Understanding BOAS (Brachycephalic Obstructive Airway Syndrome)

Author: Emi Kooyman | Founder

What is BOAS and why does it matter for my pet?

BOAS, short for Brachycephalic Obstructive Airway Syndrome, is a condition that affects short-nosed breeds, causing narrowed airways and making breathing more difficult—especially under stress or anesthesia. Pets with BOAS are at a higher risk for complications during and after surgery.

Which breeds are at risk for Brachycephalic Airway Obstruction Syndrome (BOAS)

Commonly affected breeds include French Bulldogs, English  Bulldogs, Boston Terriers, Pugs, Shih Tzus, as well as Himalayan and Persian cats.

What are the signs and symptoms of BOAS?

Signs include noisy breathing, snoring, exercise intolerance, gagging, or regurging. This is because they often have stenotic nares (small nose holes), elongated soft palates (tissue which spans over the airway making it difficult to breathe) and /or laryngeal paralysis (swollen flappy laryngeals from excessive effort to bring air to the lungs; amongst other conformation challenges. If you notice any of these signs in your pet, please inform us before your appointment.

Why does BOAS increase anesthesia and surgical risk?

Pets who are brachycephalic can have difficulty maintaining an open airway, especially when sedated. This requires special monitoring and anesthetic protocols to keep them safe.

Clinic Protocols for Brachycephalic Breeds

What extra steps does the clinic take for brachycephalic (short-nosed) dogs?

For these pets, we:

• We pre-oxygenate for 5 mins prior to induction to allow for oxygen saturation to the lungs.

• We use a different drug protocol which is shorter-acting so the patient may wake up quicker.

• Assign extra staff for close monitoring.

• We allow the patient to be maintained on oxygen post surgery for 5 mins to provide lung saturation as they are getting recovered.

• We recover them on a cooling pad to prevent them from over heating and panting

Required Medication:

For brachycephalic breeds, we require the use of Cerenia (an anti-nausea injection) to reduce the risk of vomiting and aspiration post-surgery. The cost of this medication is weight-based.

How do you assess and prepare these breeds before surgery?

We may request photos to determine their brachycephalic status prior to approving their appointment. We will conduct a pre-surgical exam and review your pet’s history for any previous anesthetic complications. We’ll discuss any concerns with you before proceeding.

Is there a chance my brachycephalic breed pet will be denied surgery?

Yes. It is our goal at Spay Neuter Vets to select good candidates for surgery and minimize risk. While anesthesia always carries a certain amount of risk, we would rather have you take your pet elsewhere than to undergo an emergency or fatality at our clinic. Brachycephalics that are overweight, have a very pronounced conformation with restricted airways, and/or have co-morbidities will be asked to go to a full service hospital where the monitoring systems are more robust so that unnecessary risk does not need to be taken. Spay/neuter surgeries are performed at most veterinary clinics and hospitals. There is a wide range of places who can accommodate your pet and we would be happy to give recommendations so you can find an appropriate facility for your pet’s specific needs.  

Surgical Considerations at Spay Neuter Vets:

Due to the increased risks, surgery for brachycephalic patients is ideally performed in a facility equipped with more robust monitoring equipment, (including EKG) a wider range of anesthetic drugs, and a dedicated team prepared to handle emergencies. Unfortunately, our clinic is not equipped to provide the optimal care needed for patients with airway conditions should complications arise.

However, we understand that specialty hospitals may have higher costs or longer wait times, and some pet owners may still choose to proceed with surgery at our clinic. If you wish to do so, we require you to:

• Acknowledge the increased anesthetic risks associated with this breed.

• Sign a waiver indicating your understanding of these risks.

• Please be aware that depending on the severity of brachycephalic conformation, we may still decline the procedure after the pre-operative exam.

Next Steps:

Please review the following resources for more information:

Brachycephalic Breed Risk Article 

If you have any questions, we are happy to discuss them with you. Text us at 678.834.0777.

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