Advice from a specialist surgeon


Specialist surgeon, Adjunct Professor Philip Moses, provides some words of advice for the veterinary profession about how to best tackle the welfare problems of dogs with exaggerated features.

I love brachycephalic dogs, and not just because I spend much of my working life helping them. I think they are just delightful companions. But brachycephalic breeds have many, many problems. What can we as veterinarians do?

These are my approaches:

  • Treat the individual
  • Educate the breeders
  • Lobby the kennel clubs
  • Educate the owners
  • Educate veterinarians

1. Treat the individual

Many pugs I see have significant respiratory compromise. They are chronically hypercapnaeic and hypoxic, unable to breathe properly and starved of oxygen. Their problem is directly related to their phenotype and we must do everything we can to make the individual more comfortable. The younger we can treat them, the fewer secondary changes will develop, and fewer complications associated with surgery.

I advise referring veterinarians to discuss airway and other surgery that may be necessary when the puppies are having their vaccinations, and assess the dog’s condition when neutering at 6 months of age. We prefer to perform upper airway surgery between 6 and 12 months of age where possible.

For brachycephalic airway surgery, this treatment protocol is followed in all cases:

  • Take conscious chest radiographs, assess for pulmonary pathology, hiatal hernia, tracheal hypoplasia and the presence of vertebral body abnormalities
  • Anaesthetise the dogs, assess laryngeal structure and function, and the presence of everted laryngeal ventricles. If I have any doubts that the animal needs surgery, the presence of everted laryngeal ventricles confirms that the dog is working hard to breathe and must have corrective surgery. Everted laryngeal ventricles indicate stage 1 laryngeal collapse. Using a 4mm endoscope we then assess the trachea, mainstem bronchi, the oropharynx and chonae.
  • Remove the elongated soft palate, everted laryngeal ventricles, tonsils if enlarged and perform a nasal alarplasty to open the nares.
  • These dogs are always recovered in ICU and monitored closely for 24-48 hours to ensure there are no problems with recovery. I only do these surgeries on Monday mornings – early in the week and early in the morning.
  • I do not operate on severely distressed or compromised dogs. In these cases we prefer to place a temporary tracheostomy and wait for 4-6 days for the swelling to subside. I do not believe you can perform this type of airway surgery without 24 hour monitoring and without access to a 24 hour ICU.

2. Educate the breeders

I very regularly speak to breed clubs about the issues associated with their breeds and encourage them to consider the welfare of their animals. I talk to them about the disorders that are genetic in nature. For example, hemivertebrae is highly heritable and could be virtually removed from most of these breeds if radiographic screening was compulsory. I advise all dogs should have good quality spinal radiographs taken at six months of age and ANY dog with ANY vertebral body abnormalities should be neutered.

Breeders also must educate new owners of puppies. They must advise them of the problems associated with their breeds, whether this is brachycephalic airway syndrome in brachycephalic breeds, increased incidence of IVDD in dachshunds or increased incidence of GDV in Great Danes. Breeders must not consider the problems a reflection on themselves and their own dogs but an issue associated with their breed. They must not fear losing the sale of a puppy because of breed associated problems. I tell breeders that the issues related to their breeds are their responsibility. Putting their heads in the sand will not make the problems go away. This discussion is much better coming from the breeder at the time of purchase than from me when the dog is 8 years old and in real trouble.

3. Lobby the kennel clubs

As a profession, veterinarians are the leaders in animal health care. We must act as such. It is our advice that kennel clubs should be receiving and acting upon. It is up to us to contact the kennel clubs and provide the right advice. It must be from a scientifically valid point of view. Arguments must not be based on emotion and personal opinion but on scientific fact. There is a growing body of veterinarians involved directly in animal welfare but we must not leave the welfare of animals to these few. It is the responsibility of all of us. Write to your kennel club, breed clubs, offer your services in an advisory capacity, offer to address them, and when you do, present scientifically sound and referenced arguments. I would recommend the article by Beausoleil and Mellor in the New Zealand Veterinary Journal as a good starting point for discussions on the effects of breathlessness and chronic hypoxia.

4. Educate the owners

Very often people who purchase a brachycephalic dog or another breed with exaggerated features have not owned one before. You will see these puppies for their puppy vaccinations. When you do it is essential to discuss with the new owners the delights – and downfalls – of the brachycephalic breeds. I strongly recommend brachycephalic dogs have corrective upper airway surgery when they are neutered. By correcting the primary anatomical abnormalities at 6 to 12 months of age we avoid secondary changes and make the dog more comfortable long term.

5. Educate our fellow veterinarians

We are the health care professionals for animals. Their health, wellbeing and welfare is our direct responsibility. It is essential that we communicate to our fellow veterinarians, pet owners, breeders and kennel clubs the most up to date scientific data possible. Animal welfare is an emotive but very important issue; it is however an issue that our profession can lead and guide the public in.

Adjunct Professor Philip Moses is a Brisbane-based specialist surgeon with a substantial caseload of brachycephalic dogs requiring airway surgery. This page was adapted from his presentation to the North American Veterinary Conference in January 2016 on the welfare of brachycephalic dogs.