Freddy – Upper Respiratory Tract Surgery

By October 17, 2011 October 29th, 2013 Case Of The Month

We first met Freddy, a French bulldog, as an 11 week old puppy. On physical examination the only abnormalities noted were a low grade respiratory infection and stenotic nares. Stenotic nares are congenital malformations of the nasal cartilages such that the nostrils appear pinched together with abnormally narrow openings. Stenotic nares are part of a condition called brachycephalic airway syndrome (BAS) commonly seen in breeds like English Bulldog, French Bulldog, Boston Terrier, Pug, Pekingese, Lhasa Apso, Shih Tzu, Sharpei, Boxer.

The primary components of brachycephalic airway syndrome (BAS) are a combination of stenotic nares and soft palate elongation. The secondary components may include everted laryngeal saccules, laryngeal collapse, redundant pharyngeal tissue and enlarged tonsils. These findings are found singularly or in various combinations and degrees – age is a major factor. Breeds with BAS tend to present with some or all of the following concerns – noisy and difficult breathing, retching or gagging up of phlegm, trouble swallowing, exercise intolerance, restless sleeping and in severe cases collapse. These signs are worse in situations of excitement, stress and increased heat and humidity. Early treatment of the primary components of BAS will provide healthy breathing and reduce the probability of the secondary problems developing.

Freddy was admitted to Southdown Animal Clinic at six months of age for an orchiectomy (neuter) and BAS surgical correction. With a general anesthetic we were able to evaluate the upper airway structures in detail to determine a course of action.

1. Freddy had stenotic nares – a 50% reduction in nasal opening radius will result in a 16-fold increase in resistance to airflow – so we surgically removed a ‘V’ shaped wedge of nasal cartilage from both nares creating a wider passage to allow for an improved airway. This will make a significant improvement to the quality and quantity of Freddy’s breathing.

2. Freddy had everted (prolapsed) laryngeal saccules which is Stage I laryngeal collapse. Prolapsed laryngeal saccules appear as shiny, white, convex structures protruding into the airway by the vocal cords, this leads to increased effort required to achieve optimum airflow into the trachea and lungs. This is a condition that worsens over time. These structures were surgically excised.

3. Freddy’s soft palate appeared normal with the end just covering the tip of the epiglottis, so no surgical intervention was required.

4. Freddy’s orchiectomy was successfully performed.

Freddy has returned to the clinic for his follow up visits and he has recovered remarkably well. Surgical intervention at a young age is going to allow Freddy to have a much more comfortable and easier breathing system and he has retained his good looks!