We will discuss this on a case by case basis in our consultation (phone or face-to-face). Currently, the best method for diagnosis of brachycephalic obstructive airway syndrome is a combination of:

• A full physical examination

• Questionnaire about current clinical signs, exercise tolerance and sleeping habits

• Exercise tolerance tests such as the respiratory function grading scheme

• Visual airway inspection under heavy sedation or general anaesthesia

• Diagnostic imaging (e.g. Xrays)

However some important points to consider:

• EXCESSIVE RESPIRATORY NOISE FOR ANY BREED OF DOG IS NOT NORMAL

• EXERCISE INTOLERANCE IS NOT NORMAL

• REGURGITATION AND VOMITING IS NOT NORMAL

• RESTLESS SLEEP IS NOT NORMAL

• BEING “LAZY” IS NOT NORMAL

All of the above symptoms can be an indication of upper airway obstruction, and warrants further investigation.

If your dog is diagnosed with BOAS, early corrective surgery is most effective at reducing further secondary changes and laryngeal collapse.

The best time for most brachycephalic dogs to undergo surgery is:

• French Bulldogs, Pugs, Boston Terriers - around 12 months of age.

• British Bulldogs, Aussie Bulldogs, and other larger bulldogs - 12-14 months of age

YES! 5/5 BOAS Surgery refers to multi-level airway improvement surgery.

For patients that undergo BOAS surgery, I aim to correct:

1) Stenotic nares - I do this via a technique called “ala-vestibuloplasty” which not only opens the nares, but also opens the nose deeper in. There are only a handful of surgeons doing this in Australia and around the world.

2 & 3) Soft palate length and thickness - I do this via a technique called a “modified folded flap palatoplasty”, which means I not only shorten the palate, but I reduce the thickness of the palate as well.

4) Tonsils - When tonsils are enlarged or everted, I also remove these via tonsillectomy. I find many brachy patients (>90%) have enlarged tonsils that warrant removal.

5) Laryngeal Saccules - If the saccules are everted (an indicator of stage 1 laryngeal collapse), these will also be removed. >90% will have saccule eversion but this is highly age and breed dependent.

Other surgical techniques can be considered for more advanced cases.

YES! If your doggo gets stressed out when away from you (like at the vets!), provided it is safe to do so, you are welcome to be present during recovery as soon as they are waking up from their surgery.

If needed, I also use medications to help relieve stress prior to coming into the hospital. I am an accredited Stress-Free Veterinary Professional and keeping my patients calm and happy is important to reduce their risk of post-operative complications.

YES! Steroids are a type of anti-inflammatory medication that helps reduce swelling of the soft palate and tissues in the mouth. In the majority of cases, so long as there are no other drug interactions, I use steroids before surgery and after surgery, and to go home with. Each individual is assessed on a case by case basis for their medication plan.

I also use various anti-nausea medications to reduce the risk of vomiting, as well as lots of pain relief, local anaesthetics and ice-blocks.

I currently perform surgery and consults at Erina Heights Vet Hospital on the Central Coast, NSW Australia.

Your local veterinarian is welcome to contact me for advice.

Not usually. Provided your dog is a low risk patient and there have been no complications in recovery, most patients go home on the same day. This helps to reduce stress and anxiety (e.g. barking, panting, pacing) that can contribute to post-op complications.

If needed, the local emergency hospitals (SASH and ARH) are available 24/7 for after hours care.

A trach tube is a temporary device that is placed in the windpipe to bypass the upper airway obstruction. This is usually only required for advanced, high-risk patients.

99% of young, low risk patients, do not require a trach tube.

Please contact me directly so I can provide an accurate estimate for surgery (if indicated) based on your pet’s breed. Costs can vary according to clinical severity, age, breed and weight.

Dr Melissa is based on the Central Coast, NSW and is offering telemedicine, in-person consultations and surgical treatment of conditions commonly seen in brachycephalic breeds including:

• Brachycephalic Obstructive Airway Syndrome (BOAS)

  - Exercise tests and assessments

  - Airway assessment

  - Multi-level 5/5 brachycephalic airway improvement surgery

• Entropion and other eye conditions

• Cork screw tail correcitve surgery

• Management of chronic skin conditions and allergies

• Management including surgery of skin folds

• Medical management of spinal problems including intervertebral disc disease 

• Investigation and management of vomiting, regurgitation, reflux and flatulence

• Routine health and wellness

Melissa also loves all other breeds of dogs (and cats) too!