Mack is 5 year old male neutered British(English) Bulldog who has always exhibited all the enthusiasm for life that this breed is known for. In the last few years this level of joy had become markedly muted as his breathing became progressively difficult with any degree of exercise or excitement. This summer the owner noted that Mack’s respiratory distress had become more troublesome and appreciated that something had to be done to help Mack.
On presentation to Southdown Animal Clinic Mack’s symptoms were classical of advanced brachycephalic airway disease with stridorous/sterterous breathing, exercise intolerance, frequent retching, choking and gagging up of phlegm, with anxiety and restlessness after any form of exertion. After a full physical examination we performed blood work and radiographs of Mack’s larynx and thorax. Mack was admitted to our hospital for upper airway surgery. Once under general anesthetic we were then able to evaluate the upper airway structures in greater detail to determine the degree of pathology and take an appropriate course of action.
The major findings were as follows:
1) Severe stenotic nares, as pictured above, creating a resistance to airflow
2) Elongated soft palate – approximately 6.0 cm too long
3) Everted laryngeal saccules blocking the lower rima glottis
4) Stage II and Stage III laryngeal collapse
There was no significant redundant pharyngeal tissue, the tracheal diameter was good with no evidence of collapse and the tonsils were within their respective crypts.
Surgical intervention was as follows:
1) Stenotic nares – A combination of a vertical wedge technique and horizontal removal of alar wing tips
2) Everted saccules – Removal of everted tissue-see more recent photo showing #2 and # 4 in the article “Smelling the Roses and a whole lot more after early brachycephalic surgery”.
3) Soft palate – Shortened the elongated soft palate by about 6 cm (> 3.5cm is a lot of redundant soft tissue sucking into glottis on inspiration and back up into the roof of the mouth on expiration) just to cover the tip of the epiglottis
4) Laryngeal collapse – Transect the folded tissue (on one side only) that was obstructing the entry to the glottis which leads directly to the trachea
As brachycephalic airway syndrome progresses many of the secondary components of the disease are irreversible. Mack’s recovery has however been excellent as best described by the owner’s comments (also note the increased size of Mack’s new nares!):
“Mack is much happier and has more energy. He is sniffing more when outside and now enjoys being outdoors. He has the ability to be included in activities for hours not just minutes and loves going to the leash free park. After the leash free we can’t hear him breathing. He still pants after exercise but no longer has stressed breathing. Mack has a much quicker recovery after activity with no vomiting, choking or gagging. Mack is now able to lie down and rest comfortably, something he could not do in the past after any exertion. It is the best thing we ever did for him- we should have done it earlier!”
Note: That the tissue pinkness just inside the wider nasal opening will re-pigment.
Update: In October of this year 2013, the owners say Max now 7 years old has been given extra years of quality life since upper airway surgery 2 years ago at Southdown Animal Clinic in Mississauga.
Update: Max just had his Annual Health Examination and Screening Test at our Mississauga Hospital in May 2015. He remains healthy with the ability to breath without distress.
Mack lived a very rewarding active life after having airway surgery. It was in the late summer age 11 years, 2017 that he departed with unrelated critical illness.