Evaluation of measurements for tracheal hypoplasia in French bulldogs.

Tracheal narrowing may increase airflow resistance, resulting in clinical manifestations associated with brachycephalic obstructive airway syndrome (BOAS). When diagnosing tracheal hypoplasia, established values are based on measurements established for English bulldogs or non-specific "bulldog" breeds. The objective of this study was to investigate tracheal diameter ratios in French bulldogs to gain a better understanding of what would constitute tracheal hypoplasia in this breed. A retrospective observational analysis was conducted to measure the right lateral thoracic radiographs of 139 French bulldogs to investigate tracheal diameter ratios. Pulmonary disease was observed in 55/139 dogs. The mean TD:Ti for healthy French bulldogs was 0.15 (±0.02), and the mean TD:ML was 0.32 (±0.07). 44/84 dogs had a TD:Ti < 0.15 (±0.02), and 37/65 dogs had a TD:ML < 0.32 (±0.07). At least one thoracic vertebral anomaly was observed in 131/139 of evaluated French bulldogs, and sternal malformations were observed in 42/139 dogs. TD:ML showed an excellent interclass correlation between observers (ICCinter 0.9562). The listed covariables were compared for statistical significance when measuring relative tracheal ratios, and none were found. There was a statistically significant relationship between TD:Ti and sex. An objective value for tracheal hypoplasia in French bulldogs has previously not been established. The mean TD:Ti described for French bulldogs in this study is higher than that previously described in other "bulldog" populations. The mean TD:ML is similar to previously reported for non-brachycephalic and non-bulldog brachycephalic small breed dogs. The correlative relationship between TD:Ti and TD:ML was statistically significant but weak.

Awake 160-Slice Computed Tomography for Upper Airway Evaluation in 17 Dogs.

This study investigated using a 160-slice multidetector computed tomography (CT) scanner for conscious image acquisition in dogs with upper airway disease, and describes findings in dogs that had previously undergone soft palate surgery. Seventeen client-owned dogs with upper airway disease were retrospectively reviewed, and classified into three groups: group I, "untreated brachycephalic obstructive airway syndrome (BOAS) patients"; group II, "previously treated BOAS patients"; and group III, "patients with respiratory disease other than BOAS". Data included signalment, clinical history, direct laryngoscopy and endoscopy findings, previous surgeries and CT findings. CT scans in group I revealed overlong and thickened soft palates in all dogs, and signs of laryngeal collapse in four dogs. Patients in group II exhibited normal soft palate lengths, while patients in group III displayed various findings such as nasopharyngeal narrowing and tracheal collapse. Upper airway examinations under general anaesthesia confirmed most CT findings. This study demonstrates the feasibility and value of conscious CT scanning for assessing upper airway diseases in dogs, providing valuable diagnostic information while eliminating the need for chemical immobilisation, thus reducing patient stress and cost. These findings offer new insight into upper airway anatomy in awake patients, especially in brachycephalic breeds, and lay a foundation for future research.

Non-brachycephalic dogs with stertor have higher nasopharyngeal collapsibility compared with dogs without stertor and foramen lacerum level is ideal for evaluating nasopharyngeal collapse on dynamic CT.

Stertor, a clinical sign associated with obstructive airway syndrome, is often observed in non-brachycephalic dogs. This prospective, case-control study aimed to compare soft palate dimensions, nasopharyngeal cross-sectional area (CSA), and nasopharyngeal collapsibility at various locations in non-brachycephalic dogs with and without stertor. A total of 50 dogs were recruited and stratified into control (n = 34) and stertor (n = 13) groups. Static and dynamic computed tomography was conducted without tracheal intubation, and the following variables were calculated: normalized soft palate length and thickness, normalized maximum and minimum nasopharyngeal CSAs (rCSAmax and rCSAmin), and nasopharyngeal collapsibility at the level of the cranial end of the soft palate, pterygoid hamulus, foramen lacerum, bony labyrinth, and caudal end of the soft palate. The stertor group demonstrated significantly lower rCSAmax and rCSAmin, as well as higher nasopharyngeal collapsibility compared with the control group, while no significant differences were noted in the soft palate dimension. Evaluating nasopharyngeal collapse at the foramen lacerum level was recommended due to the clear presence of identifiable bony landmarks and lower overlap in the nasopharyngeal collapsibility between dogs with and without stertor. Physical dimensions of the soft palate may not be the primary contributing factor to nasopharyngeal collapse and clinical signs in non-brachycephalic dogs.

Evaluating acidic gastroesophageal reflux with wireless pH monitoring in French bulldogs with sliding hiatal herniation.

BACKGROUND: Sliding hiatal herniation (SHH) and gastroesophageal reflux (GER) commonly occur in French bulldogs. Wireless pH monitoring can quantitatively assess acidic GER in dogs affected by SHH. HYPOTHESIS/OBJECTIVES: Measure acidic GER in French bulldogs with SHH, pre- and post-brachycephalic obstructive airway syndrome (BOAS) surgery, utilizing a wireless pH capsule (Bravo Calibration-free, Medtronic, Minnesota), and correlate with owners' observations of regurgitation. ANIMALS: Eleven French bulldogs diagnosed with SHH via swallowing fluoroscopy. METHODS: Prospective cohort study. A pH capsule was endoscopically placed in the esophagus. Up to 96 hours of data were acquired as the owner logged clinical signs. Spearman's correlation and Wilcoxon rank-sum tests evaluated factors correlated with acid exposure time (AET), defined by the % time pH < 4. In 4/11 dogs, Bravo monitoring was repeated 2-4 months after BOAS surgery. RESULTS: Medians (Q1-Q3) for age and weight were 21 months (17-35.5) and 10.0 kg (8.9-11.5). BOAS severity was mild (3), moderate (4), or severe (4). Medians (Q1-Q3) for AET and reflux events were 3.3% (2.6-6.4) and 70 (34-173). Clinical score (P = .82) and BOAS severity (P = .60) were not correlated with AET, but age was negatively correlated (rho = -.66, P = .03). Median probability (Q1-Q3) that regurgitation was associated with a reflux event was 72.5% (0-99). Percent AET numerically improved in all 4 dogs that underwent BOAS surgery although not statistically assessed. CONCLUSIONS AND CLINICAL IMPORTANCE: Wireless pH monitoring documented acidic GER in French bulldogs with SHH, captured subclinical events, and showed improvements after BOAS surgery.

Awareness, experiences, and opinions by owners, breeders, show judges, and veterinarians on canine Brachycephalic Obstructive Airway Syndrome (BOAS).

BACKGROUND: Exaggerated brachycephalic features have been highlighted over the last decade by their profound effect on the health and welfare of the affected dogs. The term brachycephalic obstructive airway syndrome (BOAS) was launched in the early 2000s and has received worldwide attention and awareness. At the same time, the popularity of brachycephalic dogs increased. This study aimed to reveal the awareness and experiences of health issues related to the physical appearance of brachycephalic breeds and compare perceptions and opinions on how to counteract these issues by various stakeholders (dog owners, veterinarians, dog breeders, and show judges) by performing an online survey. RESULTS: Altogether, 1602 owners, 1551 breeders, 118 show judges, and 557 veterinarians participated. Awareness and experiences of conformation-related health issues were common among all stakeholder groups. Most participants agreed fully or partly that health issues related to conformity threaten the health of brachycephalic breeds; that the measures taken so far are positive; and that guidelines on the appearance of a dog should be based on knowledge regarding health issues related to physical appearance. A disagreement was noted on further measures to be taken and the importance of adhering to a breed standard. CONCLUSIONS: All stakeholders were aware of health issues related to the appearance of brachycephalic dogs, but had variable personal experiences of these issues. Most participants agreed fully or partly that health issues related to conformity threaten the health of brachycephalic breeds, and that attention to these issues and measures taken so far are positive. However, there is a disagreement on further actions to be taken and the importance of adhering to a breed standard. These findings could be used to understand and bridge the gap in opinions between stakeholders and to refine methods to influence the health of dogs with exaggerated brachycephalic features.

Laser-Assisted Turbinectomy in Dogs.

This article discusses the laser-assisted turbinectomy (LATE) procedure and indications for its performance in dogs suffering from brachycephalic obstructive airway syndrome (BOAS). The article summarizes landmark works that reported, for the first time, endoscopic-assisted identification and treatment of structures within the brachycephalic nose that contribute to intranasal obstruction and resistance to breathing, specifically hypertrophic and aberrant nasal turbinates. Brachycephaly is discussed in the context of how these aberrations form and how definitive treatments such as LATE and adjunctive treatments such as ala vestibuloplasty, folded flap palatoplasty, and others may ameliorate the negative effects and improve patient outcomes associated with aberrant intranasal conchal configurations.

Evaluation of risk factors for sleep-disordered breathing in dogs.

BACKGROUND: Brachycephalic dogs display sleep-disordered breathing (SDB). The risk factors for SDB remain unknown. OBJECTIVES: To identify risk factors for SDB. We hypothesized that brachycephaly, increasing severity of brachycephalic obstructive airway syndrome (BOAS), excess weight, and aging predispose to SDB. ANIMALS: Sixty-three privately owned pet dogs were prospectively recruited: 28 brachycephalic and 35 normocephalic (mesaticephalic or dolicocephalic) dogs. METHODS: Prospective observational cross-sectional study with convenience sampling. Recording with the neckband was done over 1 night at each dog's home. The primary outcome measure was the obstructive respiratory event index (OREI). Body condition score (BCS) was assessed, and BOAS severity was graded for brachycephalic dogs. RESULTS: Brachycephaly was a significant risk factor for high OREI value (ratio of the geometric means 5.6, 95% confidence interval [CI] 3.2-9.9; P < .001) but aging was not (1.1, 95% CI 1.0-1.2; P = .2). Excess weight, defined as a BCS of over 5/9, (3.5, 95% CI 1.8-6.7; P < .001) was a significant risk factor. In brachycephalic dogs, BOAS-positive class (moderate or severe BOAS signs) was a significant risk factor (2.5, 95% CI 1.1-5.6; P = .03). CONCLUSIONS AND CLINICAL IMPORTANCE: Brachycephaly decreases welfare in a multitude of ways, including disrupting sleep. Brachycephaly, increasing severity of BOAS and excess weight are risk factors for obstructive SDB.

Evaluation of the Submaximal Treadmill-Based Fitness Test in Six Brachycephalic Breeds-A Follow-Up Study.

Brachycephalic obstructive airway syndrome (BOAS) in dogs challenges veterinary surgeons both with a complex clinical picture as well as wide-ranging ways to diagnose the disease, often not easily implemented nor standardised in clinical practice. The assessment of a combination of exercise testing, the occurrence of breathing noises, recovery time, and respiratory effort proved to be an appropriate method to identify Pugs with BOAS. The purpose of this study was to apply an established standardised, submaximal, treadmill-based fitness test for Pugs to other brachycephalic dog breeds. A total of 79 participants, belonging to 6 different brachycephalic breeds, trotted 15 min with an individual comfort speed of 3-7 km/h on a treadmill. Additionally, functional BOAS grading based on respiratory clinical signs before and after exercise was applied. The test was passed if the dogs presented with a BOAS grade of 0 or 1 and their vital parameters recovered to baseline within 15 min after exercise. A total of 68% showed a BOAS grade of 0 or 1 and passed the fitness test. Of the failed participants, 65% failed due to BOAS affectedness, 9% were categorised as not affected by BOAS and failed due to not passing the fitness test only, and 26% showed both failure criteria. The fitness test can be a useful method to identify BOAS-affected dogs in other brachycephalic breeds and to diagnose BOAS in dogs that only show clinical signs under exercise.

Differences in selected blood parameters between brachycephalic and non-brachycephalic dogs.

Introduction: Cranial and upper-airway anatomy of short-nosed, flat-faced brachycephalic dogs predisposes them to brachycephalic obstructive airway syndrome (BOAS). Periodic apnoea increased inspiratory resistance, and an inability to thermoregulate effectively are characteristic of BOAS, but internationally accepted objective markers of BOAS severity are missing. The objective of this study was to compare the selected blood parameters between non-brachycephalic (NC) and brachycephalic (BC) dogs, exploring the possibility of developing a blood test for BOAS severity grading in the future. Methods: We evaluated blood biochemistry, complete blood cell counts, red blood cell (RBC) indices, reticulocyte counts, a blood-born marker of intermittent hypoxia (glutathione, NO production), RBC hydration, deformability, and blood markers of metabolic changes and stress between BC (n = 18) and NC (meso- and dolichocephalic, n = 22) dogs. Results: Reticulocyte counts and the abundance of middle-fluorescence immature reticulocytes were significantly (p < 0.05) higher in BC dogs compared to NC dogs. BC dogs had significantly more NO-derived NO2-/NO3- in plasma than NC dogs. RBCs of BC dogs were shedding significantly more membrane, as follows from the intensity of eosin maleimide staining, and had a significantly higher mean corpuscular hemoglobin concentration than NC dogs. Intracellular reduced glutathione content in RBCs of BC dogs was significantly lower, while plasma lactate was significantly higher in BC dogs compared to NC dogs. Plasma cholesterol and triglycerides were significantly lower, and cortisol was significantly higher in BC dogs compared to NC dogs. Eosinophil counts were significantly lower and the neutrophil-to-lymphocyte ratio was higher in BC dogs compared to NC dogs. Discussion: Taken together, our findings suggest that the brachycephalic phenotype in dogs is associated with alterations at the level of blood cells and, systemically, with oxidation and metabolic changes. The parameters identified within this study should be further investigated for their potential as objective indicators for BOAS.

Description of a novel method for detection of sleep-disordered breathing in brachycephalic dogs.

BACKGROUND: Sleep-disordered breathing (SDB), defined as any difficulty in breathing during sleep, occurs in brachycephalic dogs. Diagnostic methods for SDB in dogs require extensive equipment and laboratory assessment. OBJECTIVES: To evaluate the usability of a portable neckband system for detection of SDB in dogs. We hypothesized that the neckband is a feasible method for evaluation of SDB and that brachycephaly predisposes to SDB. ANIMALS: Twenty-four prospectively recruited client-owned dogs: 12 brachycephalic dogs and 12 control dogs of mesocephalic or dolicocephalic breeds. METHODS: Prospective observational cross-sectional study with convenience sampling. Recording was done over 1 night at each dog's home. The primary outcome measure was the obstructive Respiratory Event Index (OREI), which summarized the rate of obstructive SDB events per hour. Additionally, usability, duration of recording, and snore percentage were documented. RESULTS: Brachycephalic dogs had a significantly higher OREI value (Hodges-Lehmann estimator for median difference = 3.5, 95% confidence interval [CI] 2.2-6.8; P < .001) and snore percentage (Hodges-Lehmann estimator = 34.2, 95% CI 13.6-60.8; P < .001) than controls. A strong positive correlation between OREI and snore percentage was detected in all dogs (rs = .79, P < .001). The neckband system was easy to use. CONCLUSIONS AND CLINICAL IMPORTANCE: Brachycephaly is associated with SDB. The neckband system is a feasible way of characterizing SDB in dogs.

Clinical review of high-flow nasal oxygen therapy in human and veterinary patients.

Oxygen therapy is the first-line treatment for hypoxemic acute respiratory failure. In veterinary medicine this has traditionally been provided via mask, low-flow nasal oxygen cannulas, oxygen cages and invasive positive pressure ventilation. Traditional non-invasive modalities are limited by the maximum flow rate and fraction of inspired oxygen (FiO2) that can be delivered, variability in oxygen delivery and patient compliance. The invasive techniques are able to provide higher FiO2 in a more predictable manner but are limited by sedation/anesthesia requirements, potential complications and cost. High-flow nasal oxygen therapy (HFNOT) represents an alternative to conventional oxygen therapy. This modality delivers heated and humidified medical gas at adjustable flow rates, up to 60 L/min, and FiO2, up to 100%, via nasal cannulas. It has been proposed that HFNOT improves pulmonary mechanics and reduces respiratory fatigue via reduction of anatomical dead space, provision of low-level positive end-expiratory pressure (PEEP), provision of constant FiO2 at rates corresponding to patient requirements and through improved patient tolerance. Investigations into the use of HFNOT in veterinary patients have increased in frequency since its clinical use was first reported in dogs with acute respiratory failure in 2016. Current indications in dogs include acute respiratory failure associated with pulmonary parenchymal disease, upper airway obstruction and carbon monoxide intoxication. The use of HFNOT has also been advocated in certain conditions in cats and foals. HFNOT is also being used with increasing frequency in the treatment of a widening range of conditions in humans. Although there remains conflict regarding its use and efficacy in some patient groups, overall these reports indicate that HFNOT decreases breathing frequency and work of breathing and reduces the need for escalation of respiratory support. In addition, they provide insight into potential future veterinary applications. Complications of HFNOT have been rarely reported in humans and animals. These are usually self-limiting and typically result in lower morbidity and mortality than those associated with invasive ventilation techniques.

Assessment of the number of mast cells in the soft palate of dogs affected by brachycephalic obstructive airway syndrome.

BACKGROUND: Oedema is described in the soft palate of dogs affected by brachycephalic obstructive airway syndrome (BOAS). Activated mast cells (MCs) release vasoactive mediators that temporarily increase vascular permeability. METHODS: Data and caudal soft palate tissue were prospectively collected from a population of dogs undergoing surgical management of BOAS and a control group of greyhound cadavers with no previous history of respiratory signs. Histological assessment was performed to quantify the number of MCs within the lamina propria of each group. RESULTS: The mean number of MCs in the BOAS group (53 MCs/10 400× high-power fields [HPF]; standard deviation [SD] = 23) was significantly greater than that in the greyhound group (24 MCs/10 400×HPF; SD = 10). LIMITATIONS: The small size of the control group and the heterogeneous nature of the dogs in the BOAS group limit the generalisability of the findings. The use of different surgical techniques in the BOAS group may have also affected the degree of inflammation present within the samples. The cohort was not screened for concurrent disease processes that could potentially increase the number of circulating MCs. CONCLUSION: This study demonstrated a statistically significant difference between the numbers of MCs in the soft palate of brachycephalic dogs with clinically significant BOAS and the greyhound control group.

Advances in animal models of obstructive sleep apnea.

Animal experiments play an important role in the study of the pathogenesis of human diseases and new methods of diagnosis and treatment. Due to the great differences in the anatomical structure and physiology of the upper airway between animals and humans, there is currently no animal model that can fully simulate the pathological anatomy and pathophysiological characteristics of human obstructive sleep apnea (OSA) patients. Herein, we summarizes the construction methods of several OSA animal models that have been widely used in the studies published in the last 5 years, the advantages and limitations of each model as well as related evaluation techniques are described. This information has potential to provide further guide for the development of OSA related animal experiments.

In-silico decongested trial effects on the impaired breathing function of a bulldog suffering from severe brachycephalic obstructive airway syndrome.

BACKGROUND AND OBJECTIVE: Brachycephalic obstructive airway syndrome (BOAS) susceptible dogs (e.g., French bulldog), suffer health complications related to deficient breathing primarily due to anatomical airway geometry. Surgical interventions are known to provide acceptable functional and cosmetic results; however, the long-term post-surgery outcome is not well known. In silico analysis provides an objective measure to quantify the respiratory function in postoperative dogs which is critical for successful long-term outcomes. A virtual surgery to open the airway can explore the ability for improved breathing in an obstructed airway of a patient dog, thus supporting surgeons in pre-surgery planning using computational fluid dynamics. METHODS: In this study five surgical interventions were generated with a gradual increment of decongested levels in a bulldog based on computed tomography images. The effects of the decongested airways on the breathing function of a patient bulldog, i.e., airflow characteristics, pressure drop, wall shear stress, and air-conditioning capacity, were quantified by benchmarking against a clinically healthy bulldog using computational fluid dynamics (CFD) method. RESULTS: Our findings demonstrated a promising decrease in excessive airstream velocity, pressure drop, and wall shear stress in virtual surgical scenarios, while constantly preserving adequate air-conditioning efficiency. A linear fit curve was proposed to correlate the reduction in the pressure drop and decongested level. CONCLUSIONS: The in silico analysis is a viable tool providing visual and quantitative insight into new unexplored surgical techniques.

Comparison of habitual physical activity in French Bulldogs, Pugs and normocephalic dogs by accelerometry.

Brachycephalic obstructive airway syndrome (BOAS) is a major welfare concern in flat-faced dog breeds. As BOAS causes respiratory difficulties and exercise intolerance, it can reduce dogs' daily quality of life (QOL). However, evaluation of QOL in dogs is difficult, and many owners perceive BOAS signs as 'normal' for the breed. Accelerometers that measure frequency, duration and intensity of activities can offer an objective way of evaluating dogs' daily activity and thereby deliver potential insights into QOL. The aim of this study was to assess habitual physical activity of 48 brachycephalic and 23 non-brachycephalic dogs using accelerometers. The accelerometers were used for one week and owners filled in a questionnaire regarding their dog's well-being and activities. Veterinary-assessed BOAS grading for brachycephalic dogs was determined. Compared with controls, more severely affected French Bulldogs and Pugs had significantly lower total activity counts and spent less time in high activity. In Pugs, mildly affected dogs were also less active, but age can be a contributing factor here, as older age decreased activity in Pugs and controls showed a wider age range. In French Bulldogs, those dogs with no or mild signs of BOAS did not differ from controls regarding their daily activity. In conclusion, accelerometers were easy to use for objective measurement of daily activity in bracycephalic dogs, although a degree of discomfort due to the collar was reported. Results showed that BOAS signs were associated with decreased habitual physical activity. These findings emphasise the importance of actions taken to reduce incidence of BOAS in brachycephalic breeds.

Evaluation of VEGF-A and CCL2 in dogs with brachycephalic obstructive airway syndrome or canine idiopathic pulmonary fibrosis and in normocephalic dogs.

Brachycephalic obstructive airway syndrome (BOAS) and canine idiopathic pulmonary fibrosis (CIPF) of West Highland White Terriers (WHWTs) often cause intermittent or chronic hypoxemia. Our objective was to evaluate serum and bronchoalveolar lavage fluid (BALF) concentrations of hypoxemia-related proinflammatory mediators vascular endothelial growth factor A (VEGF-A) and chemokine (CC motif) ligand 2 (CCL2) in brachycephalic dogs (BDs) and WHWTs with and without CIPF. Additionally, effects of BOAS severity and ageing on these mediators were assessed. 114 BDs (28 English Bulldogs (EBs), 37 French Bulldogs, 49 Pugs), 16 WHWTs with CIPF, 26 healthy WHWTs, and 39 normocephalic control dogs were included. Fifty-four BDs were re-examined after two to three years. Bead-based immunoassay was used for proinflammatory mediator measurements. Compared with controls, significantly higher serum concentrations of VEGF-A were seen in EBs (P = 0.009) and of CCL2 in CIPF and healthy WHWTs (P < 0.001; P = 0.002). BALF samples were available from controls, EBs, and WHWTs. VEGF-A was significantly lower in EBs (P < 0.001) and in CIPF and healthy WHWTs (P = 0.006; P = 0.007) and CCL2 was higher in CIPF WHWTs (P = 0.01) compared with controls. Between visits, only serum VEGF-A significantly decreased in BDs (P < 0.001), but breed, BOAS severity, or its change had no significant effect. In conclusion, in EBs with BOAS proinflammatory changes in VEGF-A were detected in both serum and BALF. Ageing reduced serum VEGF-A in BDs. In WHWTs, our results confirmed earlier findings of CCL2 as an important biomarker for CIPF.

Wound healing complications following folded flap palatoplasty in brachycephalic dogs.

OBJECTIVE: To determine the incidence and characteristics of wound healing complications after folded flap palatoplasty (FFP). METHODS: Prospective study of 25 dogs that underwent FFP as a component of corrective multilevel surgery for brachycephalic obstructive airway syndrome. Oropharyngeal re-examination was conducted after a minimum of 28 days post-operatively, unless indicated earlier by the onset of clinical signs. RESULTS: Wound healing complications occurred in nine dogs (36%). Minor and major wound complications were diagnosed at a median of 36 days (1.5-51 days) post-operatively. Eight dogs had major wound complications, four of which showed no associated clinical signs. Two patterns of major wound complications were observed: incisional dehiscence (ID) with caudal retraction of the soft palate mucosa and development of a full-thickness defect (FTD) in the centre of the soft palate. Revision of the soft palate surgery was performed in five dogs, failing again in one dog with ID. Clinical signs resolved in symptomatic dogs after revision surgery to close FTD. CONCLUSION: In this study, wound healing complications were common after FFP and were not associated with significant clinical deterioration. Further research is necessary to determine the value and timing of routine post-operative oropharyngeal examination for assessment of soft palate healing after FFP as well as the indication for and success of approaches to the management of wound healing complications. The two distinct patterns of FFP failure recognised may provide insight into the underlying causes and lead to refinements in folded flap palatoplasty technique.

Brachycephalic Obstructive Airway Syndrome.

Dogs presenting with brachycephalic obstructive airway syndrome suffer from multilevel obstruction of the airway as well as secondary structural collapse. Stenotic nares, aberrant turbinates, nasopharyngeal collapse, soft palate hyperplasia, macroglossia, tonsillar hypertrophy, laryngeal collapse, and left bronchial collapse are described as the most common associated anomalies. Rhinoplasty and palatoplasty as well as newer surgical techniques and prudent preoperative and postoperative care strategies have resulted in significant improvement even in middle-aged dogs.

Impact of an educational intervention on public perception of brachycephalic obstructive airway syndrome in brachycephalic dogs.

BACKGROUND: The popularity of brachycephalic dogs continues to increase despite inherent breed health problems. Increased education of current and potential brachycephalic dog owners could reduce the desirability of severely affected dogs. METHODS: Members of the general public were prospectively recruited to assess their understanding and opinions of brachycephalic breed-related health problems, before and after an educational intervention on brachycephalic obstructive airway syndrome (BOAS). RESULTS: A total of 587 people participated. Before the intervention most participants considered characteristics of BOAS to be normal for brachycephalic dogs. Following the intervention this was moderately reduced. Responses highlighted that defining 'normal' for a breed is difficult. Referring to a trait as 'normal', even in a negative context results in normalisation. 99.7% of participants had an improved understanding of BOAS following the intervention. However, only 53.0% of the total participants and 29.3% of brachycephalic dog owning participants had their opinion of brachycephalic dogs changed. 99.5% of participants believed that potential owners should be more aware of BOAS and 57.3% of brachycephalic dog owners would have liked further information about breed health problems before purchasing their dog. CONCLUSION: Educational interventions may be beneficial in improving understanding and awareness of BOAS however, normalisation of clinical signs of BOAS remains prevalent.