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Harvey gets better breaths of fresh air

Harvey was referred earlier this Spring for surgery to his upper airways to try to improve his breathing, which had become more problematic due to narrowing of certain parts of his airway. 

Dogs and cats with flattened faces are known collectively as brachycephalic breeds. Common brachycephalic breeds include English and French bulldogs, Pekingese, Boxers, Boston terriers, Pugs, and Shih Tzus and all can be affected with a number of upper respiratory problems affecting the nose, mouth and throat.

             

Brachycephalic dogs have the same number of bones and soft-tissues as other dogs with longer noses, but compressed into a much smaller space. The result is that they have very narrow upper airways to breath through e.g. narrow nostrils and an overlong soft palate and later onset degenerative changes such as laryngeal collapse. 

Brachycephalic dogs may breathe well through a narrow airway at rest, but as they start to run about, or it gets hot, they can start to have breathing problems and this is when their owners often seek veterinary help e.g. with loud raspy breathing and getting out of breath easily at exercise, particularly in hot weather. Blood tests show that brachycephalic dogs often have low levels of blood oxygen akin to climbers at high altitude. Being overweight can exacerbate the breathing problems. In addition, some brachycephalic dogs will also regurgitate  causing oesophagitis or 'heartburn'.

Happily, it is possible to help these dogs by performing surgery to make their airways wider, by addressing the changes listed above. 

Harvey was a fit, lean Pug who regularly exercised with two Labradors, but his owner had noticed that he had started to slow down when exersised in warm weather: he often had to lie down and rest. At times his breathing became particularly raspy and rapid.

Surgery for Harvey involved widening his nostrils, shortening his soft-palate and surgery to help the changes in Harvey's larynx (or 'voice box'). After an uneventful surgery, Harvey was kept in our hospital overnight for close monitoring (in case of airway swelling). He was discharged the following day.  

                          

Harvey’s throat before and after shortening of the soft-palate. A tube is entering the larynx to provide oxygen and anaesthetic to the patient. Initially the larynx is obscured by the soft-palate which actually obstructs and gets sucked into the entrance to the larynx and airway.

                        

The soft-palate has been shortened and oversewn to a “normal” length (white curve) improving visualisation of the entrance to the larynx and airway (*)

 

                         

Harvey’s nose before and after surgery. Many brachycephalic dogs have slit-like nostrils (stenotic nares) and benefit from widening (rhinoplasty). 

                        

Dissolvable sutures are present, following Harvey's rhinoplasty in the immediate post-operative photograph.

 

Harvey showed a good improvement after surgery, especially his ability to exercise in warm weather. He can now play for longer with his Labrador friends!

Upper airway surgery is likely to become more common due to the recent surge in popularity of breeds like French Bulldogs and Pugs. The Kennel club reports dramatic increases in litter registrations for some of these brachycephalic breeds in recent years. The Kennel club and their affiliated breed clubs are beginning to recognise welfare problems in certain dog breeds and reputable breeders have expressed a commitment to address these problems. 

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