Advanced Soft Tissue Surgery

Brachycephalic Obstructive Airway Syndrome (BOAS)


The most distinct feature of brachcephalic breeds is their short muzzle. In recent decades, breeding selection for extreme brachycephalic features has resulted in dogs that predispose to upper airway tract obstruction and subsequent respiratory distress, among several other health issues. The disease related to brachycephalic confirmation is called brachycephalic obstructive airway syndrome (BOAS). The signs of BOAS can range from mild snoring to struggling to breathe. Collapse due to lack of air is common in BOAS patients during exercise. A reduction in exercise tolerance is also common. Excessive panting when dogs are cooling themselves down makes BOAS suffering pets more susceptible to over heating. Choking can also occur due to an over-long soft palate. Brachycephalic dogs often have a thickened tongue base and a long /or thickened soft palate, which can obstruct the airway during closed-mouth breathing. As the dog makes greater effort to bring air into the respiratory tract, the soft palate edge vibrates and causes a snoring sound, especially when the dog is sleeping. Eventually, breathing difficulty (dyspnoea) and periods of no breathing (apnoea) can be observed in these dogs during their sleep. This condition is life-threatening however surgical techniques have been developed to shorten the soft palate. Pets predisposed to be affected by BOAS include: Dogs:

  • French Bulldog
  • Bulldog
  • Boxer
  • Pug
  • Lhasa Apso
  • Shih Tsu
  • Pekingese
  • Boston terrier
  • Yorkshire Terrier
  • Cavalier King Charles Spaniel
Cats:
  • Persian
  • Himalayan
This list is not exhaustive and other breeds and cross-breeds can be affected. Why They Have Problems Narrowed nose passages decrease the amount of air intake in the lungs leading to a reduced oxygen flow.
An over-long soft palate can obstruct air flow into the trachea causing inflammation to the upper airway. Treatment Options Available Widening of stenotic nares (narrowed nostrils)
Removal of a section of the cartilage from the front of the nose to enlarge the nostrils can improve airflow. Shortening of an overlong soft palate
The excess length of the soft palate can be reduced by surgery in order to reduce the interference with air flow into the larynx (voice box). Removal of prolapsed laryngeal saccules
The larynx controls the the air opening between the oral cavity and the trachea. The increase in negative pressure within the airway lumen chronically draws the laryngeal soft tissues (saccules) and cartilages into the airway lumen. Eversion of the laryngeal saccules is a condition where the soft tissue located in front of the vocal cords becomes swollen and inflamed. These protruded laryngeal tissues are then pulled into the airway lumen, and partially obstruct airflow. In more severe cases, the cartilage that supports the larynx may also collapse.




Anal Sacculectomy


Anal glands are scent glands — some people refer to them as “anal sacs.” They are located between the layers of muscles that make up the rectum and, when all is working right, they are naturally expressed, through the duct that connects the gland to the “outside world,” each time a dog poops. A dog "Scooting" or dragging their butt along the ground is only one of the many possible signs indicating a potential anal gland problem. Others may be:

  • Excessive licking of their rectum
  • Straining, vocalising, or otherwise having difficulty or pain when defecating (pooping)
  • A swelling or “bump” under the skin next to their rectum
  • Blood and/or pus on their stools
  • Blood and/or pus on the carpet, their bed, or on your lap after they’ve been laying there
In most cases the anal glands can be expressed conciously but in cases of repeated or chronic infections removal of the anal glands could be advised by the vet. An anal sacculectomy is where the surgeon makes an incision near the anus directly over the affected anal gland. The gland is then dissected from the external and internal anal sphincters. The opening created by the vet is flushed out before closing the surgical site completely or prior to placing a drain. A drain is usually placed if the dog has been suffering from a chronic anal gland infection, as infectious material should be drained entirely before complete closure. If only one anal gland is affected, the surgeon may choose to leave the healthy anal gland intact as unilateral anal sacculectomy is not associated with incontinence.




Total Ear Canal Ablation (TECA)


A TECA or Total Ear Canal Ablation is a procedure undertaken to manage severe middle ear or ear canal disease and to treat ear canal cancers. It is used as a last resort treatment where all other options, such as topical medications, have failed. The TECA procedure is the removal of the ear canal in dogs and is nearly always combined with a Bulla Osteotomy. The Bulla Osteotomy part of the procedure involves opening and clearing the middle ear of all infected material. Combining these procedures greatly reduces the chance of recurrence of ear infections in the future therefore giving your animal a better quality of life. A TECA is performed as a last resort treatment in cases of chronic ear infection where topical medications such as ear drops have stopped working. Chronic ear infections cause swelling of the ear canal tissue which can cause discomfort to the animal. This in turn can make it even harder for topical treatments to be administered as the ear canal can swell nearly shut. A TECA is advised to remove the tissue that is causing the problem and alleviate the discomfort caused. In cases where ear canal tumours are present a TECA is the treatment advised as it can fully remove the affected tissue. The TECA procedure is the removal of the ear canal so once the incision site has healed and your pets fur grows back it is quite difficult to tell that the surgery has been performed. The only difference in your pets appearance will be the opening to the ear will no longer be present as it has been removed along with the ear canal. The organ used by the animal to allow it to hear is not affected during the TECA surgery as it is only the ear canal that is removed. Due to this hearing sensitivity may be reduced but in most cases the inflammation in the ear will have been causing decreased hearing sensitivity already therefore there is usually no change noticed post-operatively. In most cases animals recover quickly following the TECA procedure. We advise two weeks rest and lead exercise post operatively. To allow the incision sites to heal quickly we will send your pet home with a buster collar which must be worn to prevent interference with the surgical site. Once healed your pet can return to normal activities quite quickly and in most cases will seem happier as the discomfort from their ears has been eliminated. The TECA surgery is performed in an area surrounded by important structures including blood vessels and nerves and should therefore be performed by an experienced surgeon who is familiar with the procedure to minimise any potential complications.





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