Brachycephalic Syndrome

This is a medical condition that affects short snouted dogs and cats. Brachycephalic breeds are particularly common nowadays with a massive increase in numbers of French bulldogs, pugs and Staffordshire bull terriers.
As a direct result of this increase in these breeds we are seeing a rise in cases of animals suffering from Brachycephalic Syndrome. What effectively this means is that there is an airway obstruction in these pets that results in these animals having to make more of an inspiratory effort when they breathe. 

There are four main anatomical deformities that cause this constriction:
1. Stenotic nares
2. Elongated soft palate
3. Everted laryngeal saccules
4. Narrow(hypoplastic) trachea 


Stenotic nares
This problem is visually obvious and can be seen in a normal consult. Looking at the nose the nasal folds are collapsed inwards, as a direct result of this the animals have a constricted airway, it would be like trying to breathe through your nose whilst pinching your nostrils. 

Elongated Soft Palate
At the back of the mouth on the dorsal aspect behind the hard palate lies the soft palate, a tissue that acts like a valve preventing food going up the back of the nasal cavity. In these problematic breeds there is often a problem where the soft palate is too long and fleshy and this results in a restriction of air flow through the pharyngeal area. 

Everted laryngeal saccules
At the entrance to the trachea in the larynx there are laryngeal saccules. Due to negative inspiratory pressure in animals suffering with stenotic nares and the elongated soft palates this often results in eversion of the saccules , this in turn further compounds the narrow airway. This element of the condition can be prevented in many cases if surgical correction of the nares and palate are tackled early.

Narrow hypoplatic tracheas
This is pretty much self explanatory and there is nothing much that can be done with these cases. These animals will also always have a respiratory problem.

Consequences of the above can be catastrophic for the animal. The increased respiratory effort over a long period of time has knock on effects on the cardiovascular system, and long term will cause heart failure and chronic respiratory problems. 

Signs/ Synptoms to look out for
Loud inspiratory noise
Mouth breathing
Very little exercise tolerance/collapse
Narrow nares
Sleep apnoea
Snoring
Regurgitation /choking/vomiting
Cyanosis(blue tongue) 


Treatment
With advances in veterinary medicine and equipment surgery of the nares and the elongated soft palate can be done with very little risk to the pet. It is very important that this is done early when the dogs are still young as this will mitigate long term damage to the cardiovascular and respiratory systems. THIS IS NOT A CONDITION TO IGNORE UNTIL ANIMAL GETS OLDER. Surgery is not 100% curative due to the major anatomical problems but they will alleviate symptoms and will extend the life of your pet.
At the Gibraltar Veterinary Clinic we have invested heavily on a laser machine to undertake laser surgery , this means that soft palate surgery is as safe as spaying your pet, this is practically no bleeding and there is very little damage to the surrounding tissue. Therefore there is hardly any post operative swelling; this was often the problem with the older more primitive techniques.

In summary Brachycephalic Syndrome is a common ailment of brachycephalic breeds that if left will substantially decrease the lifespan of your pet. If you feel your pet is suffering from the above please phone the clinic on 20077334 and make an appointment to discuss your case, don’t ignore it, surgical correction could extend your pets' lives.

Is your dog always scratching??

There are a multitude of causes of pruritus (itching) in dogs and it is impossible to cover all of these in one article, where pruritus is the presenting symptom this condition can be broadly be divided into two categories, one is parasitic and the other is allergic dermatitis.

Today I shall be dealing primarily with the main cause of allergic dermatitis, which is atopic dermatitis.

The cause of this is allergens in the environment, microscopic molecules that translocate across the skin and result in histamine release mainly by mast cells in the sub-epidermal tissues. This histamine release causes pruritus, therefore the dog scratches itself; this then breaks the skin barrier and damages the skin’s protectant layers allowing bacteria, usually staphyloccos aureus, to cause a secondary skin infection. These skin infections are often seen as concentric rings and are often confused with ringworm( a fungal infection).  This secondary skin infection in itself also causes inflammation and more pruritus, this causes more itching etc and therefore a cascade effect is set off.

When neglected and treatment is not sought promptly enough the problem can escalate, with further yeast infection and often more pathogenic bacteria invading the affected areas. At this point the dog has a particularly pungent odour and you are looking at a long protracted course of treatment to bring the condition under control.

The equivalent in humans to atopy in dogs, again broadly speaking, is asthma. Due to the different distribution of mast cells in dogs these develop skin problems as opposed to coughing and respiratory problems. In the cat on the other hand feline asthma is particularly common, but that is a topic I will leave for another day.

The areas of principally affected by atopy in dogs are those with poor coat cover and often areas of increased movement, and it generally first presents when the dog is over a year of age.  Most classical sites affected are the groin, axilla, ventral areas, feet and ears. If your dog has recurrent skin problems in the afore mentioned regions then you are more likely than not dealing with an atopic dermatitis and therefore treatment must be tailored at this.

Another pattern you might notice is you might find that the condition is seasonal; again this can often be correlated very closely with people who suffer from asthma. For example if the flare up is in spring then it is likely to be caused by the increase in pollen in the atmosphere. If the flare up is in colder periods when these allergens are markedly reduced then the condition is most likely to be caused by house allergens, the main culprits being house dust mites. In the winter dogs will seek more warmth and blankets are a great habour for these mites. Keeping the bedding clean is not sufficient, washes have to be at high temperatures to kill the mites otherwise all you are doing is giving the mites a shampoo and blow dry and putting them back.

Treatment is a relatively simple affair but it will be a minimum of three weeks of aggressive therapy, usually when the dog is presented for treatment the skin is already infected, and skin infections need an obligatory period of three weeks of antibiotics and adjunct medicines, shampoos etc. One of the main shortfalls of treatment is not giving the animals medication for long enough, therefore the problem recurs rapidly and the clients become disenchanted.

The biggest challenge once the condition is diagnosed is trying to control the illness long term with prophylactic therapy. There are a multitude of options available, there is no specific treatment plan to treat all dogs, and it has to be tailored to each individual case. This varies with the severity of the problem and the response to treatment by each individual animal, so sometimes patience is a virtue.

In summary if your dog has recurrent skin complaints with itching, usually affecting the same regions then your pet is probably suffering from atopic dermatitis and the earlier it is treated the better  and the easier it is to manage the problem.