Category: respiratory problems

Lungworms in dogs (Angiostrongylus)

Referring to Angiostrongylus vasorum as a lungworm is quite misleading. Although the early stages of the parasite do affect the lungs and severely infected dogs may show signs of coughing, other signs are far more common. These lungworms (Angiostrongylus vasorum) are also known as the French heartworm.

This is a parasite where the adult worm infects dogs but the young stages are carried by slugs and snails. The parasite itself may not cause the dog any problems unless present in very large numbers. However, in order to survive in the blood vessels the parasite releases substances which affect the clotting of the host’s blood. Thus infected dogs are more prone to bleeding than normal dogs. This bleeding can pose a life-threatening risk to an affected pet. Thus this parasite is can be more dangerous to a dog than the more common worms that live in the intestine and it is very important to take precautions to prevent infection.

This disease used to be confined to dogs living in the South of the country (especially the South East, South West and South Wales). However, in the last ten years the disease has become much more common and has been seen in dogs as far North as Scotland. All dogs in the UK should now be considered potentially at risk.

The adult worms spend most of their lives in the blood vessels close to the heart. However, when the eggs laid by the adults hatch, the immature worms (larvae) force their way through the walls of the blood vessels and into the lungs. The dog then coughs up the larvae and swallows them. The larvae pass into the faeces which is in turn eaten by slugs and snails (which love dog poo!).

The larvae develop in their new host until this is eaten by a dog. Slugs and snails often crawl into dog’s food bowls or onto toys if these are left outside. Dogs also eat these garden pests when drinking from outdoor water sources and eating grass. Once back in the dog the young worms make their way back through the dog’s body to the blood vessels.

Many infected dogs show no signs of illness. Dogs that are unwell show a wide range of symptoms: breathing problems, coughing, bleeding excessively from cuts or bleeding internally with no signs of trauma, anaemia and loss of condition. Other animals may show neurological changes including seizures. If your dog is unwell in any way make an appointment to see your vet.

Not all dogs with lungworm show breathing-associated signs. The adult worms in the blood vessels and heart can cause heart failure but also produce a substance to stop the blood clotting. This can cause your dog to bleed, with or without an injury. The bleeding can take place inside the body and may affect the brain or eyes resulting in seizures or blindness.

It is unlikely that your vet will know straight away what is wrong with your dog and they will need to do a number of tests in most cases to make the diagnosis. If you live in an area where lungworm is common your vet may be more familiar with the disease and may be suspicious of the signs at an earlier stage. If there is a suspicion that your dog is infected your vet can do a test for lungworms.

The infection can’t pass direct from to dog without first passing through a slug or snail. However, if you have several dogs living in the same household and one is found to be infected it is likely that the others will also be at high risk of infection. The common lungworm of dogs (Angiostrongylus vasorum) does not affect cats or people.

The aims of treatment are to eliminate the lungworm infection and also to manage the clinical signs. There are a number of drugs that can be used to eliminate the worms but infected dogs should be monitored carefully when receiving treatment as the sudden killing of the worms could result in a severe allergic reaction.

If your dog has severe signs (particularly affecting the brain or signs of heart failure) your vet will want to keep your pet in the hospital for specialised care.

Most dogs go on to make a full recovery with appropriate treatment. However, infection can prove fatal for some dogs despite intensive treatment.

Most dogs are infected by contact with slugs or snails (and usually from eating these) – so if you can reduce your dog’s exposure to these that will reduce the risk.

Regular treatment of your dog with a product that can kill the worms can help to protect them against infection. The standard worming treatment that you give your pet every 3 months or so may not protect them from lungworm infections. You will need to get additional treatment from your vet and this may be given in the form of a monthly spot-on (at the back of the neck) which will protect against lungworms and treats your dog for other common parasites such as fleas, worms, and mites. Contact your own vet for further advice on the risks to your dog and how to manage them.

Laryngeal paralysis

Laryngeal paralysis causes respiratory (breathing) noise and exercise intolerance in medium and large breeds of dogs. The disease is very slowly progressive and may start very subtly, so by the time you notice significant breathing noise or inability to exercise it might be quite far progressed. If you notice these changes in your dog you should seek veterinary advice and have a vet check your dog for possible associated problems or diseases.

The larynx is the voicebox, but it has many other functions than producing sound. All of the functions of the larynx require the vocal cords to open and close. Tensing of the vocal cords during air movement produces sounds. When your dog breathes in, the vocal cords open to allow more air in, the harder the breathing, the more open the larynx is to maximize air flow.

The larynx also stops food and liquids from entering the windpipe (trachea).  During swallowing or vomiting, the vocal cords move together to completely close the opening of the larynx. If any food, water, or irritant reaches the larynx, trachea, or lungs, coughing occurs to force foreign materials out of the larynx or airways.

Just before coughing, a deep breath is taken to completely fill the lungs, and the larynx opens wide to let that large amount of air in. During the cough, the larynx closes partially, making the air move rapidly at a high pressure, pushing out the abnormal material.

Laryngeal paralysis is lack of function of the larynx due to damage or degeneration of the nerve supply to the laryngeal muscles. Loss of the nerve function leads to loss of muscle contraction. The end result is a larynx that cannot open and close normally.

If the vocal cords cannot move out of the larynx, the larynx does not open wide enough to allow maximum airflow. If this happens your dog will not be able to exercise normally and can even progress to episodes of collapse, or passing out.

Laryngeal paralysis is typically a disease of larger breed dogs (such as setters and Labrador retrievers) and some medium breeds (Brittany spaniel). In most cases the nerves degenerate over time as part of a general disease of the nerves. Because the nerves degenerate slowly the signs of disease are not seen until dogs are quite old, usually more than 9 years old.

However some dogs have other diseases that cause laryngeal paralysis and may be affected at less than 1 year of age. In most affected dogs the signs really only affect the larynx but some dogs may have diseases affecting other nerves in the body and these may show signs of regurgitation (inability to swallow food properly) or difficulty in walking.

The first sign of laryngeal paralysis may be a subtle change in bark. Slowly progressing, the condition then results in noisy breathing, especially during panting. The noise is usually much worse during activity, when maximal air flow is required. Since the vocal cords cannot move, they sit in the airway and vibrate as the air flows by, resulting in the noise that we call “stridor.”

If the condition progresses, your dog may not be able to move sufficient air through the larynx panting (in hot weather) or during exercise, resulting in a blue tinge to the tongue and lips. In hot weather your dog may be at risk of developing heat stroke as efficient panting is the dog’s main cooling mechanism. The worst clinical signs are those of collapse, passing out, and potentially death.

Your vet will listen to your dog’s breathing and can recognise the stridor, or noise, as being more prominent during inhalation, or when you dog breathes in. They will also carefully listen to the lungs in an attempt to diagnose aspiration pneumonia. Other conditions can also cause coughing and exercise intolerance, such as heart disease, so listening to the chest with a stethoscope is very important.

An ultrasound machine can be used to look at the vocal cords during breathing but the best way to diagnose laryngeal paralysis is to look directly at the larynx. In order for your vet to do this your dog will need to have a very mild general anaesthetic so that your dog will allow the vet to look into your dog’s throat.

Although it is uncommon to find an underlying cause for laryngeal paralysis your dog should be tested for the conditions that can cause laryngeal paralysis. If one is missed, the condition could lead to more signs in the rest of the body, such as the regurgitation or difficulty walking. Since the larynx cannot close to protect against aspiration pneumonia, chest X rays are important. They also allow the heart size and shape to be evaluated for potential heart disease that could cause coughing and exercise intolerance.

Your dog’s general health should be assessed prior to general anaesthesia required for laryngeal examination, so blood and urine samples are usually tested. If your vet has any concerns about other specific diseases they may want to perform other tests.

Once nerve and muscle function are lost they cannot be recovered. If the laryngeal paralysis results in a decreased quality of life, a surgery can be done to permanently tack one side of the larynx in an open position and allow better airflow past the vocal cords. A vet with experience with this type of procedure should be able to perform the surgery with minimal difficulty. Your vet may want to refer your dog to a specialist surgeon for the operation.

Laryngeal paralysis is a slow, progressive disease. You may not notice early changes, as you are with your dog every day and mild changes are hard to recognise. Changing your dog’s activity level and keeping them in a cool environment may help and your dog may be more comfortable wearing a harness rather than a collar.

If the condition is affecting your dog’s quality of life, you can consider surgery. Surgery may never be done or can be done early in the course of the disease. The most important thing is to know what you and your dog like to do for a happy quality of life and to know the potential outcomes after surgery.

The strict answer to this question is no because laryngeal function cannot be restored. The surgery restores the ability of air to move past the larynx, relieving the problem of obstruction of air flow. Thus, most dogs have less noisy breathing, can be more active, and are at a reduced risk of overheating. You should notice an immediate improvement in your dog’s ability to exercise, but do not let them overdo it early on!

For an experienced vet the surgery is rapid and relatively straightforward. After surgery you must keep your dog quiet for a couple of weeks to ensure that healing has occurred. If the stitches break during this period then the vocal cords will flop back into the larynx.

After surgery one vocal cord is always in an open position, so the ability to protect the airways and lungs is permanently lost. Your dog may cough or clear its throat more frequently, especially when eating, drinking, or exercising because material may contact the larynx and first part of the trachea.

Your dog will always be at risk of developing aspiration pneumonia after surgery. Some dogs never get it, some get it once and respond to treatment, some get it repeatedly, and rarely a dog dies of aspiration pneumonia. Early detection and treatment are key to minimising the affect of aspiration pneumonia.

Coupage for dogs

If you think your pet has a respiratory condition that might benefit from coupage, seek advice as soon as possible from your veterinary surgeon or veterinary physiotherapist.

Coupage is a form of chest physiotherapy that when performed correctly can be beneficial in loosening and removing excess secretions from the lungs. Many respiratory conditions result in an accumulation of secretions (also called mucous, phlegm, sputum) within the lungs that the patient cannot easily clear. This can result in difficulty breathing, poor gas exchange, collapse of lung segments and infection.

The lungs naturally produce mucous as part of their natural defence mechanism. When there is a chest infection, and occasionally with other conditions, the mucous increases and becomes thick and sticky. In the normal situation, these secretions are removed by coughing, but if the animal has lung disease or weakness, this is not always possible. The use of antibiotics can control any infection but they do not remove the secretions. Some will be absorbed naturally into the body but some will remain within the lungs.

Excess secretions provide a good environment for infection to develop as well as causing breathing difficulties. They block the airways and prevent the passage of oxygen from the inspired air to the blood stream, so having a detrimental effect on gas exchange. It is important therefore to remove the secretions to allow more effective and efficient breathing and increase the amount of oxygen getting into the body.

It is certainly possible for you to perform coupage on your pet as long as you have received training from an appropriately qualified veterinary professional. Coupage is a specialised technique. However, veterinary professionals will be adequately trained to perform it. In particular, chartered physiotherapists will have undergone extensive training in all chest physiotherapy techniques.

In many cases, coupage is more effective when used in combination with other techniques such as postural drainage and vibrations, and if appropriate you will also be advised about these.

  • Hands should be formed into a ‘cup’ shape (with your fingers and thumb held closely together).
  • Keeping your wrists loose you should flex and extend them whilst you gently pat your pet’s chest wall in a rhythmical manner. Your hands should pat the chest alternately, moving around the area being treated. Do not use too much force when performing this technique as the momentum developed in your wrists is sufficient, and too much force can be uncomfortable and may be detrimental to your pet.
  • The coupage technique sends shock waves to the lungs which loosen the secretions and allow their transfer from the small airways to the larger airways where they can be cleared by coughing.
  • Coupage can be performed using a one-handed or two handed technique and at a slow or fast speed, but you should be taught the correct technique for your pet by your veterinary professional.
  • The technique should be performed through a sheet or thin towel to prevent too much stimulation to the skin. If your pet is small you can perform the same technique with 2 or 3 fingers from one hand.
  • In most cases, coupage should be continued for 30 seconds to one minute. You should perform the technique continually during the advised time period.
  • The hands are positioned on the chest wall over the affected part of the lung, and the chest is vibrated. During each vibration the hands gradually move towards the head end.
  • Vibrations are only carried out whilst your pet is breathing out (during the expiration phase), so each vibration lasts for approximately 3-6 seconds.
  • Generally 4-6 repetitions are carried out before allowing the animal a short rest period and then resuming coupage.

Postural drainage involves getting your pet into the best position to allow secretions to drain from the affected part of the lung. There are positions appropriate to all parts of the lung, and if appropriate you will be taught the postions that should be adopted for your pet.

When the techniques of coupage, vibrations and postural drainage are used in combination, the optimal chest physiotherapy regime is as follows:

Your pet should be positioned in its postural drainage position for 10-20 minutes, during which time the following should be carried out as in the example below:

  • Coupage for 30 seconds to 1 minute
  • Vibrations for 4-6 expirations
  • Rest period of 1-2 minutes to allow drainage of the now loosened secretions
  • Repeat several times over the 10-20 minute period*

*The number of repetitions, times, etc. will be determined by your veterinary professional (treatment is individual for the patient).

Coupage dislodges the secretions, vibrations move them towards the large airways, and the postural drainage position then allows the secretions to drain during the rest periods. Your pet may cough during its treatment, thereby clearing some of the mucous from its airways. It is common however for animals not to cough during treatment, but to cough 15-20 minutes later once they are walking around. Sometimes the secretions are swallowed rather than being coughed up, but at least they are out of the lungs.

Chest physiotherapy should never be done straight after a meal or drink, and you should wait at least one hour before starting the treatment.

Chest physiotherapy treatment involving coupage, vibrations and postural drainage should only be carried out when excessive secretions are known to be present. This may be once a day or it may be 4-5 times a day, but you will be advised on this. It is often more beneficial to do it after periods of rest (e.g. first thing in the morning) when the animal has been relaxing and the secretions have been draining naturally.

Performing these techniques on animals that have no secretions can be detrimental to that animal’s overall condition. Your pet should therefore be reassessed regularly during the treatment period, so you can receive updated guidance from your veterinary professional as to the appropriateness of continuing this therapy.

Coughing in dogs

It is not uncommon for dogs to cough occasionally. However, if your pet is coughing frequently or has persistent episodes of coughing then you should seek veterinary advice. There are many causes of coughing and many of these can be treated successfully. Some dogs occasionally cough when they get excited or pull on their lead. Many causes of coughing if left untreated, can progress over time causing severe consequences for your pet. If your dog develops a constant cough, an intermittent cough that does not get better after 2 weeks or becomes at all unwell then you should make an appointment to see your vet.

The trachea (also known as the wind pipe) is a tube that runs from the throat down into the chest where it branches to form the major airways in the lungs. The normal trachea is a soft tube that is held open by numerous rigid rings of cartilage. Coughing is the result of irritation or inflammation of the sensitive lining of any part or the airways or the lungs, and is an important protective mechanism allowing the removal of foreign material and mucus from the airway.

In young animals coughing is more likely to be caused by an infection, as a result of the dog inhaling a foreign body (such as a grass awn) or irritation due to smoke or other irritants. Some dogs have a congenital problem with their trachea which can allow the trachea to collapse and obstruct their airway so that they cough every time they get excited or pull on their lead. Brachycephalic dogs (those with short noses like pugs) may have long term respiratory problems that cause persistent or intermittent coughing.

In older animals other causes of coughing, such as heart disease and tumours, become more common. However, chronic bronchitis and other long term diseases reflecting damage to the respiratory tract over a lifetime can also develop in later life. A cough associated with chronic airway disease may be persistent but not get worse and your pet may remain bright and well otherwise.

Older dogs may also develop damage to the nerve controlling the vocal cords and these can obstruct their airway causing coughing particularly after eating, drinking or swimming if food and liquids pass into the airways instead of the oesophagus (the food pipe or gullet).

If your dog is coughing it is really important to get your vet to check them over to identify any possible causes that require treatment or to reassure you that nothing more serious is going on.

Some dogs with a cough may be completely normal in other respects, but this depends entirely on the underlying cause of the cough. In a young, otherwise healthy dog, kennel cough (infectious tracheobronchitis) is the most likely cause of cough. This usually gets better without treatment in 1 to 2 weeks but if coughing is persisting beyond this time or your pet is unwell you should seek veterinary advice. If you are taking your dog to the vet and think there is any possibility your dog may have kennel cough then it is advisable to leave you dog in the car until the vet has examined your dog, rather than risking potentially passing it to other dogs in the waiting room.

Dogs with pneumonia may have a fever, be off their food and feel pretty miserable. Nasal discharge may be present and this can be clear or snotty. Dogs with heart disease or lung problems may also have breathing problems and be unable to exercise normally. If laryngeal paralysis is present the changes to the vocal cords can cause changes in the tone of a dog’s bark (generally sounding hoarse), and exercise intolerance with some dogs developing blueness of the membranes (cyanosis) in their mouth or even collapse after exercise.

When presented with a coughing dog your vet will first want to establish some information which may help then localise which part of the respiratory tract is affected. Questioning you about the nature of the cough (whether it is dry or moist, intermittent or always present) will provide valuable information so it is important you think about the circumstances in which your dog coughs before you attend the veterinary visit. If you are able to take a video clip of your dog coughing on your mobile phone this may help your vet further. Your vet will want to examine your pet and look for any other signs of illness such as fever which may give a clue as to the cause of the cough. By listening to your dog’s chest with a stethoscope your vet will be able to assess heart and lung health. There are many diseases that can cause chronic coughing and your vet will want to rule out the more serious causes of coughing before a final diagnosis is made.

Investigation of coughing involves X-rays of the trachea and the chest and your vet may want to pass an endoscope (a small tube with a camera on the end) through the trachea and down into the lungs to take some samples; these are usually washes to look for inflammatory or cancerous cells, and to provide material for culture.

The treatment of coughing varies greatly depending on the cause. In some cases, if the cough is not too severe, no treatment may be necessary. Medical treatment may be available for coughing related to heart disease and infectious causes of cough. Rarely, if more sinister disease such as cancer is present, other treatment options willbe considered. It is important not to administer human cough medicine to your dog without veterinary advice.

Collapsing trachea

If you have a small dog that coughs every time it gets excited or pulls on its lead it may be suffering from tracheal collapse. Tracheal collapse results in narrowing of the airway and, if left untreated, can progress over time causing severe consequences for your pet. If your dog develops a cough that does not get better after 2 weeks you should make an appointment to see your vet.

The trachea (also known as the wind pipe) is a tube that runs from the throat down into the chest where it branches to form the major airways in the lungs. The normal trachea is a soft tube that is held open by numerous rigid rings of cartilage. In some dogs the tracheal rings gradually weaken over time so that they are not sufficiently rigid to hold the tube open and the walls collapse inwards narrowing the airway.

Tracheal collapse is mostly seen in toy breeds (e.g. Yorkshire terriers, Pomeranians and Poodles) but has also been reported in some larger dogs. In many toy breeds of dog there is a tendency to have softer tracheal rings which makes development of tracheal collapse more likely. Most dogs are middle-aged (around 7 years of age) when they develop signs but occasionally a congenital form is present from birth and can cause clinical signs in animals as young as 4 months of age. Animals with tracheal collapse that are overweight are more likely to show signs of coughing.

Dogs with tracheal collapse initially develop a classical cough which may persist for months or years before owners seek investigation. The cough associated with tracheal collapse is described as ‘goose honking’ as it supposedly sounds like the noise made by geese. The cough often comes on when the dog is excited or has been pulling on the lead and once an affected dog has started to cough they may have a prolonged bout during which they cannot stop coughing. Affected dogs may faint during a coughing spell. Severely affected animals may be unable to exercise normally and may even turn blue when they are excited or stressed.

Your vet will probably suspect a diagnosis of tracheal collapse based on the history and by listening to your dog cough. However, there are other diseases that can cause chronic coughing and it is important to make sure these are not present before a final diagnosis is made. Investigation of the condition involves X-rays of the trachea and the lungs and your vet may want to pass an endoscope (a small tube with a camera on the end) through the trachea to see if collapse is occurring.

In many cases it is possible to control the condition initially with simple changes to management. Weight loss in overweight animals will always help and, since coughing is exacerbated by exercise or pulling on a lead, exercise reduction and fitting a harness instead of a collar should help reduce the cough. Any respiratory diseases should be treated and environmental triggers such as pollens and cigarette smoke should be avoided.

Medical treatment may also be required to control the signs. Steroids can be used to reduce the irritation in the airways; sometimes these are given using an inhaler (similar to that used by asthmatics) as this reduces the side effects of steroids on other parts of the body.

Other drugs that may help to reduce coughing are cough suppressants, airway dilators and drugs to dry up secretions in the airways. Your pet may also need courses of antibiotics from time to time to reduce bacterial infections in the airways. Most animals cope reasonably well on medical management for years after diagnosis.

In some cases medical treatment alone is not sufficient and if this is the case it may be wise to talk to your vet about possibilities for surgery. The aim of surgery is to help improve the structure of the trachea to limit collapse as much as possible; this helps to improve airflow, but will not completely resolve other signs such as coughing.

An operation is available to place artificial rings around the trachea to hold it open; this technique can work very well, however this operation is very challenging as often the collapsing portion of the trachea lies within the chest so the procedure is not without risks. More recently techniques to provide internal support to the trachea using stents have had promising results. A tracheal stent is a flexible metallic tube, usually made of a special metal called nitinol (a nickel titanium alloy), which is designed to stay within the lumen of the trachea and hold it open.

Stents are placed under general anesthesia using fluoroscopy (real time movie like X-rays) to assess positioning. The stent needs to be carefully measured so that it is the correct size, but once in position, they are very well tolerated to the extent that the tracheal membrane will grow over the inert surface of the stent and they stay in position lifelong. Stent placement is much less invasive compared to open surgery with very encouraging long term results.

Surgical treatments of tracheal collapse should be performed by a specialised veterinarian with experience and specialist training in the technique, so your vet may make a referral to a specialist centre for the procedure. It is important to remember that the aim of surgery is to help improve airflow and that longer term medication will be needed after both artificial ring and stent placement to limit coughing and prevent inflammation.

Brachycephalic upper airway obstruction syndrome (BUAOS)

If you are considering buying, or already own, a dog with a short nose such as a Pug, Boston terrier, Pekingese or Bulldog then you need to be aware of the welfare issues surrounding brachycephalic upper airway obstruction syndrome.

Over the past hundred years human beings have designed for themselves a huge number of different dog breeds. The conformation of some of these breeds has become more extreme and sadly many health problems have been introduced into the dog population as a consequence. The continual increased selection pressure for ‘desirable’ physical traits has resulted in many pets presenting with more severe manifestations of certain congenital conditions and at a much younger age.

Brachycephalic upper airway syndrome otherwise known as BUAOS arises from the effects of a group of congenital anatomical defects present in brachycephalic breeds. Brachycephalic breeds of dogs are those with characteristically short noses such as the Pug, Boston terrier, English and French bulldog and Pekingese. Animals with shortened noses still have the same amount of tissue in their nose and throat but this is squashed into a smaller space which causes folds and wrinkles that obstruct the airways. Animals with BUAOS may have one or more of the following defects:

  • Excessively long and thickened soft palate.
  • Narrowed laryngeal lumen caused by protruding laryngeal saccules.
  • Collapsed larynx.
  • Stenotic nostrils.
  • Excessively narrow trachea, especially common in bulldogs.

The abnormal anatomical conformation of these dogs means that airflow through airways is impeded resulting in noisy breathing and an inability to take on board sufficient oxygen to meet increased demands imposed by exercise. The nasal cavity has a huge surface area covered by richly vascularised tissue that in normal dogs cools inhaled air thus forming an important part of the body’s mechanism for temperature regulation. This is compromised in brachycephalic breeds and many breath through their mouth bypassing the nasal cavity altogether.

This explains why many of these breeds have poor heat tolerance and cope poorly with hot weather. Hot weather also causes swelling of the tissues in the nose and throat further impeding airflow and exaggerating symptoms.

Severely affected dogs may show signs of breathing problems at a very young age (4-6 months of age) although most will present with signs at around 1-3 years of age. The first signs you may notice if your dog has BUAOS are that it has noisy breathing or may snore loudly whilst sleeping. In fact many owners of dogs with short noses such as pugs and bulldogs think it is normal for their pets to snore and snuffle. However, these noises indicate that their pet’s airways are already narrowed and breathing is difficult. Dogs with BUAOS frequently have significantly disrupted sleep as every time they lie down and relax their airways become obstructed.

Many dogs with BUAOS are unwilling (or unable) to exercise normally and this can predispose them to putting on weight which further exacerbates their problems. Sudden deterioration in breathing may develop, leading to respiratory distress or sudden collapse (particularly in hot weather). This deterioration may be brought on by exercise and excitement. Severely affected animals may have almost total airway obstruction and can develop fluid build-up on the lungs. Animals that have severe bouts can die rapidly if they do not get emergency veterinary treatment.

When dogs are hot they cool themselves by panting. When they pant they move air back and forth over their hot airways and thus evaporate water and lose heat. Dogs with BUAOS are unable to move air through their airways efficiently which prevents adequate heat loss through panting. Dogs with BUAOS are at particular risk of over heating in hot weather, following exercise or when under stress.

The diagnosis is based on the clinical signs (and typical breed) but further examination may be required to confirm the diagnosis and rule out other conditions. If your vet suspects that your dog is suffering from BUAOS they will want to perform a detailed inspection of the upper airway with your dog under anaesthesia and may pass an endoscope (containing a small camera) through your dog’s airways so they can access which abnormalities your dog has and how severe each of these is. These examinations are best performed by a veterinary surgeon experienced at treating this condition so that treatment can be carried out at the same time. Anaesthesia and examination without correction poses unnecessary risk to your pet.

There have been many reports suggesting that brachycephalic dogs often have difficulty or experience pain on swallowing and some may regurgitate or vomit frequently. This may be due to reflux of fluid from the stomach but many brachycephalic dogs also have anatomical defects in the gastrointestinal tract. Some examples of these include: hiatal hernias (where part of the stomach passes through a larger than normal hole in the diaphragm into the chest), and pyloric stenosis (where the stomach exit is narrowed preventing food from leaving the stomach normally).

Always make sure you give your vet a full history of all your dog’s problems even if you think one (like breathing difficulties) is more important. In many cases treatment of the airway problem with improve the gastrointestinal symptoms but more severely affected patients may require additional medication.

Most animals with BUAOS will be improved if they lose weight, so a dietary regime forms part of any management.

Because BUAOS is caused by congenital abnormalities of the airways the only way to resolve the problems is to correct the underlying abnormalities. Surgical procedures can open up the nostrils and remove excess tissue within the airways that is restricting airflow. Surgical correction requires a great deal of skill and is not without risks. Your vet may choose to refer you for treatment to a surgeon who specializes in these procedures.

Following surgery, the lives of affected animals should be significantly improved. Correction of the reversible primary abnormalities early in life will slow down or potentially prevent secondary irreversible changes occurring that would otherwise compromise the airway further. This emphasizes the importance of critically evaluating how well your pet can breathe early in life and seeking professional advice.

Since the condition is inherited it is important not to breed from animals that suffer from BUAOS (even if they have had surgery) as their offspring will also be affected. Unfortunately most show animals in affected breeds have been deliberately bred to produce the external appearances that are the result of these defects (such as a very short nose and flat face) so the defects are present to a greater or lesser extent in all animals within the breed.

Ultimately BUAOS is a significant welfare issue in brachycephalic breeds and the only way this can be alleviated is by breeder acceptance that extreme conformations (such as excessively short noses) are not desirable in dogs.

If your dog is registered with the Kennel Club and has had correction of any conformation abnormalities associated with BUAOS please notify the Kennel Club that these surgical procedures have been performed.

If you are worried about your pet in any way, but especially if it appears to have breathing problems, then you should contact your vet for advice.