Let’s start with the basics.
What does brachycephalic mean?
When you break down the word brachycephalic, you get brachy- which means shortened, and cephalic which means head. This term therefore refers to the much loved breeds such as French Bulldogs, Boxers, Pugs, English Bulldogs, Boston Terriers, among others.
If you think about all these breeds mentioned above, the one thing they have in common is that their snouts are much shorter than other breeds. You may even describe them as having squished faces, and that is a pretty perfect description.
The problem with brachycephalic breeds
The characteristic of a squished face can be aesthetically cute and a distinct appearance to these breeds; however, functionally, it can be a nightmare.
Brachycephalic breeds have shorter noses and face bones. This results in their upper airway also being compressed and altered.
If you have ever had a brachycephalic fur baby then you may be familiar with some of these problems, especially the ones involving their ability to breath ‘normally.’
These characteristics are collectively known as Brachycephalic Airway Syndrome.
What is Brachycephalic Airway Syndrome?
Brachycephalic Airway Syndrome, or BAS, refers to a specific set of abnormalities with the upper airways that affect brachycephalic breeds.
Primary anatomic abnormalities include:
- Stenotic Nares. These are abnormally small or narrow nostrils. This restricts the amount of airflow through the nostrils when these pups breath through their nose.
- Elongated Soft Palate. This is the soft tissue that makes up the part of the roof of the mouth that is near the throat area. When this is too long it acts like a curtain covering the airway.
- Hypoplastic trachea. This is when the trachea or windpipe has a smaller diameter than normal. Think of this as breathing through a straw.
- Nasopharyngeal turbinates. These are ridges on the roof of the mouth, but when they extend past a certain point in the mouth they can contribute to variable amounts of airflow obstruction.
The characteristics above are considered genetic abnormalities, however, there are secondary complications that develop and lead to additional changes with the airways.
Secondary complications include:
- Everted laryngeal saccule. Laryngeal saccule are small bags of tissue that are normally located in front of the vocal cords. When they become everted they are pulled into the trachea and block the airway.
- Tracheal collapse. With a smaller and weakened trachea and extra force needed for these pups to breath the trachea can close on itself during moments of rapid breathing, exercise, or excitement which also leads to difficulties with breathing and usually results in coughing or hacking.
How to tell if your pup has Brachycephalic Airway Syndrome
Most of the breeds that are true brachycephalics will have at least one, but usually more, of the abnormalities that can contribute to signs of BAS.
The ones that have the least abnormalities will be less likely to experience complications with breathing in their lifetime. The less fortunate individuals that are born with multiple abnormalities will likely start to show signs early on in life.
These signs will include:
- Noisy breathing
- Snorting
- Snoring
- Difficulties with exercise
- Gagging or retching
- Cyanosis (turning blue) with increased breathing or exercise
Things your vet can do to help
Stenotic Nares Correction
The more common abnormalities that we can do something about include stenotic nares, elongated soft palates, and everted laryngeal saccules.
Your vet will be able to assess for stenotic nares during your pup’s first physical exam.
Below are two examples of different degrees of stenotic nares in French Bulldogs.
You can see that the pup on the right has a bit more narrowing of the nostrils compared to the pup on the left.
When these breeds first come to me I will assess the size of the nostrils and I will have a discussion with the owners to educate them on the condition and what I am seeing on their physical exams. I will also communicate the recommendation for surgical intervention at the time of their neuter/spay if it is appropriate for that individual.
Below is an example of a post surgical patient who had his stenotic nares corrected by me. Consider this like a ‘nose job.’
If you compare the two photos you can see a big difference in the opening of the nostrils!
Elongated Soft Palate Resection
The other common trait, an elongated soft palate, can sometimes be noted on physical exam as well; however, your pup needs to be very cooperative and allow for opening of the mouth to get a good view of the back of the throat area. Many times this needs to be confirmed under sedation.
There is also surgical correction for elongated soft palates that involves trimming of the excess tissue. This surgery is not as straightforward as correction of the nostrils. We can see complications with severe swelling at the back of the throat which will also impair breathing after surgery. Usually these patients are referred to board certified surgeons and may require a few days stay at the hospital, but well worth it if it means improving your pup’s breathing abilities.
Everted Laryngeal Saccule Resection
If your pup has already developed the complication of everted laryngeal saccules this can also be surgically corrected with removal of the excess tissue.
These also are located at the back of the throat and can be corrected at the same time as the elongated soft palate surgery. Surgical recovery will also involve staying in hospital after surgery which makes sense given that it involves removing tissue from the back of the throat area.
Things you can do to help your pup
Trust your vet’s advice
Probably one of the most important things you can do is listen to your vet’s advise. Trust me when I say I am not going to make a recommendation for a surgery, especially involving the airways, if it is not necessary.
When your vet does mention these options to you, take them seriously! Know that the recommendations being made are to prevent progression and future complications that we see all the time with these breeds.
Use a harness
Consider using a harness over a collar. Collars tend to compress the neck area and affect breathing especially in pups that love to pull on walks. If they are really bad on a leash, the constant pulling on the collar can cause enough trauma to create inflammation in this area which doesn’t help an airway that is already compromised. The harness allows for control on the leash without the added constant compression of the throat and neck areas.
Be mindful of the temperature
Avoid very hot temperatures for long periods of time. Heat tends to worsen symptoms in these breeds. When these breeds over heat they have to breath faster or pant; however, when the airways are narrowed this doesn’t always work out so well for them. Again, think of it as being out on a run, on a hot day, and having to breath through a straw. It is not a good situation.
Weight management
Having a healthy weight is important for any pet, but when it comes to brachycephalic breeds it is that much more important. Extra weight and fat can indirectly affect the airways. When there is extra fat around the neck this can lead to having additional difficulties with breathing. Also, just having to carry around the extra weight is more work for these pups, especially for their respiratory system. Keeping these pups at an ideal body condition will make a huge difference in their ability to exercise and breath.
Final thoughts
If your pup is a brachycephalic breed or if you have always wanted one I do recommend you do your research and educate yourself on the breed characteristics, special considerations for them, and how to improve their overall health and longevity.
There are many vets that are completely against the breeding of these breeds, and rightfully so. Time and time again we are faced with cases where these patients are frequently presenting as emergencies with life threatening situations that are related to their messed up respiratory tracts.
I can’t see these breeds being ‘discontinued’ so let’s all work together to promote responsible breeding and if we can’t do that at the very least help with the above recommendations to ensure your brachycephalic pup can live their best life and breath as best as they can!