Brachycephalic Obstructive Airway Syndrome - BOAS
This syndrome is seen in brachycephalic breeds such as Pugs, French bulldogs and English bulldogs who tend to have anatomical differences such as flattened faces and shorter noses.
BOAS actually encompasses a range of anatomical changes in these types of breeds and includes the presence of narrowed nostrils, elongated soft palate (sometimes overlapping the airway) and abnormally shaped saccules (structures found at the sides of the larynx). These abnormalities can have a significant impact on the dog’s ability to breathe normally and to lead a normal life.
Owners commonly report noise when their dog breathes which becomes worse after exercise and can lead to exercise intolerance where the dog does not want to exercise, particularly on hot days. It can also lead to coughing, gagging, snoring and excessive panting. In severe cases it may lead to the animal fainting or collapsing because it cannot maintain an adequate oxygen supply. This may be exacerbated during periods of exercise or in hot weather.
Treatment for BOAS
The only treatment for BOAS is surgical correction of the anatomical abnormalities. The surgery may encompass a range of procedures aimed at increasing airflow into the airway and enabling the patient to breathe more normally.
The surgeon will be able to fully evaluate the soft palate, larynx, tonsils and saccules once the patient is anaesthetised. If these require correcting this can be done under the same anaesthetic. Some patients may not require correction of all of these but some combination of them.
The following surgical corrections can be performed:
· Nostril widening- in order to allow for greater airflow
· Soft palate resection- the palate is shortened in order to prevent it overlapping and obstructing the larynx
· Laryngeal saccule resection- the saccules can be removed to prevent them from obstructing the airway
Most patients will require an overnight stay in hospital following BOAS surgery. They are monitored very closely for the first 24 hours after surgery to ensure that any post- operative swelling or bleeding does not obstruct the airway. If necessary drugs can be given to reduce any swelling or inflammation. They are also at risk of regurgitation and vomiting post surgery and require close monitoring by nursing staff to ensure that they do not accidentally breathe in any stomach contents which may lead to infection.
It is important that patients are kept as calm and stress free as possible following BOAS surgery in order to keep their breathing as normal as possible. It is also a good idea to try to maintain a cool environment for them to recover in, for example, restrict walks to cooler times of the day and use a fan at home if necessary. Exercise should be restricted to short walks a couple of times a day and use of a harness rather than a neck collar is advisable. Most of the surgical treatment is concentrated at the back of the throat, therefore soft food is recommended as it is less abrasive to the surgical sites and likely to cause less inflammation.
The vet will require that the patient has a post operative check with one of the nurses to make sure that everything is going well at home and to address any concerns.