We do nares and palate surgeries on brachycephalic breeds here at Family Pet Clinic of Redondo Beach. Most bulldogs coming in these days have airway issues, which is secondary to very poor breeding practices, unfortunately. The surgical risks are moderate—on rare occasion a patient needs overnight “babysitting” after surgery in order to receive a little more oxygen and monitoring. We are confident that the benefits of surgery far out-weigh the risks of anesthesia. Our patients usually wake up from surgery actually breathing better virtually instantaneously.
For the stenotic nares surgery, we use a #11 surgical blade to cut a deep wedge of tissue from the lateral nasal folds. We place a few absorbable sutures that will fall out on their own in a few weeks. The surgery sites often look a little “crusty” and lose their pigment for a few weeks and then re-pigment again once the sutures fall out. The surgery site is sometimes itchy so we recommend a cone for the first 2 weeks or so until the nose is no longer itchy. Check out our before and after photos on our facebook page and website.
For the elongated soft palate resection surgery (“staphylectomy”) we use a radiosurgery cutting device—the excess soft palate tissue is removed via high frequency sound waves, which allows for minimal anesthesia time and almost no bleeding. We place 3-5 tiny sutures in the oral mucosa which seems to hasten healing time. The recovery is apparently almost “instantaneous” and the dogs go home ready to eat and drink.
We have discovered a number of “tricks” that allow us to safely anesthetize brachycephalic breeds: All patients have a set of chest x-rays taken pre-op in order to determine if they also have hypoplastic trachea, and also to confirm that they do not currently have evidence of aspiration pneumonia or bronchitis. All patients are given nausea medication (Cerenia) and also a prokinetic drug (metoclopramide) to decrease chances of regurgitation. Palate surgery patients are given a steroid as an anti-inflammatory which decreases swelling at surgery sites. We use dental nerve blocks which block pain to the nares surgery sites---- which is a VERY cool discovery found only here, by the way---- and we use pre-and post-surgery cold laser therapy (photobiomodulation) which blocks pain and inflammation and regenerates collagen. We pre and post oxygenate each patient which really helps with anesthesia and recovery. We have an assigned nurse attached to each patient until the patient goes home.
If a patient needs overnight observation, we recommend VCA Advanced Veterinary Care Center in Lawndale.
I always send home pain, relaxation medications (anxiolytics), and a short course of antibiotics to prevent infection at the nares surgery sites, since “boogers” are notoriously bacteria laden.
Our brachycephalic patients benefit greatly from airway corrective surgeries. Our clients tell us that their pets improve 50% to 100% after surgery. Some “brachy” issues cannot be corrected surgically, and so they may still snore, they may still not be as athletic as some breeds, and they may still be heat stroke risks to some degree. Some of the congenital issues that we cannot surgically repair include hypoplastic trachea and “folded” or tortuous nasal turbinates. That being said, opening up the nostrils and resecting back excess palate tissue seems to be a dramatic solution for most affected brachycephalic individuals.
Please refer to this website for more detailed information regarding the pathophysiology of these airway syndromes:
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Dr. Kimberly Daffner