of Facial Conformation on Canine Health: Brachycephalic Obstructive Airway Syndrome. PLoS One. 2015;10(10):e0137496.
3. Oechtering GU, Pohl S, Schlueter C, Lippert JP, Alef M, Kiefer I, et al. A Novel Approach to Brachycephalic Syndrome. 1. Evaluation of Anatomical Intranasal Airway Obstruction. Vet Surg. 2016 Feb;45(2):165–72.
4. Bernaerts F, Talavera J, Leemans J, Hamaide A, Claeys S, Kirschvink N,
et al. Description of original endoscopic  ndings and respiratory functional assessment using barometric whole-body plethysmography in dogs suffering from brachycephalic airway obstruction syndrome. Vet J. 2008/10/28. 2010;183(1):95–102.
5. Poncet CM, Dupre GP, Freiche VG, Estrada MM, Poubanne YA, Bouvy BM. Prevalence of gastrointestinal tract lesions in 73 brachycephalic dogs with upper respiratory syndrome. J Small Anim Pr. 2005/06/24. 2005;46(6):273–9.
6. Roedler FS, Pohl S, Oechtering GU. How does severe brachycephaly affect dog’s lives? Results of a structured preoperative owner questionnaire. Vet J. 2013/11/02. 2013;198(3):606–10.
7. Oechtering GU, Pohl S, Schlueter C, Schuenemann R. A Novel Approach to Brachycephalic Syndrome. 2. Laser-Assisted Turbinectomy (LATE). Vet Surg. 2016 Feb;45(2):173–81.
8. Poncet CM, Dupre GP, Freiche VG, Bouvy BM. Long-term results of upper respiratory syndrome surgery and gastrointestinal tract medical treatment in 51 brachycephalic dogs. J Small Anim Pr. 2006/03/04. 2006;47(3):137–42.
An Urban Experience

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