There are minimal data describing brachycephalic airway obstructive syndrome (BAOS) prevalence and individual disease components in brachycephalic dogs (including everted tonsils). This study examined BAOS components and analyzed the frequency occurrence of each component (with 1 or more BAOS components) in a population of medically and surgically treated brachycephalic dogs. Records were reviewed from 90 BAOS dogs that included descriptions of signalment, clinical signs at admission, clinical history, stenotic nares, elongated soft palate, everted laryngeal saccules, everted tonsils, evidence of surgical correction, and perioperative complications. The authors identified prevalence values for everted laryngeal saccules and stenotic nares that differed from those in previous studies. However, these differences may have reflected differences in study design. Stenotic nares, an elongated soft palate, everted saccules, and everted tonsils were the most frequently identified BAOS components in the study. Most dogs had 3 or 4 components, most often stenotic nares, elongated soft palate, everted laryngeal saccules, and everted tonsils; this is suggestive of an increased awareness of the role of everted tonsils in BAOS during surgical examination. Differences in data from this study and prior studies could be partially attributable to the overwhelming increase in the popularity of brachycephalic dogs in the current pet population and possible selection for certain physical characteristics.

Commentary: Small animal practitioners must be cognizant of the perioperative complications associated with brachycephalic dogs. BAOS is an important risk factor in surgical patients, and functions as a key factor in the patient’s abilities to thermoregulate and clear respiratory disease. Our hospital developed a “brachycephalic committee” that routinely scours the literature to search for novel ways to decrease BAOS-associated airway inflammation during anesthetic procedures. We take extra precautions during intubation procedures for brachycephalic dogs, including administration of preoperative steroids and one-on-one recovery technicians. Other anesthetic protocols may also include furosemide administration and judicious administration of respiratory depressants.—Heather Troyer, DVM, Diplomate ABVP (Canine & Feline Practice)

Brachycephalic airway obstructive syndrome in dogs: 90 cases (1991-2008). Fasanella FJ, Shivley JM, Wardlaw JL, Givaruangsawat S. JAVMA 237:1048-1051, 2010.