Brachycephalic airway syndrome: Gorgeous George and his new nose!

Brachycephalic airway syndrome is a condition that can affect brachycephalic cats and cause breathing problems. So what does brachycephalic mean? The word “brachy” means “shortened” and the word “cephalic” means “head”. In certain cat breeds such as the Persian, Exotic Shorthair and British Shorthair, there has been a progression to selective breeding for a much shorter face shape, pushed in nose and larger eyes. Whilst we cannot deny that a lot of these cats are super adorable, sadly their breeding has also resulted in a number of health problems arising directly from their abnormal shaped anatomy.

Abnormalities that occur in brachycephalic cats may include:

  • Stenotic nares (most common) – abnormally small sized, narrowed nostrils which restrict the amount of air that can flow into the nose
  • Elongated soft palate (also quite common) – the soft palate (which is the soft part of the roof of the mouth) is too long for the length of the mouth making the excess length partially block the entrance to the trachea or windpipe at the back of the throat
  • Hypoplastic trachea – the trachea or windpipe has a smaller diameter than normal
  • Everted laryngeal saccules – laryngeal saccules are small sacs or pouches located just inside the larynx (voice box). They can evert (turn outwards) or become sucked into the airway by the pressure associated with the increased respiratory effort caused by the stenotic nares and/or the elongated soft palate. Everted laryngeal saccules will further obstruct airway flow.
  • Abnormal tear duct anatomy – this can lead to tear overflow and watery eyes

An individual cat with brachycephalic syndrome may be affected with a combination of one or more of these abnormalities.

George is a sweet as pie Persian who presented to us for an assessment of his ongoing breathing issues. His owners had noticed that he would often tire easily and would intermittently breathe through his mouth. His owners also noticed he was quite snuffly too.

On a full physical exam Dr Martine observed that George had very stenotic nares and he needed to use a lot of effort to try inhale air. He became quite puffed out during his visit, so his exam was conducted slowly with plenty of rest breaks to avoid stressing him out. After discussions  with Dr Martine, his dedicated cat-parents were keen to proceed with corrective surgery for his nose along with further diagnostics to ensure there were not any other abnormalities associated with his brachycephalic syndrome.

George was admitted into our hospital the following week. Brachycephalic cats have a higher risk when undergoing anaesthetic so George’s parents opted for a full pre-anaesthetic blood profile to be performed, in addition to thoracic (chest) radiographs. Fortunately, his test results showed he was ok for us to proceed and after letting him enjoy some pre-operative oxygen via a cute little cat-specific face mask, we administered a general anaesthetic to further assess George and go ahead with his “nose job”.

Dr Martine performed endoscopy using our Olympus flexible video endoscope which allowed us to clearly visualise right behind George’s nasopharynx and ensure there were no further indications for surgery. We were pleased to find that George did not have any other abnormalities needing intervention and prepped him for surgery for his stenotic nares.

Dr Ariadna performed the delicate nasal surgery which involves enlarging the opening to the nostrils to allow George to breath easier and more freely. The surgery was a wonderful success and the same night as his surgery his parents already could see a difference in his energy and comfort levels.

One week post-op, George is going great guns and has started to play with his toys where he doesn’t get puffed out anymore. He is a real smoocher and we are so happy to be able to give him a breathe-easy life. Well done gorgeous George!

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