Seasonal Airway Disease

with Tim Charlesworth 

We are all happy to see some warmer weather recently (at the time of writing!) but the increasing temperatures do place a strain on any dogs who suffer from significant upper airway disease. Many dogs will self-regulate and compensate for their respiratory compromise through reduced exercise/seeking out the cool shade etc. but many dogs can’t say ‘no’ to a good walk and so we regularly see dogs referred to Eastcott as emergencies with acute upper airway compromise.

Breeds Affected by Seasonal Airway Disease

Broadly speaking, the dogs we see fall into 2 categories – the ‘brachycephalics’ and the ‘paralysis’ dogs.

1. Brachycephalic breeds include the English and French Bulldogs, Pugs and Boston Terriers. Many dogs with overlong soft palates and narrowed (stenotic) nostrils etc. will have major problems in regulating their body temperature due to an inability to pant and exchange heat efficiently. Many of these dogs will start showing signs of exercise intolerance, retching and even gastrointestinal disturbances all because of their breed-associated conformation. Symptoms often start at a very young age but progress due to secondary changes and further deformation of their respiratory tracts i.e. laryngeal collapse. These dogs can appear stable but can rapidly decompensate if they exercise or even just sunbathe on a hot day. Prompt treatment is essential and normally comprises oxygen therapy, rapid cooling, sedation and anti inflammatories.
2. Laryngeal paralysis is very common in certain breeds especially Labradors and Golden Retrievers but any breed can be affected (including brachcephalics!). These dogs often present as older dogs with a history of panting, exercise intolerance and a change of bark (dysphonia). We now believe that the majority of affected dogs suffer a generalised polyneuropathy and many dogs will go on to develop subtle proprioceptive deficits, recurrent regurgitation and generalised muscle wastage as they get older. Many people attribute the observed ‘slowing up’ to concurrent osteoarthritis or ‘old age’ and it can be very difficult to differentiate between the two syndromes. Dogs with laryngeal paralysis can also
   decompensate in the heat. Their increased breathing effort sucks in the flaccid arytenoids occluding the laryngeal opening leading to cyanosis and potentially syncope and asphyxiation. These dogs have characteristically high pitched (stridorous) respiratory noise as they become excited or agitated. Affected dogs are managed with a ‘tieback’ procedure and usually have a vastly improved quality of life following the surgery with many dogs going home the same day as surgery is performed.

   

   Presumptive diagnoses can often be made from history, signalement and clinical signs. The diagnosis can be confirmed when performing laryngoscopy under a light plane of anaesthesia but this is not without risk. We are happy to see any cases of suspected upper respiratory tract (URT) compromise and to perform the laryngoscopy ourselves so that we can then take the dogs straight to theatre. This avoids you having to recover dogs with un-corrected URT compromise which can be hazardous and occasionally require tracheotomy.

   We are happy to give telephone advice about any possible referrals so please do contact us if you think you may have a brachycephalic or laryngeal paralysis case and we can discuss management with you or arrange the referral if required.