Brachycephalic Airway Syndrome in Dogs and Cats

Brachycephalic Airway Syndrome refers to a combination of structural abnormalities of the upper respiratory tract that may be present in varying combinations:

• Stenotic nares: Narrowed nostrils that limit airflow

• Elongated soft palate: Excess tissue that blocks the airway opening

• Everted laryngeal saccules: Tissue that gets pulled into the airway due to constant effort to breathe

• Hypoplastic trachea: A smaller-than-normal windpipe, common in Bulldogs

An individual pet may have one or more of these abnormalities, and the more defects that are present, the more severe the breathing difficulty becomes.

Secondary Problems Caused by Brachycephalic Airway Syndrome

Over time, brachycephalic airway syndrome doesn’t just affect the airways—it can also contribute to a range of secondary health problems, especially in dogs with multiple anatomical abnormalities. These complications can significantly impact your pet’s comfort, digestion, and even heart function. Common secondary issues include:

• Bronchial collapse: Weakened lower airways that collapse under pressure, further restricting airflow. • Gastroesophageal reflux (GERD): Stomach contents may backflow into the esophagus due to altered pressure during heavy breathing. • Chronic gastritis: Inflammation of the stomach lining caused by reflux or stress on the digestive tract. • Heart strain: Continuous respiratory effort can increase cardiac workload, potentially leading to long-term heart problems. • Inflammation of upper airway structures: Ongoing airway resistance can cause swelling and thickening of tissues, making breathing progressively more difficult.

Recognizing and treating BAS early can reduce the risk of these secondary complications and improve your pet’s overall health and longevity.

Signs Your Pet May Have BAS

Recognizing the clinical signs of Brachycephalic Airway Syndrome early is crucial for timely intervention and improving your pet’s comfort and longevity. Symptoms can range from mild to severe and often worsen with age, heat, stress, or exercise.

Common signs include:

• Loud snoring or noisy breathing – Often the first noticeable symptom, especially during rest or sleep.

• Open-mouth or labored breathing – Struggling to breathe through the nose, especially after activity or in hot weather.

• Exercise intolerance – Quick fatigue or refusal to engage in normal activities due to poor airflow.

• Gagging, coughing, or retching – May occur during or after eating, drinking, or excitement.

• Collapsing episodes or fainting – In more severe cases, pets may collapse during exertion due to oxygen deprivation.

• Cyanosis – A bluish tint to the gums or tongue, indicating inadequate oxygenation and a potential emergency.

• Vomiting or lack of appetite – Especially in pets with concurrent gastrointestinal effects from the syndrome.

• Frequent panting or overheating – These pets have a reduced ability to regulate body temperature through panting.

If your dog or cat exhibits any of these symptoms, an airway evaluation should be scheduled as soon as possible to prevent long-term complications.

Diagnosis & Airway Evaluation

Accurate diagnosis is the foundation of effective treatment for Brachycephalic Airway Syndrome. At Canton Animal Hospital, we take a thorough and individualized approach to evaluating each pet’s condition.

During your pet’s visit, we begin with a complete physical examination and collect a detailed history of your pet’s breathing behaviors, exercise tolerance, and any past episodes of distress. Because many abnormalities associated with BAS are internal, additional diagnostics are often needed for a full assessment.

The diagnostic process may include:

• Breed-specific assessment and history: Understanding breed-related risk factors and early clinical signs helps guide diagnosis.

• Sedated oral and laryngeal examination: Allows direct visualization of the soft palate, laryngeal saccules, and nasopharynx to evaluate the severity of anatomical abnormalities.

• Thoracic radiographs (chest X-rays): Used to assess the lungs, trachea size (for hypoplastic trachea), and to rule out secondary problems like aspiration pneumonia or heart strain. to assess tracheal and lung health

• Endoscopy or advanced imaging: In complex cases, we may recommend endoscopy or a CT scan to visualize deeper structures and identify less obvious abnormalities such as extended turbinates or laryngeal collapse.

Because many of these tests require sedation or general anesthesia, we perform careful pre-anesthetic screening including bloodwork and airway risk assessment. If surgery is anticipated, we often combine diagnosis and treatment during a single anesthetic event to reduce risk and stress for your pet. for complex airway concerns

Treatment Options

Treatment for Brachycephalic Airway Syndrome is based on the severity of your pet's symptoms and the specific anatomical abnormalities involved. At Canton Animal Hospital, we offer both conservative medical management and surgical correction to improve breathing and prevent long-term complications.

Medical Management

Medical treatment may be appropriate for mildly affected pets or used to stabilize more severely affected pets prior to surgery. While it does not correct anatomical abnormalities, medical management may offer temporary relief from inflammation and discomfort. This may include:

• Weight control: Maintaining a lean body condition is essential to reducing airway pressure and improving respiratory efficiency.

• Activity regulation: Avoiding strenuous activity, excitement, and exposure to heat and humidity helps minimize breathing difficulties.

• Environmental control: Keeping pets in cool, well-ventilated environments reduces the risk of overheating.

• Anti-inflammatory medications or airway dilators: These helps reduce tissue swelling and ease breathing temporarily.

• Oxygen therapy: Used in emergency cases or for temporary support in moderate to severe respiratory distress.

Surgical Correction

Surgery is the treatment of choice when anatomical defects interfere with normal breathing. Surgical options are tailored based on your pet’s individual anatomy and may include:

• Stenotic nares correction: A small wedge of tissue is removed from each nostril to widen the nasal openings and improve airflow.

• Soft palate resection: The elongated portion of the soft palate is surgically trimmed to prevent it from obstructing the tracheal opening.

• Laryngeal saccule removal: These tissues are removed to reduce airway blockage and improve airflow to the lungs.

• Additional procedures: In more complex or advanced cases of BAS, further surgical interventions may be necessary. These can include procedures to correct laryngeal collapse, which occurs when chronic strain causes the laryngeal cartilage to weaken and obstruct the airway. In such cases, advanced techniques are used to stabilize or remove affected laryngeal structures.

• Another advanced procedure is the surgical removal or modification of nasopharyngeal turbinates—bony ridges that may extend into the pharynx and obstruct airflow. These are typically addressed using specialized surgical instruments or laser ablation to carefully open the airway and reduce resistance. These procedures are generally considered in pets with severe clinical signs or those not responding well to traditional soft palate and nare corrections.

The earlier the surgical intervention, the more successful the outcome. Surgery not only helps correct current breathing problems but also helps prevent irreversible damage to the airway structures.

Potential Risks and Complications

While surgical and medical treatments for Brachycephalic Airway Syndrome can greatly improve a pet's quality of life, there are potential risks and complications associated with both the condition and its correction. Understanding these helps pet owners make informed decisions and recognize when post-operative care may require closer monitoring.

• Swelling or obstruction post-surgery: In the first few days after airway surgery, swelling of the soft palate or surgical site can make breathing more difficult and may require temporary oxygen support.

• Aspiration pneumonia: Pets with severe upper airway obstruction or regurgitation may inhale fluids into the lungs during or after surgery, increasing the risk of pneumonia.

• Persistent respiratory noise: While most noise improves significantly, some residual snoring or nasal sound may continue based on anatomical factors.

• Laryngeal collapse: If surgery is delayed too long, the cartilage supporting the larynx can weaken irreversibly, leading to collapse and more guarded outcomes.

• Anesthesia risks: Brachycephalic pets are more sensitive to anesthesia, so specialized monitoring, positioning, and recovery protocols are used to ensure their safety.

• Regrowth of tissue: In rare cases, soft tissue may thicken again over time, necessitating a second surgical procedure.

At Canton Animal Hospital, we take all necessary precautions to minimize these risks and provide proactive post-op monitoring to ensure a smooth and successful recovery.

Postoperative Care

Proper postoperative care is essential for a safe and successful recovery from airway surgery. At Canton Animal Hospital, we provide detailed recovery plans to support your pet through each stage of healing.

Immediately following surgery, pets are closely monitored in our hospital for any signs of airway swelling, respiratory distress, or complications. Oxygen therapy may be provided during the initial recovery period if breathing is compromised. Our veterinary team ensures your pet remains comfortable and calm during this critical time.

Once discharged, home care becomes a vital part of the recovery process. Key components of post-surgical care include:

• Anti-inflammatory and pain medications: These reduce swelling, discomfort, and inflammation in the airway.

• Strict rest and reduced activity: Physical exertion should be avoided for 10–14 days to allow tissues to heal and prevent airway irritation.

• Environmental control: Keep your pet in a cool, quiet, and stress-free environment. Avoid hot, humid conditions.

• No collars or neck pressure: Use a chest harness instead of a neck collar to avoid compressing the healing airway.

• Nutritional support: Feed a soft, easily digestible diet to avoid irritation while swallowing.

• Follow-up appointments: We schedule rechecks to monitor healing, check for complications, and ensure airway function is improving.

Pet owners should monitor for signs such as noisy breathing, gagging, lethargy, loss of appetite, or cyanosis during recovery and report them to us immediately. With appropriate care, most pets recover smoothly and return to an improved quality of life within a few weeks.

Expected Outcomes & Prognosis

The overall prognosis for pets diagnosed and treated for Brachycephalic Airway Syndrome depends on the number and severity of anatomical abnormalities, the pet’s age at the time of treatment, and the presence of any secondary complications.

• Mild to moderate cases—especially when addressed early—respond very well to surgery, with most pets showing significant improvements in breathing, stamina, and quality of life.

• Pets treated before 2 years of age typically have better outcomes and may avoid long-term complications like laryngeal collapse.

• Pets with multiple abnormalities or a hypoplastic trachea may experience partial improvement and need continued management.

• Severely affected or older pets may still benefit from surgery, but outcomes can be less predictable due to existing airway or cardiac strain.

With proper surgical correction and ongoing care, most pets enjoy a more active, comfortable life. Regular monitoring and lifestyle adjustments help ensure lasting benefits and prevent relapse.

Why Early Intervention Matters

Without treatment, brachycephalic pets often experience progressive airway damage, heat intolerance, and life-threatening emergencies. Early surgical correction not only reduces breathing effort but also helps prevent complications like collapse of the larynx or trachea.

Additional Advice for Pet Owners

Helping your pet live comfortably with Brachycephalic Airway Syndrome also includes practical lifestyle changes and responsible ownership. Here are a few important recommendations:

• Use a harness, not a collar: Dogs with BAS should always wear a chest harness instead of a neck collar to avoid putting pressure on the airway.

• Avoid neck strain: Any tugging or pulling on the neck can worsen respiratory difficulty, especially post-surgery.

• Spay or neuter during surgical correction: If your pet is undergoing airway surgery, we often recommend performing spay or neuter at the same time. Pets with moderate to severe airway obstruction should not be bred.

• Breed awareness: This condition is linked to breed conformation. Breeding dogs with severe BAS symptoms may contribute to the perpetuation of this issue in future generations.

Schedule a Brachycephalic Evaluation

• If your flat-faced dog or cat shows signs of airway obstruction, Canton Animal Hospital can help. We provide expert diagnosis, surgical planning, and compassionate care to help your pet breathe and thrive.

  Call us today or Book an Appointment Online to schedule your pet’s airway evaluation.

Canton Animal Hospital – Helping Michigan’s Flat-Faced Pets Breathe Easier.