BOAS surgery - giving your dog a breath of fresh air.
Brachycephalic Obstructive Airway Syndrome (BOAS) is a condition that all short-faced dogs have to differing degrees. Owners often notice increased noise when breathing during excitement, exercise, humid weather, and snoring when sleeping. Affected dogs may pant excessively, have exercise intolerance, over-heat, gag, cough, regurgitate, vomit, and in severe cases aspirate, collapse, asphyxiate and even die. Once the spiral of lack of air and overheating starts, it can happen very quickly. The basic problem is there are anatomic structures that are too big trying to fit into a throat that does not have enough space. This causes a vacuum that pulls surrounding tissues into the larynx, restricting breathing. This vacuum effect can also have secondary effects on the gastrointestinal system, such as acid reflux and can progress to lifelong gastrointestinal problems.
The solution is to remove the structures causing the interference, without disturbing ongoing function. Some Brachycephalic dogs are born with narrow nostril openings, which restrict airflow. Surgical correction involves removing a triangular wedge from the bottom of each nostril fold and opening it to the side in similar fashion to opening a curtain. Sutures hold this repair in position until it has healed.
The soft palate is the membrane at the back of the mouth that separates the nasal passages from the larynx. Enlargement, thickening and elongation of the soft palate are the main cause of airway obstruction in most dogs. This causes the familiar ‘snoring’ sound of Pugs, French Bulldogs, British Bull Dogs and many more breeds. Surgery aims to shorten, stretch and/or thin this membrane to stop it blocking airflow and reducing the ‘snoring’ turbulence of airflow.
The laryngeal saccules are inverted membranes that allow the vocal cords to move to close. They are sucked into the airway and are the second most common reason for airway obstruction. Surgical removal is performed to enhance vocal cord mobility and reduce airflow restriction.
Lastly, the tonsils sit at either side at the roof of the mouth become enlarged and can impair airflow, to a lesser degree. They can be removed easily, creating more space in the upper oral cavity.
Studies recommend surgical intervention to be performed before 5 years of age as postponing surgery past middle age allow permanent changes to occur within the larynx that cannot be corrected, and also increases the risk associated with general anaesthesia.
Dr Raewyn has studied BOAS surgery under a specialist surgeon in Auckland and is experienced in all four of the surgeries above. While any general anaesthetic on a brachycephalic dog faces increased risk, the utmost care is taken to minimise these. Each patient receives one week of pre- and post-surgery medication to reduce risk of reflux and vomiting during and post-surgery. During their stay, BOAS cases are given top priority and are consistently monitored by Dr Raewyn or our experienced nurses. Post operative complications in the first few days following surgery include vomiting, gagging, pain, swelling, drug reaction and bleeding. Dr Raewyn and the team support the patient with post-op medications to reduce the recovery time and get every BOAS patient enjoying their new breath of fresh air.
Most cases go home the same day, but on one rare occasion, such as with Dr Raewyn’s oldest BOAS patient Ringo (9 years old), the patient needed extra monitoring and spent the night with Dr Raewyn on her couch. Even though Ringo has permanent changes to his larynx, the BOAS surgery performed was successful and has given him a new lease on life.
Ringo Post Surgery - he was very comfortable to keep his ET tube in place after surgery and have a snooze. Ringo was a rescue French Bulldog and had previously had an eye removed.
To date, all BOAS surgeries at Omokoroa Pet Vets have gone without a hitch and each of Dr Raewyn’s surgeries have seen a dramatic improvement in exercise tolerance, a reduction in raspy breathing and overheating. While we do not take the risks of BOAS surgery for granted, the success rate and improvement of quality of life for our patients builds the confidence in the preparation, surgical techniques and post-op care we provide.
