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Updated: May 20, 2019


Upper Airway Syndrome

There are four upper airway obstruction conditions that commonly affect bulldogs. It is important to know that not all bulldogs have these problems or require surgery. Some dogs may only have one or two of these structural issues, and not necessarily to the same degree.

First, a bulldog can have nostrils that are too narrow. This is called stenotic nares. The openings in the nostrils are too small and the sides of the nostrils are pulled in with inhalation making the openings even smaller. With laser surgery, we make the openings larger.

The second upper airway obstruction condition is elongated soft palate. The palate (roof of the mouth) should end in a position where it does not interfere with air passing into the opening of the windpipe. When a bulldog has an elongated soft palate, the palate tissue partially blocks the opening of the windpipe. Many dogs live with this for a while with only excessively loud breathing noises or snoring. But when an affected dog becomes hot or excited, the palate swells and more of the windpipe opening is blocked. The dog has difficulty breathing, makes loud clattering breathing noise and can even collapse or faint. Untreated elongated soft palate causes poor quality of life, inability to enjoy normal play and even death. The time to surgically correct this is when the elongated soft palate is diagnosed on physical exam (looking in the back of the mouth) and there are any (even mild) signs of difficult breathing. Most of the time, we have found that a sedative helps to visualize the extent of the problem. With surgery, we shorten the palate to its normal length where it does not interfere with breathing. We use a CO2 laser for palate surgery. This results in virtually no bleeding, less chance of complications and a more comfortable recovery from the surgery for the bulldog.

When we do a soft palate surgery, we look for everted laryngeal saccules, the third upper airway obstruction condition. Everted laryngeal saccules are tissue from the wall of the larynx that protrudes into the windpipe. If these are there, we surgically remove them, too.

The fourth upper airway obstruction condition is a windpipe that is too small (hypoplastic trachea). This is diagnosed with an x-ray of the chest. This is the only upper airway obstruction that cannot be corrected. Puppies with extremely small tracheas do not live to adulthood. Most adult dogs with hypoplastic tracheas can live with the condition as long as all other airway obstruction conditions are corrected. Most affected dogs respond well to medication to make it easier to breathe.

Even with surgical corrections of these problems, there are natural restrictions within the nasal bones (turbinates) which cannot be corrected. These natural “pinch points” slow down the air flow and can create noise. The nasal turbinates are scroll-like thin bone plates inside the nose and they are covered with mucus membranes. They function to warm and moisten the air and the membranes provide immune surveillance against infectious respiratory pathogens. In the brachycephalic breeds (Bulldogs, French Bulldogs, Pugs, Shih Tzu, and all the “pushed in” face breeds), the base of the skull is genetically foreshortened, resulting in a “compression” of the head and face. All the soft tissues inside are “squished” into a shorter skull. Thus, even with a great corrective surgery of the nares and soft palate, some dogs can still have breathing noises.

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