BAOS - Brachycephalic airway obstructive syndrome

Question 1

Affected systems

Answer 1

Respiratory complications
Gastro-intestinal signs
Cutaneous (e.g., skin fold dermatitis)

Question 2

Secondary Changes

Answer 2

Everted laryngeal ventricles (secondary complication)
Laryngeal collapse (secondary complication)
Pharyngeal soft tissue obstruction:
Dynamic
Diagnosed by fluoroscopy

Question 3

Bronchial abnormalities

Answer 3

קריסת ברונכוסים נפוצה כחלק מהסינדרום וכנראה זו שגורמת לשיעול, לרוב השמאלי הראשי הוא זה שקורס

bronchial collapse

Question 4

gastro-intestinal complications of BAOS

Answer 4

ptyalism, vomiting, regurgitation, repeated swallowing, eructation

Histologic changes were common

Speculated mechanisms:

• Negative pressures during strenuous inspiration induce reflux
• Decreased gastric emptying due to increased sympathetic tone
• Increased acid secretion from gastric hyperplasia
• Hiatal hernia
• Mega-esophagus and esophageal dysmotility

Question 5

Clinical signs

Answer 5

-Inspiratory (+/- expiratory) effort and noise
-Cyanosis
-Stress, heat and exercise intolerance
-Stertor, stridor
-Cough and retching (infrequently):
Tracheal hypoplasia
Bronchial collapse
-Syncope in severe cases

Question 6

Diagnostics Tests

Answer 6

Evaluation of nares, soft palate and larynx
Chest and cervical x-rays, fluoroscopy
Endoscopy

Question 7

Treatment

Answer 7

ניתן לטפל כבר בגיל צעיר אך האינדיקציה היא כאשר החיה מראה סימנים קליניים

Early surgical correction of primary anomalies is crucial in preventing secondary complications

Correction of secondary complications:
Ventriculectomy
Turbinectomy
Corrections of laryngeal collapse

Medical Tx of GI signs:
Omeprazole, sucralfate, metoclopramide

Question 8

Primary Changes

Answer 8

Stenotic nares

Soft palate elongation

Thickening of soft palate

Under-diagnosed

Macroglossia

French and English bulldogs overrepresented

Tracheal hypoplasia

English bulldogs overrepresented

Distorted ethmoidal turbinates

May protrude into nasopharynx

Pugs over-represented

Superfluous soft tissue in oropharynx, edema (may be secondary)