BOAS
what do I need to know?
BOAS -
what is it?
B.O.A.S refers to Brachycephalic Obstructive Airway Syndrome.
Brachycephalic dogs are those with flat faces and shortened skulls.
Unfortunately, this shape results in abnormal anatomy and narrowing of the upper airways.
What signs will they show?
The above abnormalities result in obstruction of air flow and can cause a number of clinical signs, including:
- Snoring
- Loud breathing
- Reduced ability to tolerate excercise
- Poor tolerance to heat and a greatly incresed susceptability to heat stroke
- Sleep apnoea and resultant trouble sleeping
- Gastrointestinal signs such as vomiting and regurgitation
In spite of the fact that there are many brachycephalic dogs that are living decent lives without surgery, almost all of them would benefit from surgery.
As the airways are placed under more and more pressure, gradually secondary changes develop, mainly around the structural integrity of the larynx. Eventually this can also lead to heart failure, hiatal hernias and secondary thickening of the tissues at the back of the throat.
Performing surgery at a young age is very beneficial and achieves the best long-term results.
A great summary of this condition is provided in this video interview of Prof Philip Moses.
BOAS treatment -
what does it entail?
Surgery is required to treat the area of the airways that are obstructing airway flow. Most often this entails:-
- Nostril widening
- Reducing the length and thickness of the soft palate so that it doesn't obstruct the larynx
- Removing any everted laryngeal saccules that may be present
- In some cases, removing excessive nasal turbinate tissue and tonsillectomy may be required
How much will my dog improve after surgery?
The most important concept to understand about surgery in young dogs, or dogs that don't seem to be overly affected by their symptoms, is that surgery is aimed not only at improving their current symptoms, but is aimed at preventing problems from getting worse as they age.
Surgery at a young age is most beneficial and has the best long-term results.
As a general rule, 90% of dogs treated at a young age will be improved with surgery. The degree of improvement can be slightly variable but in our hands more than half of these cases will have a significant improvement in signs so that their ability to exercise well and be less prone to heat stroke is greatly improved.
Surgery in older dogs is always beneficial too, but there are certain secondary changes that we are not able to address surgically.
It is also important to note that not every case will improve as well as stated. In a small percentage of cases, the noise they make will not be significantly improved. These cases nevertheless benefit from surgery because the progression of secondary changes is slowed as they age and their overall quality of life will be greatly improved as they grow older compared to if they hadn’t had the surgery.
FAQ's
In spite of BOAS surgery being a big operation, most patients will be able to go home on the evening of the surgery.
Generally, patients are admitted at 8am and are then prepared for surgery by having blood tests done and giving them pre-emptive pain relief. They will also be placed on a drip for their time with us.
Once they are in recovery, we’ll message you with an update – and we’ll then keep you regularly informed through the rest of the day while we administer appropriate pain relief and keep them comfortable.
The majority of young patients will go home in the early evening. Some cases will require overnight hospitalisation and oxygen therapy.
At your discharge appointment, all the post-operative instructions will be discussed and a plan for the following few days will be put in place.
Yes.
Usually both front legs will have a patch shaved where their drip will be placed.
In most cases, an immediate reduction in respiratory noise will be heard. In others, this improvement may take a few days.
They will be drowsy on the first night at home because of the pain relief they receive, but generally they will be back to normal within 36 hours.
If your dog was showing gastro-intestinal signs such as regurgitation, these signs should also improve in time
In the first week after surgery, we recommend all cases be kept inside in an air conditioned room.
Only short walks to the toilet in the back yard, using a harness, are allowed. No outside walks or off-leash activity is recommended. Once they’re done their business and had a brief sniff around, it’s time to go back inside.
For example, allowing your dog off leash in the back yard to chase possums the day after surgery, is a recipe for surgical failure.
We recommend someone is home with your dog for the first week after Surgery so that they can be monitored and prevented from doing too much activity and from becoming overheated by accident.
We’ll perform a post-op check within the first week. Based on this exam, we may be able to allow a bit more exercise.
If you have a very active, energetic dog that will be difficult to rest and confine, please speak to us about some medication to calm them down to reduce the chances of excitement induced problems.
It’s important to note that some dogs can get very excitable in small spaces, so good control on the leash, even indoors, is important.
Dogs that present late in the course of the disease are significant surgical risks and need hospitalisation in advanced ICU situations. In these cases we may refer them to the local Emergency Centre because their recoveries from surgery can be very risky.
However, for the vast majority of cases, especially those are treated early, the surgical complications are minor.
Probably the most common ‘complication’ is that their respiratory noise isn’t significantly reduced with surgery.
Even if this is the case, the progression of secondary changes will be greatly slowed and all of these cases would almost always benefit from surgery compared to if they hadn’t had it.
After 1 week your dog will usually be allowed to start harness walks outside the house.
Once we’re happy that harness walks are progressing well for a week, we can consider getting back to normal off-leash exercise.
chat with us instead?
Our clients understandably have many questions about their pets – especially those requiring complex Surgery.
We prefer to discuss all of these in person during a relaxed and approachable consultation, so please feel free to contact us for a free initial telephone chat.