Brachycephalic obstructive airway syndrome: much more than a surgical problem

Mitze, Stefanie; Barrs, Vanessa R.; Beatty, Julia A.; Hobi, Stefan; Bęczkowski, Paweł M.

doi:10.1080/01652176.2022.2145621

Cited by 19 publications

(11 citation statements)

References 115 publications

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“…Progressive increase in airway resistance and pressure changes during breathing may result in laryngeal collapse or progression of laryngeal collapse when it is already present. But, in the absence of stridor and absence of laryngeal collapse during laryngoscopy, progression of BOAS as the sole cause was considered less likely 30,31 . In this case, the soft palate was shortened to the desired level, which corresponded to just rostral to the most rostral edge of the PMMA block.…”

Section: Discussionmentioning

confidence: 98%

“…But, in the absence of stridor and absence of laryngeal collapse during laryngoscopy, progression of BOAS as the sole cause was considered less likely. 30,31 In this case, the soft palate was shortened to the desired level, which corresponded to just rostral to the most rostral edge of the PMMA block. Cinical signs improved after FFP, supporting the hypothesis that the significant progression of BOAS was secondary to the stabilisation construct exacerbating the narrowing of the nasopharyngeal passage.…”

Section: Discussionmentioning

confidence: 99%

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Deterioration of brachycephalic obstructive airway syndrome in a French bulldog following surgical stabilisation of atlantoaxial subluxation with concurrent atlas malformation

Perez¹,

Renfrew²,

Jack³

et al. 2023

Vet Record Case Reports

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A 2‐year 10‐month‐old French bulldog presented with a history of intermittent yelping episodes and low head carriage. Examination revealed cervical hyperaesthesia and grade I brachycephalic obstructive airway syndrome. Magnetic resonance imaging and computed tomography of the cervical vertebral column demonstrated a malformation of the atlas and atlantoaxial subluxation causing spinal cord compression. Ventral atlantoaxial stabilisation was performed, aided by three‐dimensional printed, patient‐specific drill guides, bicortical bone screws and polymethylmethacrylate. Four months later, the patient re‐presented being pain free but for deterioration of upper respiratory noise, distress and exercise intolerance. Grade III brachycephalic obstructive airway syndrome was evident on examination. Assessment of the post‐stabilisation computed tomography images and recent radiographs suggested that the rapid progression of brachycephalic obstructive airway syndrome had been caused by the stabilisation construct causing further narrowing of the nasopharynx by ventral and rostral displacement of the dorsocaudal nasopharyngeal wall. A folded flap palatoplasty was performed leading to excellent short‐ and long‐term outcome.

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Section: Discussionmentioning

confidence: 98%

Section: Discussionmentioning

confidence: 99%

Deterioration of brachycephalic obstructive airway syndrome in a French bulldog following surgical stabilisation of atlantoaxial subluxation with concurrent atlas malformation

Perez¹,

Renfrew²,

Jack³

et al. 2023

Vet Record Case Reports

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“…Brachycephalic breeds, due to their airway and chest confirmation, are notorious for hypoventilation, especially in the face of illness (Mitze et al . 2022). The body has mechanisms in place to compensate for this chronic respiratory acidosis.…”

Section: Discussionmentioning

confidence: 99%

Acid–base and electrolyte evaluation in dogs with upper GI obstruction: 115 dogs (2015‐2021)

Lozano,

Yankin,

Perry

et al. 2023

J of Small Animal Practice

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ObjectivesMetabolic alkalosis, although uncommon in small animals, has been previously associated with gastrointestinal obstructions. Depending on the population and disease process evaluated, previous prevalence of metabolic alkalosis is reported as ranging from 2% to 45% in canine patients. The objective of this study was to determine the prevalence of metabolic alkalosis and other acid–base and electrolyte disorders in a cohort of dogs with a confirmed upper gastrointestinal obstruction.Materials and MethodsElectronic medical records were reviewed to identify dogs who presented for vomiting with evidence of an upper gastrointestinal obstruction from January 2015 to October 2021. Patients were enrolled only if a preoperative venous blood gas was obtained and analysed in house. Traditional acid–base analysis was utilised to determine an acid–base status before relieving the obstruction. When available, post‐operative venous acid–base status was determined within 24 hours after surgery, and compared to preoperative results.ResultsA total of 115 dogs were included in the study. Twenty‐five out of 115 (22%) dogs displayed either a simple metabolic alkalosis or a mixed acid–base disturbance before surgery. Twenty‐seven out of 115 dogs (37%) had a normal acid–base status at entry. Seventy‐one dogs had pre‐ and post‐operative venous blood gas results available. Metabolic alkalosis was resolved in nearly all patients post‐operatively, with no patients displaying a simple metabolic alkalosis. A mixed metabolic acidosis and respiratory alkalosis was the most common condition post‐operatively, found in 25 of 71 (35%) dogs. Severe derangements of electrolytes were infrequent preoperatively (3/115; 2.6%). A majority of patients in this study exhibited hypokalaemia (64.4%), hypochloraemia (72.8%) and hyponatraemia (77.4%) on preoperative venous blood gases. Venous pH, PvCO2, bicarbonate and base excess were significantly higher preoperatively when compared to the post‐operative results.Clinical SignificanceThis study found the prevalence of pre‐operative metabolic alkalosis in dogs with a documented upper gastrointestinal obstruction to be lower than previously reported. Surgical or endoscopic alleviation of the upper gastrointestinal obstruction resulted in resolution of metabolic alkalosis in nearly all patients.

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“…The diagnostic significance of respiratory indicators in pets has received insufficient research attention 19,20 . A major challenge with BOAS is its frequent lack of recognition by the general public, as well as by veterinary surgeons 7,[21][22][23][24] .Moreover, the lack of a standardized, objective and easily applicable method for diagnosing BOAS often leads to underdiagnosis, causing its prevalence and effects to be routinely underestimated 6,11,13,25 .…”

Section: Introductionmentioning

confidence: 99%

BrachySound: Machine Learning Based Assessment of Respiratory Sounds in Dogs

Oren,

Turkcu,

Meller

et al. 2023

Preprint

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The early and accurate diagnosis of brachycephalic obstructive airway syndrome (BOAS) in dogs is pivotal for effective treatment and enhanced canine well-being. Owners often do underestimate the severity of BOAS in their dogs. In addition, traditional diagnostic methods, which include pharyngolaryngeal auscultation, are often compromised by subjectivity, are time-intensive and depend on the veterinary surgeon’s experience. Hence, new fast, reliable assessment methods for BOAS are required. The aim of the current study was to use machine learning techniques to bridge this scientific gap. In this study, machine learning models were employed to objectively analyze 366 audio samples from 69 Pugs and 79 other brachycephalic breeds, recorded with an electronic stethoscope during a 15-minute standardized exercise test. In classifying the BOAS test results as to whether the dog is affected or not, our models achieved a peak accuracy of 0.85, using subsets from the Pugs dataset. For predictions of the BOAS results from recordings at rest in Pugs and various brachycephalic breeds, accuracies of 0.68 and 0.65 were observed, respectively. Notably, the detection of laryngeal sounds achieved an F1 score of 0.80. These results highlight the potential of machine learning models to significantly streamline the examination process, offering a more objective assessment than traditional methods. This research indicates a turning point towards a data-driven, objective, and efficient approach in canine health assessment, fostering standardized and objective BOAS diagnostics.

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Brachycephalic obstructive airway syndrome: much more than a surgical problem

Cited by 19 publications

References 115 publications

Deterioration of brachycephalic obstructive airway syndrome in a French bulldog following surgical stabilisation of atlantoaxial subluxation with concurrent atlas malformation

Deterioration of brachycephalic obstructive airway syndrome in a French bulldog following surgical stabilisation of atlantoaxial subluxation with concurrent atlas malformation

Acid–base and electrolyte evaluation in dogs with upper GI obstruction: 115 dogs (2015‐2021)

BrachySound: Machine Learning Based Assessment of Respiratory Sounds in Dogs

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