BOAS surgery in brachycephalic breeds

Last month we saw a lovely bulldog who was rushed in as an emergency. The poor dog had started wheezing and rasping shortly after waking up and by the time he arrived he was rapidly deteriorating. His gum colour was decidedly blue and he his breaths were becoming more desperate with each passing second. With only precious seconds left we managed to intubate him (placed a tube into his airway/trachea) bypassing a very swollen and oedematous larynx (throat). Bulldogs are classed as brachycephalics which essentially means 'flat faced'. This flat face, that is classic for the breed, often comes with a number of health implications. The nose is squashed and the nostril openings narrowed, the soft palate at the back of the mouth extends too far and obstructs the opening to the windpipe and the throat area generally is over-crowded and narrowed. Sometimes this is manageable and causes little more than noisy breathing and loud snoring but far too often it causes actual breathing problems and occasionally this becomes life threatening. Our bulldog patient underwent emergency surgery to shorten his soft palate (a procedure called a “folded flap palatoplasty”) and trim away excess tissue from his throat (sacculectomy and tonsilectomy). However the inflammation in his larynx would take several days to settle, so he also required a temporary tracheostomy, this is where a tube is placed through the skin of his neck directly into his windpipe to create a temporary opening and bypass the mouth and throat.

He needed round the clock care for the next few days until his throat inflammation improved and we were able to remove the tracheostomy tube. The surgery to open up his throat should make this life-threatening episode much less likely to occur again in the future.      

Interestingly Norway recently legislation banning the breeding of Bulldogs as they feel there are too many inheritable health problems in the breed. Whilst the breed often comes with a family friendly temperament and a charming character hopefully responsible breeding will improve the health of these characterful dogs, so a similar ban won't be required here.