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“Smelling the Roses” Watt, Oliver and many others after early Bachycephalic Surgery (BOAS)

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Brachycephalic Obstructive Airway Syndrome (BOAS) is a result of many soft tissue factors directly related to design with shortened skull bone length .  Various breeds are recognized as brachycephalic including Boston Terriers, Shih Tzus, Boxers, English and French bulldogs, Lhasa Apsos, Pekingese, Pugs and Shar Peis.  It should be noted that not all brachycephalic breed dogs suffer from this syndrome.  Bulldogs are usually the most severely affected.

The primary soft tissue abnormalities are stenotic nares and soft palate elongation. The secondary changes include eversion of the laryngeal saccules (Stage 1 laryngeal collapse), further elongation of the soft palate, tonsil enlargement, more advanced irreversible laryngeal collapse and often gastrointestinal symptoms.  These changes can be halted by early surgical correction of the primary airway obstructive problems.  Stenotic nares may be the only issue that needs correction.

Stenotic nares is a congenital abnormality where the nostril diameter is diminished and therefore reduces airflow as the pet breathes.  BAS is a progressive disease and the best treatment is an early treatment. Air passage through the nasal cavities accounts for approximately 75 % of total airflow resistance in dogs. It is a known fact that a 50 % reduction in tube radius (the narrow nasal opening ) leads to a 16 fold increase in resistance to air flow. (Poiseuille’s Law)

BOAS individuals may have laboured breathing example, snorting, noisy breathing, gagging etc….. as they struggle to obtain sufficient oxygen.  The reason this occurs is due to the excessive negative pressure that occurs with every breath they take.  With their airway pathway being reduced, the individual exerts this negative pressure during inspiration in attempt to maintain air flow which distorts the pharyngeal tissue.  This results in a vicious cycle of more tissue stretching, swelling and more severe laryngeal collapse. It just goes from bad to worse!

Here are two recent surgical cases that have been performed at our Mississauga hospital that have greatly benefited from early corrective upper airway surgery! In the majority of cases once corrective surgery has been performed, the dog has carefree, effortless breathing with a much more active, healthier lifestyle.

 

 

1) Wyatt is a male, neutered, English Bulldog, who had BOAS surgery when he was 7 months old.

Structural findings were as follows:  (All these features are visible in the photos)

  • Severe stenotic nares ( surgical correction)
  • Laryngeal saccule eversion/Stage 1 Collapse ( surgical correction)
  • Inwards position of the aryepiglottic folds/Stage 11 Collapse)
  • Enlarged tonsils
  • Normal length to soft palate with a deformed shortening on the left side.

It's my good looks that most people adore!     A view of Wyatt's Larynx during surgery Wyatt Evans Pre Op WebNostrils opened surgically

                        A view of Wyatt’s Larynx during surgery

 

Wyatt’s photo clearly demonstrates that his good looks will forever be adorned.

 

2) Oliver is a male, neutered, French Bulldog, who had BOAS surgery when he was 5 months old.

Structural findings were as follows:

  • severe stenotic nares (surgical correction)
  • laryngeal saccule eversion (surgical correction)
  • enlarged tonsils (common)
  • normal length soft palate

Oliver Batchelor Web    Oliver Batchelor Mid Op WebOliver Batchelor Pre Op Web   Oliver Batchelor Post Op Web

 

In this photo Oliver’s nose has completely re-established pigmentation 2 months later.

 

It is expected that both these pets will do very well in life now that corrective surgery has created a good airway!
Time does fly when every day counts. Both these dogs have maximum activity and ability to breath-September 2017

 

 

Key Points:

1) Owners always comment that after surgery as in the case of Wyatt and Oliver smelling everything is a new found gift.

2) People always say that they are surprised that their dog doesn’t make any noise when he/she breathes.

Pleased note that these advanced airway surgeries are done at both our animal hospitals in Mississauga and Oakville.

Our health care team at Southdown Animal Clinic in cooperation with Wyatt and Oliver and their respective parents are proud to share their success stories.

 

My name is Mason (French Bulldog) :

 

My name is Brock: I am also a Frenchie and I am Mason’s brother. We both had stenotic nares surgery (BOAS) on the same day!

My name is Leo (Shih Tzu):

Pre and post surgical appearance of stenotic nares surgery

 

My name is Finn:# 10011  I am a male Pug, born on Feb 28, 2021. My parents describe my personality as perfect. It is just that my breathing has always been a problem.

I had stenotic nasal surgery (Rhinoplasty) in the month of September 2021.

 

Pre surgical photo along with immediate post surgical airway opening as illustrated in photos.

The owners noticed immediate benefits. The most obvious findings are that Finn’s breathing is now quiet and has a lot more energy.

(Sutures removed on Oct 1, 2021 under a light anesthesia)

 

 

 

 

 

 

 

white dog with eye issue

Surgery for chronic prolapsed THIRD EYELID GLANDS (Dog) : EYELIDS can now be fully CLOSED*

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  Chronic Cherry Eye PRE SURGERY Modified Pocket T.Midge is a 5 year old spayed female Yorkshire Terrier mix that has had prolapsed glands of the third eyelid for 3 years. The prolapsed gland appears as red masses (also know as Cherry Eye) that protrude from behind the third eyelid( Midge in pre:surgery photo).This gland is vital for aqueous tears. Surgical replacement of the prolapsed glands of the third eyelid was reviewed with the owners in detail before proceeding with surgery.  The advantage of the Modified Morgan Pocket technique is that it allows the third eyelid to move normally after surgery. There are a number of key fundamental steps to ensure optimum success with this procedure including attention to detail suturing and innovative thinking. It is important to note that Surgical Treatment For Dogs with Nictitans Gland Prolapse of several months’ duration has a less favourable prognosis for success.  We fully discussed  the benefits of surgery with the owners and the possibility of unsuccessful results.  We always approach these cases with favourable outlook and with goal of excellent results. Surgery was performed  in our surgical suite at our  Mississauga Hospital  (Southdown Animal  Clinic) on  October 07, 2016.This technique uses the scar tissue of the subconjunctival to hold the gland in place. Things that must be considered for a successful outcome: 1) Schirmer tear test-that measures that for adequate tear production is still good ( greater than 16 mm/minute ). 2) Use of topical steroids for 1 to 3 months to reduce inflammation and swelling of the nictitans gland before surgery. 3) The sooner surgery is done after obvious prolapse of the glands the higher the success rate. We are always reluctant to unequivocally state that something is beyond hope no matter how chronic. There are a tremendous number of variables that enter into the picture. 4) Attention to detail in surgery. 5) The bodies ability to heal. 6) With the Pocket Technique once the gland stays down for 30 days then it most likely will stay down permanently 7) The breed of dog maybe a factor; for example,  the British Bulldog may have a higher failure rate. The owners comments on the last follow up at 6 weeks post surgery: “It is the first  time in many months that Midge has been able to sleep with her eyes closed!” Midge has done amazing well with perfect vision up to the time of this update September 2017.

 

Prolapsed Gland of 3rd Eyelid in Place Chronic Cherry 7 days PO Surgery #6493-2Cherry Midge 6 weeks PO(9) copy