ER VET

In this episode of ER VET, Dr. Justine Lee, DACVECC, DABT talks about brachycephalic syndrome in dogs (and rarely cats). If your dog snores, you'll want to tune in to learn everything you need to know about elongated soft palate, stenotic nares, everted laryngeal saccules and so much more!

Transcript:

00:00:01.900 --> 00:00:03.520
<Announcer> This is Pet Life Radio.

00:00:03.920 --> 00:00:05.060
<Announcer> Let's talk pets.

00:00:26.459 --> 00:00:28.279
<Dr. Justine Lee> Welcome to ER Vet on Pet Life Radio.

00:00:28.519 --> 00:00:29.299
<Dr. Justine Lee> I'm your host, Dr.

00:00:29.319 --> 00:00:34.779
<Dr. Justine Lee> Justine Lee, and I'm a Board Certified Emergency Critical Care Specialist and a Toxicologist.

00:00:35.159 --> 00:00:36.119
<Dr. Justine Lee> Thanks for joining us.

00:00:36.399 --> 00:00:40.099
<Dr. Justine Lee> Today, we're gonna be talking about Brachycephalic Syndrome.

00:00:40.539 --> 00:00:43.699
<Dr. Justine Lee> This is mostly in dogs, but sometimes in cats.

00:00:44.099 --> 00:00:49.739
<Dr. Justine Lee> So for all you French bulldogs and English bulldogs and pug owners out there, you have to pay attention.

00:00:50.159 --> 00:00:52.539
<Dr. Justine Lee> If your dog snores at night, you have to tune in.

00:00:52.839 --> 00:00:54.519
<Dr. Justine Lee> We'll be right back after these messages.

00:00:57.799 --> 00:00:59.719
<Announcer> Take a bite out of your competition.

00:01:00.319 --> 00:01:04.759
<Announcer> Advertise your business with an ad in Pet Life Radio podcasts and radio shows.

00:01:05.079 --> 00:01:11.999
<Announcer> There is no other pet-related media that is as large and reaches more pet parents and pet lovers than Pet Life Radio.

00:01:12.279 --> 00:01:18.999
<Announcer> With over 7 million monthly listeners, Pet Life Radio podcasts are available on all major podcast platforms.

00:01:19.339 --> 00:01:28.459
<Announcer> And our live radio stream goes out to over 250 million subscribers on iHeartRadio, Audacy, TuneIn, and other streaming apps.

00:01:28.599 --> 00:01:37.699
<Announcer> For more information on how you can advertise on the number one pet podcast and radio network, visit PetLifeRadio.com/advertise today.

00:01:39.839 --> 00:01:42.959
<Announcer> Let's Talk Pets on PetLifeRadio.com.

00:02:01.830 --> 00:02:05.930
<Dr. Justine Lee> Today, I'm gonna be talking to you about all things nose.

00:02:06.450 --> 00:02:08.170
<Dr. Justine Lee> You're probably thinking, what?

00:02:08.710 --> 00:02:12.950
<Dr. Justine Lee> Well, if you've never heard of brachycephalic syndrome, I know it's a mouthful.

00:02:13.450 --> 00:02:16.730
<Dr. Justine Lee> Brachy basically means short-headed.

00:02:17.190 --> 00:02:27.190
<Dr. Justine Lee> So, when we look at brachycephalic breeds, your classic breeds are the English bulldog, the French bulldog, Pekingese, Boston terriers, pugs.

00:02:27.550 --> 00:02:32.750
<Dr. Justine Lee> There are some dogs that have slightly longer heads, like the boxer.

00:02:33.130 --> 00:02:37.290
<Dr. Justine Lee> So, when in doubt, if your dog snores, you probably have a brachycephalic breed.

00:02:37.630 --> 00:02:39.810
<Dr. Justine Lee> Now, don't forget, there's some cats out there too.

00:02:40.030 --> 00:02:45.170
<Dr. Justine Lee> And it's a Persian cat that is the most brachycephalic of all cat breeds out there.

00:02:45.710 --> 00:02:48.530
<Dr. Justine Lee> So, what do I mean about brachycephalic syndrome?

00:02:48.910 --> 00:02:59.010
<Dr. Justine Lee> Well, first of all, this is an airway problem, and this is what we probably have caused by breeding these dogs to have those adorable smushed faces.

00:02:59.410 --> 00:03:11.830
<Dr. Justine Lee> If you can imagine just taking your hand or your palm and pretending to like smush the muzzle of your dog, you can imagine evolution-wise, we basically bred these dogs to have that smushed airway.

00:03:12.150 --> 00:03:19.630
<Dr. Justine Lee> So everything that went from their nose all the way to the back of their head basically gets condensed and smushed into a smaller space.

00:03:20.190 --> 00:03:27.570
<Dr. Justine Lee> So when we talk about brachycephalic syndrome, it's usually a combination of three to four different problems.

00:03:28.110 --> 00:03:31.610
<Dr. Justine Lee> Now, brachycephalic syndrome, again, is seen in these breeds.

00:03:31.630 --> 00:03:37.490
<Dr. Justine Lee> And I would say the number one breed that I see it in is typically the French bulldog and English bulldog.

00:03:37.890 --> 00:03:39.190
<Dr. Justine Lee> Now, why do you care?

00:03:39.550 --> 00:03:41.590
<Dr. Justine Lee> You care because it makes your dog snore.

00:03:41.990 --> 00:03:45.750
<Dr. Justine Lee> Not a big deal, but I will disclose, I have a French bulldog.

00:03:46.130 --> 00:03:48.790
<Dr. Justine Lee> I usually am a huge advocate of adopting.

00:03:48.810 --> 00:03:53.890
<Dr. Justine Lee> I always say, you know, don't breed or buy when homeless animals die, but there's some breeds I just love.

00:03:54.390 --> 00:03:56.070
<Dr. Justine Lee> I usually am a pit bull adopter.

00:03:56.090 --> 00:04:00.170
<Dr. Justine Lee> I like to adopt pit bull puppies because they're so hard to find homes for sometimes.

00:04:00.590 --> 00:04:14.470
<Dr. Justine Lee> Well, I happened to be able to find a French bulldog when I was basically approached by a fellow veterinarian, and they had this poor French bulldog puppy who unfortunately had parvovirus.

00:04:14.890 --> 00:04:24.770
<Dr. Justine Lee> Parvovirus is like almost 99% protective with the vaccine, but your dog needs at least three to four vaccines to be fully protected from parvo.

00:04:25.250 --> 00:04:33.990
<Dr. Justine Lee> Unfortunately, without vaccination or without more than one to two vaccines, your puppy is really immunosuppressed and not protected from this virus.

00:04:34.470 --> 00:04:41.370
<Dr. Justine Lee> So unfortunately, the French bulldog ended up getting parvovirus and got really sick, so I ended up fostering him and adopting him.

00:04:41.870 --> 00:04:42.990
<Dr. Justine Lee> And he's amazing.

00:04:43.130 --> 00:04:45.850
<Dr. Justine Lee> However, he also has brachycephalic syndrome.

00:04:46.050 --> 00:04:47.550
<Dr. Justine Lee> So what exactly is it?

00:04:48.130 --> 00:04:50.850
<Dr. Justine Lee> Again, it's four to five different problems that we see.

00:04:51.050 --> 00:04:55.490
<Dr. Justine Lee> The first problem that we see is an elongated soft palate.

00:04:55.770 --> 00:05:06.810
<Dr. Justine Lee> If you can imagine sticking your finger into your mouth, you can feel that soft part of your mouth at the roof of your mouth, and then you feel that hard palate, which is like the ridges of the back of your mouth.

00:05:07.230 --> 00:05:20.830
<Dr. Justine Lee> Well, that soft, fleshy part in the very beginning part of your mouth basically helps protect food from going into, you know, like the brain cavity, but also to make sure that your dog doesn't inhale the food into their airway.

00:05:21.470 --> 00:05:30.510
<Dr. Justine Lee> If that soft palate is too long, it often protrudes and blocks the airway, and it really interferes with air getting into the lungs.

00:05:31.230 --> 00:05:37.070
<Dr. Justine Lee> The second syndrome, a brachycephalic syndrome, is something called stenotic nares.

00:05:37.530 --> 00:05:45.290
<Dr. Justine Lee> And these are basically when the nostrils of a dog are smooshed and they are basically occluded and they can't breathe.

00:05:45.550 --> 00:05:49.790
<Dr. Justine Lee> So you could hear I was basically smooshing my nostrils and I sound different.

00:05:50.550 --> 00:06:00.150
<Dr. Justine Lee> Well, if the diameter of the nostril is small and it's only a quarter of the size that it should be, you can imagine how hard it is for your dog to breathe through your nose.

00:06:00.570 --> 00:06:09.210
<Dr. Justine Lee> My dog had a tiny, tiny stenotic nares where he couldn't get a lot of airflow in, and he often couldn't smell well.

00:06:09.370 --> 00:06:12.330
<Dr. Justine Lee> And I often noticed my pit bull could smell lots of good things.

00:06:13.230 --> 00:06:16.750
<Dr. Justine Lee> And I would put a treat right near my French bulldog and he wouldn't smell it.

00:06:17.090 --> 00:06:20.330
<Dr. Justine Lee> So they probably don't have as strong of a sense of smell either.

00:06:20.630 --> 00:06:25.350
<Dr. Justine Lee> So not only do they have that elongated soft palate, but they also have a stenotic nares.

00:06:25.830 --> 00:06:32.290
<Dr. Justine Lee> The third part of brachycephalic syndrome is something called averted laryngeal saccules.

00:06:32.710 --> 00:06:42.930
<Dr. Justine Lee> Now, I know that sounds like a mouthful, but that's basically where there's too much tissue within the airway just in front of the vocal folds or the vocal cords.

00:06:43.270 --> 00:06:49.730
<Dr. Justine Lee> And oftentimes it gets pulled into the trachea or the windpipe, and this can block the airflow also.

00:06:49.870 --> 00:07:05.390
<Dr. Justine Lee> In other words, remember when I mentioned smooshing your dog's muscle, if you did that to a golden retriever, a long nose dog, and you ended up smooshing their nostril and their muzzle, all that extra tissue sort of just folds up on itself.

00:07:05.750 --> 00:07:11.430
<Dr. Justine Lee> And so with these smoosh-faced breeds, again, all that extra tissue is in their airway and can block their airway.

00:07:11.610 --> 00:07:17.910
<Dr. Justine Lee> The last couple of syndromes that we can see with brachycephalic syndrome include a narrow trachea.

00:07:18.390 --> 00:07:24.350
<Dr. Justine Lee> And so the trachea, again, is basically the tube that goes from the mouth into the lungs.

00:07:24.850 --> 00:07:29.430
<Dr. Justine Lee> It's gonna go from your vocal cords and bring oxygen directly into the lung.

00:07:29.790 --> 00:07:35.930
<Dr. Justine Lee> Well, you can imagine if you had a tube and it's only half the normal diameter, you can't get enough oxygen in.

00:07:36.390 --> 00:07:38.050
<Dr. Justine Lee> We can normally see this on X-ray.

00:07:38.390 --> 00:07:39.750
<Dr. Justine Lee> So this is something we worry about.

00:07:40.150 --> 00:07:44.390
<Dr. Justine Lee> Now, these are the most common problems that we see with brachycephalic syndrome.

00:07:44.750 --> 00:07:58.610
<Dr. Justine Lee> There's a couple of rarer types, and that's when the larynx or the voice box folds or collapses completely, or very rarely when there's paralysis of the larynx or the cartilage within the larynx.

00:07:58.650 --> 00:07:59.570
<Dr. Justine Lee> And those are rarer.

00:07:59.910 --> 00:08:01.030
<Dr. Justine Lee> Why am I telling you this?

00:08:01.390 --> 00:08:08.530
<Dr. Justine Lee> Because if you have one of these breeds that has a history of snoring or breathing harder, they can't breathe well.

00:08:09.010 --> 00:08:17.370
<Dr. Justine Lee> And if you notice this or you can hear it, you do want to talk to a veterinarian about potential options and what we can do to avoid it.

00:08:17.730 --> 00:08:19.210
<Dr. Justine Lee> So what can you do?

00:08:19.570 --> 00:08:22.990
<Dr. Justine Lee> So let's talk about signs of brachycephalic syndrome.

00:08:23.330 --> 00:08:40.950
<Dr. Justine Lee> If your dog wretches or has difficulty swallowing or snores or just gets really tired when they're walking, gets really, really tired when they're overly excited, can't go for a walk in the heat or the humidity, well, your dog may have brachycephalic syndrome.

00:08:41.450 --> 00:08:53.070
<Dr. Justine Lee> If you're staring at your adorable dog and you notice that the nostrils are like tiny little vertical slits instead of the normal P-shaped nostril, that means your dog has stenotic nares.

00:08:53.510 --> 00:09:02.870
<Dr. Justine Lee> And these signs have to be fixed because I can't tell you how many times I see brachycephalic dogs presenting into the ER Vet for difficulty breathing.

00:09:03.250 --> 00:09:08.570
<Dr. Justine Lee> Now, there are other problems that can contribute and make brachycephalic syndrome worse.

00:09:08.950 --> 00:09:10.750
<Dr. Justine Lee> And the first one is obesity.

00:09:11.450 --> 00:09:18.230
<Dr. Justine Lee> Now, 40 to 60, up to 70% of pets in the United States are overweight to obese.

00:09:18.690 --> 00:09:22.730
<Dr. Justine Lee> And obese we define as greater than 20%, the ideal body weight.

00:09:23.310 --> 00:09:33.350
<Dr. Justine Lee> If you have a purebred, my go-to recommendation is to go to the American Kennel Club website, the AKC website, and see what the average weight is for that breed of dog.

00:09:33.530 --> 00:09:34.490
<Dr. Justine Lee> Why is this important?

00:09:34.790 --> 00:09:44.350
<Dr. Justine Lee> Because when you actually Google what the ideal weight on an AKC breed is, you'll see what the ideal weight is for you Labrador Retriever dogs.

00:09:45.030 --> 00:09:48.570
<Dr. Justine Lee> Oftentimes Labrador Retrievers are 60 to 70 pounds.

00:09:49.190 --> 00:09:52.930
<Dr. Justine Lee> And if you have a Labrador who's 90 pounds, that's not healthy, right?

00:09:53.070 --> 00:09:55.850
<Dr. Justine Lee> All that extra weight aggravates so many problems.

00:09:56.230 --> 00:10:00.290
<Dr. Justine Lee> We know in veterinary studies, it predisposes them to osteoarthritis.

00:10:00.710 --> 00:10:03.270
<Dr. Justine Lee> It predisposes them to a shorter lifespan.

00:10:03.730 --> 00:10:09.070
<Dr. Justine Lee> All that extra obesity or all that extra fat can actually cause difficulty breathing.

00:10:09.430 --> 00:10:13.370
<Dr. Justine Lee> So it's gonna aggravate the clinical signs of brachycephalic syndrome.

00:10:13.490 --> 00:10:24.430
<Dr. Justine Lee> So especially if you have an English bulldog, you have a French bulldog, I know these guys love to eat, but it's really, really important that you make sure to keep them on the skinnier side.

00:10:25.110 --> 00:10:30.210
<Dr. Justine Lee> We'll continue with this really important information right after these messages from our sponsors.

00:10:33.310 --> 00:10:35.030
<Dr. Justine Lee> Molly, here's your dinner.

00:10:39.550 --> 00:10:41.650
<Announcer> Don't let that happen to your precious cat.

00:10:41.830 --> 00:10:45.110
<Announcer> Elevate your cat's eating experience with the cat tree tray.

00:10:45.330 --> 00:10:50.750
<Announcer> The cat tree tray keeps your cat's food off the floor and conveniently located on the cat tree.

00:10:51.130 --> 00:10:53.270
<Announcer> It's the perfect way to eat.

00:10:53.650 --> 00:11:01.090
<Announcer> It's a beautiful wrought iron tray that easily attaches to your cat tree and keeps dogs and other critters out of your cat's dish.

00:11:01.430 --> 00:11:03.290
<Announcer> A must for multi-pet households.

00:11:03.570 --> 00:11:07.550
<Announcer> There's a six inch tray for large bowls and a four inch tray for smaller bowls.

00:11:08.010 --> 00:11:10.670
<Announcer> Purchase your cat tree tray today.

00:11:10.990 --> 00:11:13.510
<Announcer> Go right now to www.cattreetray.com.

00:11:13.750 --> 00:11:15.630
<Announcer> That's www.cattreetray.com.

00:11:45.132 --> 00:11:48.062
<Dr. Justine Lee> PetLifeRadio.com Welcome back to ER Vet on CatLife Radio.

00:11:48.382 --> 00:11:52.422
<Dr. Justine Lee> We've been talking about the really hard to say word Brachycephalic syndrome.

00:11:52.722 --> 00:11:54.802
<Dr. Justine Lee> Again, that means short headed.

00:11:55.242 --> 00:12:03.942
<Dr. Justine Lee> And so if you have a dog that snores, and yes, I'm talking to you French bulldog, English bulldog, Pekingese, all those little smaller dogs with smushed faces.

00:12:04.402 --> 00:12:08.762
<Dr. Justine Lee> These are when we see that combination of medical problems where they just can't breathe well.

00:12:09.142 --> 00:12:24.622
<Dr. Justine Lee> Again, that includes things like that extra long soft palate, the stenotic nares, the averted laryngeal saccules, to things like that narrow trachea or even abnormal cartilage of the larynx or voice box in the mouth.

00:12:24.782 --> 00:12:29.242
<Dr. Justine Lee> We've talked about what signs to look for, such as noisy breathing or snoring.

00:12:29.382 --> 00:12:39.202
<Dr. Justine Lee> And we talked about how obesity or being overweight can really worsen these problems because it results in a lot of internal body fat compressing the trachea and the airway.

00:12:39.462 --> 00:12:41.102
<Dr. Justine Lee> So what do we do about it?

00:12:41.542 --> 00:12:51.622
<Dr. Justine Lee> Well, the reason why I'm actually doing this episode is because my amazing adopted French bulldog, who I ended up adopting, he just had stenotic nary surgery.

00:12:52.162 --> 00:12:56.282
<Dr. Justine Lee> And he had Brachycephalic surgery because I want to make sure he can breathe better.

00:12:56.562 --> 00:12:58.022
<Dr. Justine Lee> So how do we diagnose it?

00:12:58.322 --> 00:13:02.102
<Dr. Justine Lee> Well, you can just look at your dog and see if your dog has stenotic naries.

00:13:02.122 --> 00:13:06.902
<Dr. Justine Lee> That's really easy to see when they have those little slits and not a normal size nostril.

00:13:07.322 --> 00:13:16.562
<Dr. Justine Lee> But to see if your dog actually has an elongated soft palate or those averted laryngeal saccules, well, that has to be done under heavy sedation or anesthesia.

00:13:16.862 --> 00:13:26.582
<Dr. Justine Lee> So if you're getting your dog spayed or neutered, if it's one of those brachiosophallic breeds, this is something your veterinarian has to evaluate, okay?

00:13:27.102 --> 00:13:39.282
<Dr. Justine Lee> And if you're not sure, you want to go to a vet who specializes in the surgery because they may be able to spay and neuter your dog and fix the stenotic naries or that elongated soft palate at the same time.

00:13:39.902 --> 00:13:50.902
<Dr. Justine Lee> With brachiosophallic breeds, we really want to minimize anesthesia or even sedation because they have such difficulty breathing and recovering from sedation or anesthesia.

00:13:51.122 --> 00:14:00.262
<Dr. Justine Lee> Now, I will say most brachiosophallic breeds are really hard to do an oral exam on because they have huge muscles, masseter muscles of their jaws.

00:14:00.282 --> 00:14:06.322
<Dr. Justine Lee> They have a really thick tongue, and it makes it really hard to visualize the voice box while they're awake.

00:14:06.342 --> 00:14:09.362
<Dr. Justine Lee> So unfortunately, we can't do it while your dog is awake.

00:14:09.382 --> 00:14:11.362
<Dr. Justine Lee> It has to be done under anesthesia.

00:14:11.682 --> 00:14:19.602
<Dr. Justine Lee> And what we're looking for is if that soft palate extends beyond the tip of the epiglottis, which is the start of the airway.

00:14:20.202 --> 00:14:30.802
<Dr. Justine Lee> If we do find that your dog has an elongated soft palate, we'll often do what we call a soft palate resection or trim where we'll actually cut that excessive tissue away.

00:14:31.382 --> 00:14:46.022
<Dr. Justine Lee> The next thing we'll do is if we see averted laryngeal saccules and that looks basically like these grayish blue masses in the back of your dog's mouth, in front of the vocal folds, if that's back there, those need to be removed also.

00:14:46.402 --> 00:14:57.882
<Dr. Justine Lee> And last with stenotic nares, oftentimes a surgeon or a veterinarian will take out something called a wedge, a piece of tissue on the side to basically open up the diameter of the nostrils.

00:14:58.582 --> 00:15:10.282
<Dr. Justine Lee> Now, when in doubt, please know surgery isn't necessarily curative because while it makes the stenotic nares less stenotic and it makes them bigger, they still have a lot of redundant tissue in the back.

00:15:10.662 --> 00:15:15.442
<Dr. Justine Lee> But it can help significantly and really help avoid a trip to the emergency room.

00:15:16.042 --> 00:15:26.942
<Dr. Justine Lee> When in doubt, talk to a board certified veterinary surgeon or your veterinarian to see if your French bulldog or English bulldog or smushed face snoring dog needs his surgery.

00:15:27.462 --> 00:15:35.922
<Dr. Justine Lee> I'm a huge fan of doing this surgery, especially if your dog's undergoing anesthesia or sedation, because we really want to minimize any kind of breathing problems.

00:15:36.482 --> 00:15:46.162
<Dr. Justine Lee> If you ever notice that your dog turns blue, the gum color turns blue, they're panting all the time, they're overheated, please bring them to the ER Vet right away.

00:15:46.522 --> 00:15:50.082
<Dr. Justine Lee> And please also know, brachycephalic breeds shouldn't go running.

00:15:50.242 --> 00:15:52.282
<Dr. Justine Lee> They shouldn't exercise on hot days.

00:15:52.302 --> 00:15:58.082
<Dr. Justine Lee> I'm talking like greater than 78 degrees Fahrenheit or really humid days, like greater than 80%.

00:15:58.542 --> 00:15:59.802
<Dr. Justine Lee> They can really overheat.

00:16:00.222 --> 00:16:09.082
<Dr. Justine Lee> If you need to, I always recommend walking them on the shady side or in the cooler parts of the day, either really early in the morning or in the evening.

00:16:09.402 --> 00:16:14.242
<Dr. Justine Lee> We still want your dog to exercise because that's a great way of keeping them in shape and keeping that weight off.

00:16:14.502 --> 00:16:19.122
<Dr. Justine Lee> But when in doubt, if you have one of those smushed face dogs, please make sure to keep them healthy.

00:16:19.562 --> 00:16:21.742
<Dr. Justine Lee> Well, that brings me to the end of today's show.

00:16:21.822 --> 00:16:30.762
<Dr. Justine Lee> Find me at DrJustineLee.com, on Facebook or Instagram at DrJustineLee, or email me your pet questions at DrJustine at PetLifeRadio.com.

00:16:31.162 --> 00:16:35.882
<Dr. Justine Lee> With that, we're out of time, and we want to thank Mark Winter, our producer, for making this show possible.

<Announcer> Let's Talk Pets, every week on demand... only on PetLifeRadio.com