Brachycephalic obstructive airway syndrome (BOAS)

BOAS is an established cause of respiratory distress in some brachycephalic (squished-face) breeds. Breeds most commonly affected are English and French bulldogs, Pugs, Boston terriers, Pekingese, Shih tzu, Cavalier King Charles Spaniels, Boxers, Dogue de Bordeaux, Bullmastiffs, and Persian cats. 

Many of you may think noisy breathing is ‘normal’ for these breeds, but we can assure you it is not! If a Labrador had respiratory sounds like a bulldog an owner would be concerned. Brachycephalic animals spend their entire lives walking around in some degree of respiratory distress. If you want to get a feeling for what this is like, SLIGHTLY pinch your nose and try to go about your daily business. Running out of breath quickly? Focusing more on your breathing than other things? Chest hurts a bit? This is what brachycephalic animals go through their entire lives. The good news is that we can help! 

Early surgical correction of this condition is advised before secondary changes develop, which may cause severe dysfunction and be irreversible. Most surgeons now recommend early intervention (i.e., at de-sexing). Many owners may be reluctant to consider surgery on an animal that shows only mild signs of disease such as snoring at night, not least because most cases will continue to have respiratory noise after surgery due to the excessive nasal and pharyngeal tissue. This means that the owner’s perception may be that despite treatment nothing has changed. It is important to be aware that the aim of surgery at an early stage is not to eliminate noisy breathing, but to prevent progression to a life-threatening degree of compromise. 

Post-operation, patients are closely monitored until they have fully recovered from anaesthesia, as acute respiratory tract obstruction is a risk during the first 8-12 hours. Rarely, animals may decompensate after surgery and require emergency tracheostomies. But most of the time, they go home that afternoon! 

Recent studies report that around 90% of BOAS dogs are significantly improved with surgery. Similarly, perioperative mortality rates are less than 4% in recent studies. Postoperative improvement is most often observed immediately after surgery. 

Some studies report long-term recurrence of clinical signs, but most dogs remain improved compared with their preoperative status. Postoperatively, respiratory stertor and some degree of respiratory tract compromise may continue even with appropriate management. This is something to be aware of to avoid disappointment and the assumption that the surgery did not work. 

If you want to know more or have any questions about this condition and the surgery please give us a call. 

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