Brachycephalic syndrome and the French Bulldog is synonymous.

As breeders we try to select dogs in our breeding program that are comfortable breathers. However, we all know the roulette that is dealt in the offspring we receive. As the old saying goes, “the best laid plans!”

What is to be done when you have a particular dog that is suffering from this syndrome? What is new in the treatment of this syndrome and when should we be concerned? These are all good questions. The resigned answer of, “this is a Bulldog and none of them can breathe well and this situation is to be expected” is not a reasonable healthy sequelae.

Brachychephalic syndrome consists of stenotic nares (small nasal openings), an elongated soft palate (a consequence of the shortening of the muzzle) and everted laryngeal saccules (tissue in front of the trachea that is pulled into the airway causing a flow obstruction). Left untreated this can progress into laryngeal collapse – inability of the larynx to open and allow airflow, and respiratory stridor – increase noise particularly on inhalation due to obstruction of air flow. This syndrome can consist of one or all of the above problems. Secondary problems that may also manifest consist of frequent regurgitation, tracheal collapse, exercise intolerance and possible aspiration pneumonia.

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The goal of treatment for anyone owning a dog plagued by any of these problems is to seek early treatment. The earlier the intervention is initiated, including medical and surgical correction, the better the quality and the length of life is for the pet. Many times I hear clients say, “let’s wait and see how he does as perhaps this will be something that is outgrown”. This is never the case. As French Bulldog puppies grow, so does their head. The breed is defined as a “head breed” and this is particularly problematic in male dogs. The heads of the boys can be quite massive and have an extensive soft palate. The constant need to literally “suck in the air” to breathe causes a negative pressure in the trachea. This constant pull on the tracheal rings causes the integrity to become weak. Over time this weakening of the tracheal rings will cause collapse and the need to for a tracheostomy to be performed for allow air flow to the lungs.

At the point of tracheal collapse the damage has been done. There are tracheal stents which try to reestablish the integrity of the wind pipe, as well as the need sometimes for a permanent to be surgically performed. Unfortunately, dogs that are this far along in the disease process are now very prone to pneumonia, implant rejection and infection at the opening of the tracheostomy site. This is not where any of us want to have our beloved pet. Early intervention is the key to a long and happy life and this syndrome must be treated early when clinical signs are first noticed. Sometimes treatment may require secondary surgeries and follow up. If the soft palate is only slightly long it is perfectly reasonable to correct the nares and see how much resolution is achieved. Often times, if done early, this are all that may be needed to resolve the problem.

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Treating a problem such as brachycephalic syndrome often will start with simple medication. Usually an antihistamine coupled with an anti-inflammatory, such as prednisone, is a good place to start. However, because the problem is usually a function issue, medication can only provide a limited resolution. Often the best option is to surgically correct the main problem causingtracheostomy the obstruction of air flow at the nares, the palate and occasionally the laryngeal saccules. Stenotic nares can be easily corrected by surgically taking a wedge out of the lower part of the nares. If done correctly this will substantially increase the amount of air that the dog is able to breathe. Often this is the first surgical step in treating this disease. While the dog is anesthetized for this procedure, evaluation of the soft palate and saccules is also done. The only way to determine the extent of the palate and saccule involvement is with general anesthesia, while the dog is intubated (having a tube placed into their trachea to deliver oxygen and anesthetic gas). Despite the amount of upper airway noise from stridor and snoring, all factors must be evaluated independent of each other. Breathing difficulty is often a result of one or several problems.

page5Testing is now offered through the Orthopedic Foundation for Animals (OFA) involving a radiographic study of the trachea to determine the diameter. Tracheal hypoplasia is a condition that is seen in several brachycephalic breeds where the trachea is substantially narrow resulting in breathing difficulties. Scores that exceed 2.0 are considered normal and less than 2.0 are considered to have tracheal hypoplasia. We must remember that this test is only a tool and does not in any way relate to the conformation of the nose or the upper airway. It is also unclear how highly heritable selecting for proper nasal and tracheal function translates into puppies.

As responsible breeders, educators and fanciers, we must make people that purchase our puppies attend our educational programs and interact in our daily Frenchie life. New owners should be aware of these potential problems, and we need to counsel them to seek early corrective resolution and management as oftentimes puppy owners look to their breeders for advice and guidance. This is not something that we should be embarrassed by or kept hidden. These problems cannot be easily overcome unless we want our breed to look like a Greyhound – it is what makes a French Bulldog a Frenchie.

Brachycephalic syndrome should be discussed openly and the medical management and/or surgical repairs done early to provide the best quality of life for our dogs. Although we strive to breed dogs that are free from this syndrome we must offer support and sound guidance when confronted with a dog or puppy that needs help.