To Breathe or Not to Breathe: The Case of Dakota Richardson, A French Bulldog Who Can Breathe Easier Now!

Karen L. McGlothlin, DVM, PhD

Veterinarian: Dr. McGlothlin

Patient: Dakota Richardson

Breed: French Bulldog

Current Age: 3 years old

Dakota before surgery, notice her small nostrils.

Background: Dakota Richardson has been coming to Lawndale Veterinary Hospital ever since she was just a puppy. Although when she was first adopted Dakota had some upper respiratory issues, her medical history has been relatively uneventful. While Dakota is a French Bulldog, and they are known for loud breathing and upper respiratory sounds such as snoring, snuffing and gagging, her breathing effort and breathing sounds became noticeably more intense last spring and into this past summer. At that time, it was suspected that Dakota was exhibiting a cluster of respiratory abnormalities that, together, fall under the umbrella of the veterinary medical condition known as Brachycephalic Airway Syndrome or Brachycephalic Airway Obstruction Syndrome.

What are brachycephalic pets? You may be unfamiliar with the word “brachycephalic,” unless you are a fan of dog and cat breeds that have shortened muzzles/faces that give them a sort of pushed-in appearance. Common dog breeds that exhibit this characteristic appearance include: English Bulldogs, French Bulldogs, Pugs, Shih Tzus, Pekingese, Boxers and Boston Terriers, among others. The most common brachycephalic cat breeds are: Persian, Himalayan, and Burmese.

The term brachycephalic is taken from Greek root words and literally means “short head.” As a result of selective breeding, these breeds have been modified to produce a shortened upper jaw and a lower jaw of normal length, resulting in the pushed-in appearance of their faces. While this has resulted in adorable pets that are beloved by many, it has also resulted in drastic anatomical changes that have had profound and important health effects on these breeds. One of the most potentially problematic conditions that has become incorporated into these breeds is the condition in which affected dogs or cats have one or more abnormalities of the respiratory system, a condition known as Brachycephalic Airway Syndrome or Brachycephalic Airway Obstruction Syndrome.

Dakota

What is Brachycephalic Airway Syndrome, also known as Brachycephalic Airway Obstruction Syndrome? These two terms are interchangeable, and for convenience, the disease will be referred to here as BAS. This syndrome refers to a group of upper airway abnormalities that may affect brachycephalic pets:

Stenotic nares – constricted or narrowed nostrils that may be present in pets with BAS. The presence of narrowed nostrils often results in open-mouth breathing, since the limited openings into the nasal passages are typically inadequate for sufficient air movement through the nasal passages.
Elongated soft palate – since the upper jaw is shortened in brachycephalic animals, the soft palate, which is the area of tissue on the back of the roof of the mouth that separates the nasal cavity from the oral cavity, may be elongated. The excess tissue may hang loosely down into the throat region, causing snorting sounds.
Everted laryngeal saccules – the laryngeal saccules are two small pockets of tissue located just in front of the larynx, whose normal function is unknown. In animals affected by BAS, there is increased respiratory effort and this increased force may eventually lead to these pockets of tissue being pulled inside out and forming a partial obstruction of the airway.
Hypoplastic trachea – the trachea, or “windpipe” may be more narrowed along its length, leading to increased effort required to breathe normally. A narrowed trachea is often too small to provide sufficient air flow for the affected animal, so these animals may appear to breathe “harder.”

The affected dog or cat may have any one of these abnormalities, all of them, or any combination in between. An additional abnormality that may be present in some brachycephalic breeds, including English Bulldogs and French Bulldogs, is an abnormally thick tongue.

Clinically affected animals may display a variety of clinical signs, including: noisy breathing, coughing, gagging, and snoring. More seriously affected individuals may exhibit more severe clinical signs, such as respiratory distress and collapse. These breeds are also at increased risk for overheating and should not be outside for prolonged periods or participate in strenuous outdoor activities during our hot summers.

Dakota after her surgery. Notice the larger nostrils.

Case Update: On August 1, 2019, Dakota’s owners took her to Carolina Veterinary Specialists, in Greensboro, for a surgical consultation with Dr. Jennifer Hoch, a board-certified veterinary surgeon. At that time, Dr. Hoch did a full work-up and definitively diagnosed Dakota with Brachycephalic Airway Syndrome. Dakota was determined to have stenotic nares, an elongated soft palate and everted saccules, but her tracheal diameter was within normal limits.

Dakota was scheduled for surgery with Dr. Hoch on August 6, 2019. At that time, her elongated palate was resected and the laryngeal saccules were removed. In addition, Dakota’s nostrils were widened. Dakota recovered from her surgery uneventfully and is doing great these days!

If you have one of these breeds and have concerns about its breathing, know that there are options available, both surgical and non-surgical, to increase its quality of life. Please contact us at Lawndale Veterinary Hospital if you would like to set up an exam and discuss these options.

References:

Wendy Brooks, DVM, DABVP. Brachycephalic Airway Obstruction Syndrome in Flat-Faced Dogs.

Krista Williams, BSc, DVM; Cheryl Yuill, DVM, MSc, CVH. Brachycephalic Airway Syndrome in Cats.