Apr 04 2016

Achey Brachy Palate

olaf1Olaf is a sweet, young boy. An English Bulldog by breed, his snorts and snores are already legendary. Unfortunately, they betray a potentially serious problem called, “Brachycephalic Syndrome”. The B word is greek and literally means “short-head”. Breeds such as bulldogs, pugs and pekignese are bred specifically to have short upper jaws while retaining a more mornal lower jaw length. The result is a lot of extra soft tissue in the mouth and, sometimes, the extra flesh along the roof of the mouth, the palate, will extend too far back and flutter around the entrance to the glottis. Olaf is such a patient and, in this particular visit, he came in because he could not breathe well. His palate went down the wrong tube, a condition known as “Entrapped soft palate” and this led to other problems, namely aspiration pneumonia, from being unable to close the glottis and prevent saliva and food from going down the windpipe, and everted laryngeal saccules, a technical term but very serious. An easy way to picture this problem is to imagine a wind blowing so hard that it flips an umbrella backwards. So much negative pressure builds up from the dog panicking to breathe that folds along the wall of the larynx pop inward and make the problem even worse.  I created a video of Olaf trying to breathe. It was made under anesthesia just before we intubated him to repair the problem. Click here to see it. palatesacculeIn this image, we are looking directly down Olaf’s mouth. At the top of the pic, the dark, pigmented flesh is his hard palate and the pink tissue behind it is the soft palate. He has a tube in his trachea to allow him to be given oxygen and you can see the pink flesh going right down the tube as well. This is not normal. Also, harder to see but to the left of the tube where it enters the glottis, you can just make out some shiny tissue, looks like a  pearl. That is one of the everted saccules. afterreductionSurgery consists of gently and without trauma, grasping the delicate soft palate and reducing  it to a point where it sits properly. Remove too much and the dog will have problems eating. Not enough and the problem remains. We got it just right as can be seen from this picture taken after the procedure. Minimal swelling and no bleeding at all. Both saccules were partially excised and the dog recovered uneventfully. The best part of this is how immediate the payoff is. Olaf woke up and was immediately breathing quieter than I had ever heard him breathe ever, even with his pneumonia, for which he was placed on antibiotics.

Olaf made a complete recovery. He is one of the lucky ones. He has a very attentive and loving owner who I have known for years and she got on top of the problem before it became life threatening. Many of these dogs die from this problem or develop laryngeal collapse and die terrible deaths from chronic struggling for oxygen.

midvet2015 | Uncategorized

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