Correction of brachycephalic obstructive airway syndrome (BOAS)
Surgical widening of the nostrils and shortening of the soft palate in flat-faced breeds that snore, tire easily and tolerate heat poorly. The procedure is performed with extended anaesthetic supervision.
What it involves
Brachycephalic obstructive airway syndrome (BOAS) is a set of anatomical abnormalities of the upper airway in breeds with a short skull: narrowed nostrils, a soft palate that is too long and thick, everted laryngeal saccules and, in some dogs, a narrowed trachea. Air has to squeeze through narrow gaps — hence the snoring, wheezing and rapid tiring.
The correction consists of widening the nostrils (cutting out wedges of skin and cartilage), shortening and thinning the soft palate and, where necessary, removing the everted laryngeal saccules. The aim is to widen the path of airflow. The procedure does not change the appearance of the muzzle apart from slightly wider nostrils.
A brachycephalic patient is a patient at increased anaesthetic risk, and an operation in the throat means swelling afterwards. That is why for us BOAS means an extended protocol: medication beforehand to reduce swelling, slow, controlled recovery with oxygen and hospitalisation under observation.
When it is used
Ideally between 1 and 2 years of age, before chronic breathing effort leads to secondary changes in the larynx, which by then are irreversible. In older dogs the procedure still improves comfort, but the improvement may be smaller.
Surgery is indicated by the signs, not by the breed alone: noisy breathing at rest, intolerance of exercise and heat, episodes of turning blue (cyanosis) or collapse, regurgitation. We also recommend the procedure before other operations under anaesthesia in dogs with marked BOAS — it makes later anaesthetics safer.
Indications: symptoms that should prompt a visit
- A bulldog, pug, Boston terrier, Pekingese or Persian cat snores while awake, not only when asleep.
- The dog tires after a few minutes of a walk, stops and breathes with its mouth open.
- In hot weather or when excited, the dog pants so much that its tongue turns blue or the dog collapses.
- The nostrils are as narrow as slits and collapse when breathing in.
- The dog often regurgitates food or saliva, chokes and retches.
- The dog wakes at night with pauses in breathing, or sleeps with a toy in its mouth or sitting up.
- Recovery from an earlier anaesthetic was difficult.
Conditions for which we use it in particular
Diagnostics beforehand
We begin the assessment with a clinical examination and observation of breathing at rest and after brief exertion. A chest and neck X-ray assesses the width of the trachea and rules out aspiration pneumonia and changes in the oesophagus. A blood test and pre-anaesthetic assessment under STD-01 are mandatory; in dogs with cardiac signs we add echocardiography.
We carry out the full assessment of the palate, larynx and saccules under sedation just before the procedure, in the same anaesthetic — that is when we decide the final extent of the correction.
How it proceeds
The patient arrives in the morning, fasted. Before anaesthesia we give anti-swelling and anti-sickness medicines and oxygen by mask. Intubation in brachycephalic dogs requires skill and suitable equipment; throughout the procedure the anaesthetist monitors saturation, capnography, ECG, blood pressure and temperature (STD-02).
The surgeon widens the nostrils, shortens the soft palate and removes the everted laryngeal saccules, taking care to keep bleeding and swelling to a minimum. The procedure takes roughly 45–90 minutes. The most important moment is recovery: we remove the endotracheal tube as late as possible, and the patient wakes calmly, with oxygen, under constant observation.
The patient usually stays in hospital until the next day, with monitoring of breathing and saturation, in a cool kennel. The lead veterinarian decides the extent of supervision outside opening hours individually.
Aftercare
For 2 weeks: rest, no exertion or excitement, cool rooms, soft food in small portions, and a harness instead of a collar. Anti-swelling medicines and painkillers as set out on the schedule. Check-ups after 3–5 days and after 2 weeks; the sutures in the nostrils are absorbable.
Call immediately if breathing is clearly noisier than before the procedure, the dog turns blue, brings up blood when retching or has a fever. Improvement in breathing is assessed after 4–6 weeks, when the swelling has completely gone down.
Frequently asked questions
Will my dog stop snoring after the operation?
Snoring is clearly reduced, but rarely disappears completely — the procedure does not change the structure of the skull. The aim is safe, efficient breathing and tolerance of exercise and heat.
Is the procedure dangerous?
The risk is mainly related to swelling of the airway after the procedure and the recovery period. We limit it with an anti-swelling protocol, oxygen and hospitalisation. Untreated BOAS becomes more dangerous over time than the operation itself.
Is it worth operating on a dog with no obvious signs?
If the nostrils are very narrow, widening them at a young age (even at the time of neutering) can slow the development of further changes. We decide after an examination.
Does BOAS also affect cats?
Yes — Persian, Exotic Shorthair and Himalayan cats. In cats we most often correct the nostrils.
We manage every case individually. The scope, indications and course described above are indicative; we agree the exact diagnostic and treatment plan during the consultation. This content is for information only and does not replace a veterinary consultation.
Questions about correction of brachycephalic obstructive airway syndrome?
Call us or book a consultation. We will set out the diagnostic and treatment plan in writing, before you decide.