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Frenchie with advanced Brachycephalic syndrome

Most people are not familiar with the term "Brachycephalic," but if you own a Pug, Boston Terrier, Pekingese, Boxer, Bulldog, Shih Tzu or any one of the other breeds with "pushed in" faces, you should become familiar with this word. The word comes from Greek roots "Brachy," meaning short and "cephalic," meaning head. 

Brachycephalic dogs have been bred so as to possess a normal lower jaw, that is, one in proportion to their body size, and a compressed upper jaw. In producing this cosmetic appearance, we have compromised these animals in many important ways and you, as an owner, must be familiar with the special needs.

STENOTIC NARES - This is a fancy name for narrowed nostrils. The brachycephalic dogs have very small nasal openings for breathing. If this is severe, surgical correction is an easy surgery by a soft tissue surgeon DVM, DACVS well experienced in the protocol. These specialists can also determine at the same time if further airway surgery needs to be done to eliminate problems later on.

Sometimes local DVMs offer attempting nares surgery can do a very unattractive job and butcher the nostrils so they look unnatural. So ask questions and request before and after pics of some of the surgeries they have done to be sure it is done as you want.


Elongated and/or thickened soft palate (extra long/thick tissue that hangs down in the back of the throat that causes gagging, breathing noises)

It is difficult to fit the soft tissues of the canine mouth and throat into the brachycephalic short face. As a result, the soft palate, which separates nasal passage from oral cavity, flaps loosely down into the throat creating snorting sounds.

Elongated/thickened soft palate is best corrected early from 6 months to a year old to prevent further damage to the dog's airway such as 

  • Everted laryngeal saccules

  • Compromised Laryngeal function 

Everted laryngeal saccules (“balloon” type structures that extend outwards in the throat area that limits air movement and can cause noisy breathing)

Laryngeal collapse (weakness of the cartilages near the Adams apple) Other factors, not on this list that are associated with BOAS in some breeds include neck girth ratio (neck width), body condition score/obesity (body weight), nasopharyngeal abnormalities (20% of dogs) and bronchial collapse (87% dogs, collapse of small airways in the lungs).

Complete nares, soft palate and saccule surgery


What causes airway syndrome?

Heat Stress 

Because of all these upper respiratory obstructions, the brachycephalic dog is an inefficient panter. A dog with a more conventional face and throat is able to pass air quickly over the tongue through panting. Saliva evaporates from the tongue as air is passed across and the blood circulating through the tongue is efficiently cooled and circulated back to the rest of the body. 


In the brachycephalic dog, so much extra work is required to move the same amount of air that the airways become inflamed and swollen. This leads to a more severe obstruction, distress, and further over-heating.

In addition to these airway changes, dogs can also have abdominal issues consisting of salivation, vomiting and regurgitation. It has been shown that up to nearly 80% of dogs with brachycephalic syndrome have gastrointestinal changes consisting of acid reflux, hiatal hernia, pyloric stenosis, stomach/esophageal inflammation, which is secondary to the changes in pressure created by the abnormal airway. Many of these dogs vomit regularly. When their airway resistance is corrected with surgery, the abdominal signs tend to improve as well.


1) Get good insurance for your pet with unlimited coverage and covering congenital issues like Airway Surgery. I recommend Figo currently.

2) Have airway surgery done by a specialist vet that has done extra education in soft tissue surgery usually designated by initials DACVS after DVM. These specialists are located in specialty hospitals combined with other specialties like Cardiology and Neurology and require a referral from your regular DVM. I do not recommend letting a DVM perform this surgery. Also laser should not be used for this surgery.


I recommend FIGO



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