Brachycephalic Obstructive Airway Syndrome (BOAS)
You’ve done the research. You already know that your squishy-faced (brachycephalic) furbaby has different needs. As any loving paw-rent would, you do the very best you can to keep your lovable furbaby happy and healthy.
Your veterinarian may have already told you that your dog has something called “Brachycephalic Obstructive Airway Syndrome” or better known as BOAS. Your veterinarian might also have mentioned that BOAS surgery can help your furbaby live more comfortably, since he/she will be able to breathe better.
For some paw-rents, surgery can be very scary, especially when it’s elective. Here’s a summary of what you need to know.
What is Brachycephalic Obstructive Airway Syndrome (BOAS)?
In dogs, Brachycephalic Obstructive Airway Syndrome (BOAS) refers to a group of conditions that affect breathing, arising from the anatomic conformation of dog breeds with short muzzles.
Some of the breeds that are considered brachycephalic include:
- French Bulldog
- Shih Tzu
- Japanese Chin
- Boston Terrier
What are the clinical signs of BOAS?
Signs of BOAS include:
- Noisy breathing, especially with exercise
- Sleeping with head elevated on an object or straightened neck, or with a toy in their mouth
- Tired easily with exercise/poor exercise tolerance
- Difficulty breathing when exercise
What are the components of BOAS?
BOAS is not simply just having a small nose. There are many more components besides what we can see externally! While the nostrils can be appreciated in a conscious dog, a thorough examination for BOAS (including examining the soft palate) can only be adequately performed while under general anaesthetic.
1. Stenotic nostril openings that are very narrow or collapse inwards when breathing
2. Elongated soft palate (the piece of tissue that hangs over the back of their throats) obstructing the airway opening
3. Everted laryngeal saccules (tissue just in front of the vocal cords) partially obstructing the airway opening
What are the risks with BOAS?
There are several dangers to consider with brachycephalic breeds. Imagine struggling to breathe your whole life. We will often recommend BOAS surgery because it can help them breathe a lot better and reduce the risk of life-threatening conditions including:
- Aspiration pneumonia (lung infection)
- Heatstroke and organ damage
- Regurgitation and problems eating
- Oesophageal reflux
- Obstructive sleep apnea (complete airway obstruction/no
- breathing during sleeping)
- Death (in some severe cases)
Can BOAS be fixed or cured?
Unfortunately, BOAS cannot be ‘cured’ but the signs can be significantly alleviated with surgery. However, with any brachycephalic breeds, there are a few key points to remember to try and reduce clinical signs:
- Weight control – weight loss is so important to reduce the severity of BOAS
- Avoid hot humid weather – this can cause overheating
- Avoid stress
- Avoid over-exercising
- Keep cool indoors in summer
We strongly recommend surgical specialist referral for BOAS surgery due to the risk of complications that may require 24/7 critical care (e.g. ventilation). The specialist will assess the degree and severity of BOAS to determine which components which need to be treated. Some preoperative imaging may be necessary such as chest x-rays or a CT scan.
Surgery can involve:
- Nostrils: Trimming the nostrils to help widen them (nasal alarplasty)
- Soft palate: Trimming the elongated soft palate. If the soft palate is thickened, a folded flap palatoplasty (to shorten and thin the soft palate) may be used.
- Laryngeal saccules: Trimming of the laryngeal saccules which block the trachea (windpipe).
What are the risks with BOAS surgery?
Dogs who have had BOAS surgery should never be discharged home on the same day as their procedure. Instead, they should have 24/7 supervised postoperative care due to the risk of certain complications and risks such as:
- Airway swelling: If this happens, supplemental oxygen and sedation may be required. In extreme cases, a temporary tube (tracheostomy tube) may need to be placed into the trachea (airway) to help breathe. This risk is minimised by thorough post-operative monitoring at a 24/7 emergency hospital. Your furbaby will need to stay the night in the hospital following a BOAS surgery for this reason.
- Aspiration pneumonia: If your furbaby regurgitates under anaesthetic it can cause an infection in the lungs. This risk is minimised and controlled by fasting and providing some additional medications before, during and after surgery.
Why does my furbaby need extra medication for surgery?
Because all our squishy-faced fur babies have special needs, to avoid anaesthetic complications, they require special medications before, during, and after surgery. Most of these medications relate to how BOAS can cause tummy issues, which can be very dangerous during surgery and recovery. Some common additional medications include:
- Cerenia (maropitant citrate): this is an anti-vomiting anti-nausea medication to reduce the risk of vomiting
.Metomide (metoclopramide): this is a medication that stimulates stomach and upper small intestinal movement to reduce the risk of gastro-oesophageal reflux
.Losec (omeprazole): this is a gastroprotectant medication, similar to an antacid, to reduce the risk of gastro-oesophageal reflux
That’s why we tailor an anaesthetic protocol for any squishy-nosed breed dog at My Vet Animal Hospital – we want to make sure each furbaby is getting the right medication for the right length of time at the right doses.
Ready for an appointment?
Our team is here to answer your questions and get an appointment scheduled for you.