Brachycephalic obstructive airway syndrome: much more than a surgical problem

Mitze, Stefanie; Barrs, Vanessa R.; Beatty, Julia A.; Hobi, Stefan; Bęczkowski, Paweł M.

doi:10.1080/01652176.2022.2145621

Cited by 28 publications

(25 citation statements)

References 117 publications

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“…Progressive increase in airway resistance and pressure changes during breathing may result in laryngeal collapse or progression of laryngeal collapse when it is already present. But, in the absence of stridor and absence of laryngeal collapse during laryngoscopy, progression of BOAS as the sole cause was considered less likely 30,31 . In this case, the soft palate was shortened to the desired level, which corresponded to just rostral to the most rostral edge of the PMMA block.…”

Section: Discussionmentioning

confidence: 98%

“…But, in the absence of stridor and absence of laryngeal collapse during laryngoscopy, progression of BOAS as the sole cause was considered less likely. 30,31 In this case, the soft palate was shortened to the desired level, which corresponded to just rostral to the most rostral edge of the PMMA block. Cinical signs improved after FFP, supporting the hypothesis that the significant progression of BOAS was secondary to the stabilisation construct exacerbating the narrowing of the nasopharyngeal passage.…”

Section: Discussionmentioning

confidence: 99%

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Deterioration of brachycephalic obstructive airway syndrome in a French bulldog following surgical stabilisation of atlantoaxial subluxation with concurrent atlas malformation

Perez¹,

Renfrew²,

Jack³

et al. 2023

Vet Record Case Reports

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A 2‐year 10‐month‐old French bulldog presented with a history of intermittent yelping episodes and low head carriage. Examination revealed cervical hyperaesthesia and grade I brachycephalic obstructive airway syndrome. Magnetic resonance imaging and computed tomography of the cervical vertebral column demonstrated a malformation of the atlas and atlantoaxial subluxation causing spinal cord compression. Ventral atlantoaxial stabilisation was performed, aided by three‐dimensional printed, patient‐specific drill guides, bicortical bone screws and polymethylmethacrylate. Four months later, the patient re‐presented being pain free but for deterioration of upper respiratory noise, distress and exercise intolerance. Grade III brachycephalic obstructive airway syndrome was evident on examination. Assessment of the post‐stabilisation computed tomography images and recent radiographs suggested that the rapid progression of brachycephalic obstructive airway syndrome had been caused by the stabilisation construct causing further narrowing of the nasopharynx by ventral and rostral displacement of the dorsocaudal nasopharyngeal wall. A folded flap palatoplasty was performed leading to excellent short‐ and long‐term outcome.

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Section: Discussionmentioning

confidence: 98%

Section: Discussionmentioning

confidence: 99%

Deterioration of brachycephalic obstructive airway syndrome in a French bulldog following surgical stabilisation of atlantoaxial subluxation with concurrent atlas malformation

Perez¹,

Renfrew²,

Jack³

et al. 2023

Vet Record Case Reports

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“…Brachycephalic breeds, due to their airway and chest confirmation, are notorious for hypoventilation, especially in the face of illness (Mitze et al . 2022). The body has mechanisms in place to compensate for this chronic respiratory acidosis.…”

Section: Discussionmentioning

confidence: 99%

Acid–base and electrolyte evaluation in dogs with upper GI obstruction: 115 dogs (2015‐2021)

Lozano,

Yankin,

Perry

et al. 2023

J of Small Animal Practice

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ObjectivesMetabolic alkalosis, although uncommon in small animals, has been previously associated with gastrointestinal obstructions. Depending on the population and disease process evaluated, previous prevalence of metabolic alkalosis is reported as ranging from 2% to 45% in canine patients. The objective of this study was to determine the prevalence of metabolic alkalosis and other acid–base and electrolyte disorders in a cohort of dogs with a confirmed upper gastrointestinal obstruction.Materials and MethodsElectronic medical records were reviewed to identify dogs who presented for vomiting with evidence of an upper gastrointestinal obstruction from January 2015 to October 2021. Patients were enrolled only if a preoperative venous blood gas was obtained and analysed in house. Traditional acid–base analysis was utilised to determine an acid–base status before relieving the obstruction. When available, post‐operative venous acid–base status was determined within 24 hours after surgery, and compared to preoperative results.ResultsA total of 115 dogs were included in the study. Twenty‐five out of 115 (22%) dogs displayed either a simple metabolic alkalosis or a mixed acid–base disturbance before surgery. Twenty‐seven out of 115 dogs (37%) had a normal acid–base status at entry. Seventy‐one dogs had pre‐ and post‐operative venous blood gas results available. Metabolic alkalosis was resolved in nearly all patients post‐operatively, with no patients displaying a simple metabolic alkalosis. A mixed metabolic acidosis and respiratory alkalosis was the most common condition post‐operatively, found in 25 of 71 (35%) dogs. Severe derangements of electrolytes were infrequent preoperatively (3/115; 2.6%). A majority of patients in this study exhibited hypokalaemia (64.4%), hypochloraemia (72.8%) and hyponatraemia (77.4%) on preoperative venous blood gases. Venous pH, PvCO2, bicarbonate and base excess were significantly higher preoperatively when compared to the post‐operative results.Clinical SignificanceThis study found the prevalence of pre‐operative metabolic alkalosis in dogs with a documented upper gastrointestinal obstruction to be lower than previously reported. Surgical or endoscopic alleviation of the upper gastrointestinal obstruction resulted in resolution of metabolic alkalosis in nearly all patients.

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“…Despite this, the views on BOAS as a welfare problem differ among stakeholders and strong polarisation in opinions has evolved regarding the extent and severity of BOAS in social media. Although most stakeholders seem to agree that compromised health and clinical signs due to exaggeration of anatomical features must be counteracted, not all seem to agree on the extent of clinical signs of BOAS in brachycephalic dogs and how to handle these health issues [15][16][17]. Further, most proposed strategies on how to handle BOAS are based on "expert opinions" by just one or two stakeholders [18][19][20].…”

Section: Introductionmentioning

confidence: 99%

Awareness, experiences, and opinions by owners, breeders, show judges, and veterinarians on canine Brachycephalic Obstructive Airway Syndrome (BOAS)

Åsbjer,

Hedhammar,

Engdahl

2024

Canine Med Genet

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Background Exaggerated brachycephalic features have been highlighted over the last decade by their profound effect on the health and welfare of the affected dogs. The term brachycephalic obstructive airway syndrome (BOAS) was launched in the early 2000s and has received worldwide attention and awareness. At the same time, the popularity of brachycephalic dogs increased. This study aimed to reveal the awareness and experiences of health issues related to the physical appearance of brachycephalic breeds and compare perceptions and opinions on how to counteract these issues by various stakeholders (dog owners, veterinarians, dog breeders, and show judges) by performing an online survey. Results Altogether, 1602 owners, 1551 breeders, 118 show judges, and 557 veterinarians participated. Awareness and experiences of conformation-related health issues were common among all stakeholder groups. Most participants agreed fully or partly that health issues related to conformity threaten the health of brachycephalic breeds; that the measures taken so far are positive; and that guidelines on the appearance of a dog should be based on knowledge regarding health issues related to physical appearance. A disagreement was noted on further measures to be taken and the importance of adhering to a breed standard. Conclusions All stakeholders were aware of health issues related to the appearance of brachycephalic dogs, but had variable personal experiences of these issues. Most participants agreed fully or partly that health issues related to conformity threaten the health of brachycephalic breeds, and that attention to these issues and measures taken so far are positive. However, there is a disagreement on further actions to be taken and the importance of adhering to a breed standard. These findings could be used to understand and bridge the gap in opinions between stakeholders and to refine methods to influence the health of dogs with exaggerated brachycephalic features.

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Brachycephalic obstructive airway syndrome: much more than a surgical problem

Cited by 28 publications

References 117 publications

Deterioration of brachycephalic obstructive airway syndrome in a French bulldog following surgical stabilisation of atlantoaxial subluxation with concurrent atlas malformation

Deterioration of brachycephalic obstructive airway syndrome in a French bulldog following surgical stabilisation of atlantoaxial subluxation with concurrent atlas malformation

Acid–base and electrolyte evaluation in dogs with upper GI obstruction: 115 dogs (2015‐2021)

Awareness, experiences, and opinions by owners, breeders, show judges, and veterinarians on canine Brachycephalic Obstructive Airway Syndrome (BOAS)

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