Diagnosis & Treatment of Brachycephalic Syndrome in Dog

1. Laryngeal Disorders. Laryngeal paralysis is a relatively common neurological condition in dogs, which renders them unable to open their laryngeal muscles. Laryngeal collapse is a severe latestage laryngeal disease caused by increased inspiratory effort leading to weakened laryngeal cartilage, which normally supports the laryngeal wall away from the airway.

2. Upper Respiratory Cancers or Masses. Tumors, masses, or foreign bodies trapped in the nasal cavity, pharynx, larynx, or trachea can lead to breathing difficulties due to partial obstruction of the airway.

3. Tracheal Collapse. Tracheal collapse typically occurs in small breeds and is caused by the weakness of the cartilage rings that usually keep the trachea open during breathing, resulting in severe "barking" coughs and respiratory distress.

4. Bronchial Obstruction. This is caused by primary bronchial atrophy compressing the left bronchus.

5. Heart Failure. As fluid accumulates in the chest or lungs, heart failure can lead to breathing difficulties.

6. Pulmonary Diseases. These are caused by inefficient oxygenation of the blood due to lung diseases, leading to shortness of breath and respiratory distress, such as bronchitis, pneumonia, and lung cancer.

Deepening Diagnosis

Diagnosing upper respiratory obstructions requires a variety of diagnostic tests, including:

1. A thorough medical history and physical examination

2. The diagnosis of upper airway obstruction or brachycephaly is often made simply based on the dog's breed and clinical symptoms. While shortnosed dogs often make loud snorting noises during inhalation, this is considered "normal." However, symptoms like weakness, cyanosis, or fainting indicate that the dog is not receiving enough oxygen through the airway and may require immediate treatment. Other causes of the dog's clinical symptoms must be ruled out promptly to avoid overlooking the real issue.

3. Veterinarians should obtain a complete medical history and conduct a thorough physical examination. It is particularly important to perform chest auscultation (using a stethoscope to check for abnormal lung or heart sounds).

4. A chest Xray can also be performed, especially when there are issues or abnormalities detected during chest auscultation, to confirm or rule out respiratory distress caused by heart or lung problems.

5. A visual examination of the nasal cavity can be used to confirm a diagnosis of narrow nostrils. Narrow nostrils are much smaller in opening compared to a normal dog's nose.

6. To confirm the presence of an elongated soft palate or an everted laryngeal saccule, the dog must be sedated or lightly anesthetized. The veterinarian must examine the back of the dog's mouth and throat.

7. An abnormally long soft palate can reach the base of the larynx and epiglottis, and in severe cases, it may be inhaled into the laryngeal opening during inhalation. Normally, the upper palate almost cannot reach the top of this structure.

8. An everted laryngeal saccule appears on the laryngeal wall near the vocal cords and is usually hidden. They are not visible in a normal dog but can be pulled out of their hidden areas by excessive negative pressure during inhalation. The presence of an everted laryngeal saccule indicates a more severe brachycephaly syndrome and can be considered an early sign of laryngeal collapse.

Deepening Treatment

Treatment for upper respiratory obstructions may include one or more of the following:

1. Many breeds of shortnosed dogs have narrow nostrils and elongated soft palates, leading to loud breathing, but they never cause more severe clinical symptoms. These mild cases usually do not require surgery and can be treated conservatively.

2. Obesity, due to the compression of the diaphragm and chest wall, makes it harder for dogs to inhale and exhale air. Excess fat around the airways hinders airflow. Obese dogs also have difficulty eliminating excess heat, causing them to pant more than usual. All these factors can exacerbate breathing difficulties.

3. Increased oxygen demand under stress conditions can make breathing more difficult for dogs. Hot and humid weather can be challenging for these dogs, and they should be kept cool and comfortable in airconditioned environments as much as possible.

4. A very important management technique to prevent breathing from becoming more difficult is to avoid using collars on these dogs. When a dog is pulled by a collar, it compresses part of the trachea, further exacerbating airway obstruction. A harness should be used instead.

5. While mild cases are usually treated conservatively, there is a risk of severe respiratory disease developing. Continuous inhalation over months or years can lead to serious laryngeal issues. Therefore, closely monitoring the dog's clinical symptoms for deterioration is essential.

6. For narrow sinus and elongated soft palates, surgical correction is relatively easy and has a good prognosis when performed in the early stages of the disease. If delayed until later, surgical treatment is usually less successful, and if the larynx has become very fragile, surgery may not be able to save it.

Surgical treatments include:

1. Narrow nostril resection involves removing a small piece of each nostril wall to enlarge the nostril opening size. This can be done with a scalpel or surgical laser.

2. Excision of an elongated soft palate refers to the removal of the excess length of the soft palate hanging in the airway. It requires careful trimming with a scalpel and scissors, followed by suturing, or using surgical laser to reduce bleeding without the need for suturing.

3. Excision of an everted laryngeal saccule involves removing the swollen tissue that protrudes from the base of the laryngeal wall. Sometimes, a tracheotomy is necessary to clear the larynx's view, allowing for a successful surgery.

4. Follow the medical management plan recommended by your veterinarian closely to avoid your dog experiencing respiratory crises. The progression of clinical symptoms may indicate the need for surgical intervention.

5. If your dog shows signs of respiratory distress, cyanosis, or fainting, take it to the veterinarian immediately. Severe respiratory distress can cause a period of low oxygen, leading to irreversible harm to the body.

6. After surgery, dogs may be completely cured and may never have another breathing problem, but they should be monitored regularly for recurrence of clinical symptoms.

Brachycephaly is a congenital physiological disorder. Decades of "unnatural" selection have created this issue. The dogs' genetic makeup directly affects their development, which is actually unchangeable or preventable. The only thing a responsible owner can do is to closely monitor for signs related to this disorder and treat them early to prevent future problems.