Brachycephaly (Flat-head syndrome)
Brachycephalic syndrome consists of a number of complaints that result from anatomic anomalies of the dog’s head. Short-nosed dogs are almost exclusively affected.
The anomalies described in "causes" impair the airflow through the dog’s upper airways. Subsequent symptoms are: loud breathing noises, laboured inhalation, blue-violet discoloration of mucous membranes (resulting from a lack of oxygen), and in severe cases, unconsciousness. Most affected animals snore constantly either during walks or at home on the couch. Sounds that are often perceived by owners as entertaining or calming breathing sounds may really mean that there is significant amount of stress being placed on the dog’s respiratory system. This stress on the respiratory system that leads to a rise in body temperature, which requires that a larger amount of oxygen be inhaled. Thus, the breathes more frequently. Hence, a vicious cycle develops. The mucosa lining the nasal cavity and the pharynx becomes swollen and inflamed as a result the increase in breathing activity. The dog’s vocal cords, found in narrowest part of the larynx, are often narrowed. Even a minimal breathing impairment may result in chronic respiratory or cardiac damage if it remains for a long period of time. After excitement, exercise or in high outside temperatures symptoms are pronounced. Pugs often suffer from cartilage softness which can lead to laryngeal collapse or surrounding tissue may prolapse into the larynx. Many affected dogs also show complaints of the digestive tract. Inflammation of the esophagus occurs as the result of an insufficient closure of the stomach sphincter, situated at the entry of the stomach, and can produce symptoms of heartburn. Breeds that are predisposed towards brachycephalic syndrome are also prone to develop a hydrocephalus, skin-fold pyoderma, nose-fold pyoderma and a certain type of congenital heart disease (known as Fallot’s tetralogy).
Short-nosed breeds include the Pug, French and English Bulldogs, Shi Tzu, Chihuahua, Pekinese, Maltese, Boxer, and others. These breeds are popular for their short noses, wide sculls and large, protruding eyes. Brachycephalic syndrome is the result of dog breeding aimed at obtaining animals with a shortened head and an especially shortened nose. As the development of the skull is impaired, a number of anatomic anomalies occur. These anomalies are especially visible in Pugs and French and English Bulldogs and may seriously interfere with the physiological function of vital organs. Common complaints involve narrowed nostrils, elongation and thickening of the soft palate, extended laryngeal pouches, laryngeal collapse (severe deformation of the laryngeal cartilage), enlarged tonsils, and in English Bulldogs tracheal collapse. The severity of these anomalies is variable. Yet these anomalies are intentionally selected by breeders to obtain Pugs and Boxers with virtually no noses. Therefore, an increasing number of animals are currently suffering from respiratory distress related to having an overall shortened head and nose.
Therapy should be aimed at relieving, if possible, the narrowing of the upper airways and other factors that can contribute to respiratory distress, i.e. excessive exercise, excitement or the accumulation of heat. The method of choice is a surgical correction of the respective anatomical anomalies. Just which surgery is performed depends upon the nature of the anomaly. For example, narrowed nostrils can be widened with surgery, while an elongated soft palate can be shortened. These measures often produce visible improvement in the dog’s physical condition and lead to a significant rise in their quality of life. Surgical correction should be performed as early in life as possible so respiratory impairment is kept minimal. Dogs suffering from a collapsed larynx may require a number of surgeries to correct the problem. Plastic surgery of the nostrils, resection of the soft palate, or a widening of the laryngeal pockets, and in some cases, removal of the tonsils is often necessary. In specialized clinics treatment is now available in which anatomical anomalies are corrected by using a diode-laser under CT-control. Owners should note that anytime general anesthesia is used it places a high physical burden on brachycephalic breeds. Therefore the risks related to anesthesia must to be considered higher than normal. Even dogs who are otherwise healthy may develop complications during routine surgery. Prognosis for recovery depends upon the number and severity of anomalies and if they can be corrected surgically or not. If possible and necessary, as a general rule the sooner surgery is performed the better. Unfortunately, laryngeal collapse generally has a poor prognosis and tracheal collapse cannot be treated. In cases where corrective surgery is not an option, the condition is usually worsens later in life. Subsequent complaints are likely to develop. Although some breeders are now trying to breed dogs with longer noses, this may not fully resolve the problem, as lary
If your dog shows symptoms of respiratory distress, such as a blue-violet discoloration of the tongue, avoid placing any kind of stress on him/her. A visit to the vet is always a stressful event for your dog, but may be necessary in this case. Please try to stay calm, as your own anxiety or nervousness may be sensed by your dog, and worsen the situation. During the hot summer months you can help keep your dog cool by covering him/her with wet towels, while leaving the pads of the paws uncovered. If possible, lower the temperature inside your house or car. Another point that owners of brachycephalic breeds remember is that having your dog’s teeth cleaned and removing tartar is very important. Due to the result of the abnormal position of the jaws in brachycephalic breeds, normal cleaning of the teeth is impaired.