Brachycephalic Syndrome in Dogs

If your dog has a flat face, it likely experiences brachycephalic syndrome—a condition comprised of several deformities that affect a dog's breathing. Symptoms of brachycephalic syndrome typically include noisy and labored breathing, snoring, and nasal discharge. It is a genetic syndrome disproportionately affecting breeds like bulldogs, pugs, Boston terriers, French bulldogs, Pekingese, chow chows, and Shih Tzus.

A vet will diagnose brachycephalic syndrome using a physical examination and a series of diagnostic imaging tests and will usually recommend surgery. The prognosis for dogs who receive surgery is good but depends on the severity of the condition and the dog's age. You can't prevent brachycephalic syndrome, but you can make lifestyle choices that help minimize your dog's suffering. 

What Is Brachycephalic Syndrome?

Brachycephalic syndrome is a combination of upper airway abnormalities that cause partial obstruction to a dog's breathing caused by shortened skulls/snouts. The syndrome typically includes several conditions, such as elongated soft palate, everted laryngeal saccules, and stenotic nares. A dog with brachycephalic syndrome may have one or all of these conditions.

• Elongated soft palate: The soft palate is the tissue on the roof of the mouth. When the soft palate is too long, its end extends and blocks the airway. This interferes with the movement of air into the lungs.
• Everted laryngeal saccules: The laryngeal saccules are soft tissue structures near the vocal folds and the larynx. When these tissue sacs become everted (turned outwards), they are pulled into the trachea and partially obstruct airflow. 
• Stenotic nares: Brachycephalic dogs often have overly narrow or pinched nostrils, making it difficult to breathe through the nose. Dogs that have stenotic nares rely primarily on their mouths for breathing.

Some dogs with brachycephalic syndrome also have underbites or overbites.

Symptoms of Brachycephalic Syndrome in Dogs

Dogs with one or more conditions associated with brachycephalic syndrome typically exhibit distinct symptoms related to abnormal breathing.

The symptoms of brachycephalic symptoms in dogs vary based on the number of conditions and their severity, but in any case, your dog's breathing will be affected. In most mild cases, a dog will breathe noisily, snore when sleeping, and expel nasal discharge. Due to lack of oxygen flow, your dog may show reluctance to exercise or suffer from fainting. In severe cases, the lack of oxygen can give your dog's tongue or gums a bluish tint. If the symptoms go untreated, years of labored breathing can cause secondary issues in a dog, including residual effects of strain on the heart. 

What Causes Brachycephalic Syndrome in Dogs?

Brachycephalic syndrome is caused by genetics. Dogs born into breeds with flat faces lead to malformations in their upper airways and cause issues breathing. Commonly affected species are bulldogs, pugs, Boston terriers, French bulldogs, Pekingese, chow chows, and Shih Tzus. These dogs have been bred to have shortened skulls for aesthetic purposes, even though deformities and health problems are highly prevalent. Mixes of these breeds may also have brachycephalic syndrome.

How Do Vets Diagnose Brachycephalic Syndrome in Dogs?

To diagnose your dog with brachycephalic syndrome, your vet will perform a physical examination and inquire about your dog's symptoms and health history. Because brachycephalic syndrome comprises several conditions, your vet will consider a wide range of sub-diagnoses. Your vet can diagnose stenotic nares by simply looking at the narrowness of the nostrils. If your vet suspects your dog has an elongated soft palate or everted laryngeal saccules, they may perform a CT scan or an upper airway exam while your dog is sedated. Your vet may also recommend chest, lung, and airway X-rays.

Treatment & Prevention

Combining surgery and lifestyle changes is the best way to treat brachycephalic syndrome in dogs. Suppose your dog has an elongated soft palate. In that case, your vet may recommend soft palate resection, where a surgeon stretches the excess tissue of the soft palate, then trims it away surgically using a scalpel blade, scissors, or CO2 laser. For everted laryngeal saccules, you can surgically remove them. For stenotic nares, nostrils can be surgically reshaped to create a larger opening, making it easier for the dog to breathe.

Because obesity can exacerbate brachycephalic syndrome, weight management is essential in alleviating your dog's symptoms. Limit your dog's exposure to heat and humidity, and make sure exercise is not too strenuous and is done indoors or during cooler hours of the day. You should use a harness instead of a neck collar to avoid pressure on your dog's airway. There are no corrective or curative medications, but some anti-inflammatories may provide short-term relief.

There are no ways to prevent the genetic abnormalities that cause brachycephalic syndrome in your dog.

Prognosis for Dogs with Brachycephalic Syndrome

The prognosis for dogs with brachycephalic syndrome depends on the number of conditions. If the ailments have gone untreated and become severe, the prognosis will be negatively impacted. Older dogs tend to have worse prognoses than younger dogs.

Dogs that receive successful surgery have good prognoses. They generally stay in the hospital for one to two days postoperatively and must be watched very closely. It's normal for dogs to cough and gag while recovering from surgery, but this should subside as your dog heals. Most dogs make a full recovery and go on to live normal lives. There may be some residual snoring and noisy breathing, but it is generally lesser than before treatment.