Syndrom brachycefaliczny. Rozpoznanie, etiologia, interwencje chirurgiczne

Pathophysiologic consequences

Given their narrowed nostrils and nasal passages, brachycephalic dogs must produce higher negative pressure to breathe properly. Wiestner et al discussed the intra-nasal resistance issue: „It is speculated that an increase in R(NA) is the underlying cause, although the final proof of this hypothesis has not been provided. It is assumed that increased R(NA) causes various soft tissues to be drawn into the lumen by the air stream, which leads to airway obstruction”.

Their findings (the 4 clinically normal Bulldogs had R(NA) values ranging from 1,69 to 3,48 kPa/(L/s), whereas in the 4 Bulldogs with respiratory problems, R(NA) ranged from 9,83 to 20,27 kPa/) sustain the hypothesis of increased intra-nasal resistance. This can be clinically observed in the nostrils but also in the larynx. The cuneiform and corniculate cartilages are drawn into the glottal opening following increased inspiratory efforts causing laryngeal collapse. In these cases inspiratory stridor and even suffocation can be observed. In such patients the laryngeal ventricles are usually everted into the laryngeal lumen.

Other findings in BD suffering from upper airway compromise

Many owners describe signs of regurgitation or vomiting when their BD becomes excited or suffers from respiratory distress, whose signs are usually relieved when the dog vomits or regurgitates large packs of „foam”. In a study on 73 brachycephalic dogs suffering from the upper airway syndrome, respiratory and digestive signs were graded as minimal (grade 1), moderate (grade 2), or severe (grade 3) according to their frequency and severity. A correlation between gastric and respiratory signs severity was demonstrated (p = 0,059).

Diagnosis

Diagnostic tools

Diagnosis is based on breed, age, clinical signs. Diagnostic imaging is the basis for a proper evaluation. Radiographic, CT, or MRI examinations are used to assess the length and thickness of the soft palate, as well as ...

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