Soft palate surgery for brachycephalic animals

Dogs with a short muzzle and round head are known as brachycephalic (brachy=short, cephalic = head). These 'short-headed' dogs very frequently have respiratory abnormalities linked to this particular anatomy. These are characterized by increased respiratory noise, sensitivity to heat stroke, snoring and reverse sneezing. In the most severe cases, respiratory collapse can occur during moderate exertion, leading to death.

These difficulties are due to obstruction of the respiratory tract. The air doesn't circulate properly, and the animal has to make a major effort in living conditions that would be normal for any other dog. Dogs regulate their temperature by breathing, not by sweating as humans do. In the event of respiratory difficulties, the dog is unable to expel heat from its body, hence the sensitivity of these breeds to heatstroke.

Which breeds are most frequently affected by this anomaly?

The breeds most frequently concerned are French Bulldogs, English Bulldogs, Carlins, Cavaliers King Charles, Shih Tzu, Pekingese, Lhasa, Apso, Boxer among the most common, but other breeds may also be involved.

My dog is a French bulldog. So it's normal for him to have trouble breathing!

No! as with most brachycephalic breeds, breathing difficulties may exist but should not be considered normal and must be corrected before any aggravation or fatal situation occurs.

What can happen if this problem isn't corrected?

The main risk is heat stroke, which can be fatal in a matter of minutes. It can occur with very moderate exertion and outside high ambient temperatures. You need to be very careful, and be able to cool your dog quickly in the event of heatstroke.

Other risks are cardiac, and in particular the development of progressive pulmonary hypertension, which can also be fatal.

Finally, dyspeptic disorders, manifested by increasingly severe vomiting and regurgitation of food, can appear gradually as a result of the constant respiratory effort your dog has to make.

How can I find out about my dog's respiratory abnormalities in detail?

Before deciding on surgical treatment, a thorough assessment of the respiratory, digestive and cardiac tracts is recommended.

Evaluation of the respiratory tract can be performed endoscopically or via CT scan. All stages of airflow through the respiratory tract are assessed: nose, nasal cavities, pharynx, mouth, tonsils, soft palate, larynx, laryngeal ventricles, trachea and bronchial tubes. At the end of this examination, a list of the areas of obstruction is drawn up, enabling surgical solutions and their potential outcomes to be discussed.

As cardiac anomalies are common in these breeds, an echocardiographic evaluation is also recommended. This checks for the presence of pulmonary hypertension or any other anomaly that could lead to anesthetic complications.

Finally, an endoscopic evaluation of the esophagus and stomach is of great interest, as abnormalities are also common in these breeds: tortuous esophagus, hiatal hernias, dyspeptic disorders, chronic gastritis, pyloric stenosis, etc.

What surgical treatments are available?

Depending on the area concerned, different treatments are recommended:

Correction of nostril stenosis

The nostrils are sometimes 'pinched' and a whistling sound is easily audible when the dog breathes through the nose. Nostril enlargement is then recommended to remove this obstruction. This correction involves surgically removing a fragment of the nostrils. Results are instantaneous and the after-effects are usually very favorable.

Soft palate correction

This is the main anomaly in most cases. The soft palate can be too long, but also too thick. It needs to be shortened and thickened whenever possible. A number of techniques are available, depending on the case.

Laser surgery is usually recommended, as it is faster and generates less post-operative oedema.

Will my dog breathe normally after surgery?

It all depends on the case. If the anomalies only concern the nostrils or soft palate, the improvement is often very significant. If the anomalies involve other areas, such as nasal turbinates or tracheal hypoplasia, breathing difficulties may persist, as these areas cannot be treated. However, breathing is significantly improved by correcting abnormalities of the nostrils and soft palate.

Does this surgery offer a definitive result?

Occasionally, difficulties may arise during the animal's life. In such cases, a new assessment is necessary, and any necessary corrections must be made.

Is soft palate surgery risky?

Anesthesia for brachycephalic breeds is more delicate than for other dogs, precisely because of their respiratory difficulties. The main complications are laryngeal edema and throat congestion caused by salivary secretions or regurgitation. Here too, precautions must be taken.

For example, it is usually recommended to fast these dogs from size 12 onwards the day before surgery, as these breeds are more prone to delayed stomach emptying.

In case of difficulty, these animals are kept under surveillance.

Are cats affected by brachycephalic syndrome?

Yes, Persian and related cats are typical examples. Surgical correction can usually increase their respiratory comfort.

Dwarf rabbits are also affected by respiratory difficulties linked to their hypertype.