Breathing Issues – The Most Common Upper Airway Problems in Dogs

Does Your Dog Have Breathing Issues?

If your dog is presenting with breathing issues, it could be caused by one (or more) of these problems. Here are the most common upper airway problems in dogs:

  • Brachycephalic Syndrome (flat face, short nose dogs)
  • Tracheal Collapse (usually toy breed dogs)
  • Reverse Sneezing (any breed)
  • Elongated Soft Palate (any breed)
  • Laryngeal Paralysis (usually large breed dogs)

Brachycephalic Syndrome

Brachycephalic Syndrome refers to breeds of dogs with flat faces and short noses, such as Pugs, Boston Terriers, Bulldogs, Shih Tzus, and Pekingese.  These dogs are born with shortened respiratory tracts, a smaller upper jaw with normal size lower jaw.  These dogs generally have very noisy respiratory sounds, secondary to the deformities from breeding.

Owners will typically describe snorting, heavy breathing, snoring, and open-mouthed breathing. These dogs are very sensitive to heat stroke because of inefficient oxygen exchange, and an inability to cool with panting; all of these symptoms are worsened with obesity!  The most common signs we see are narrowed nostrils, enlarged tongue, elongated soft palate, and narrow trachea/windpipe. These issues can usually be addressed surgically, in combination with recommendations from your vet. Left untreated they can result in life threatening emergencies so please talk with your vet about your individual pet’s needs and concerns.

Tracheal Collapse

Tracheal collapse refers to weakening of the hard cartilage rings of the windpipe (if you feel up and down the front of your neck firmly, you can feel the hard cartilage rings).  Why would the cartilage rings be weak? This is usually a hereditary (genetic) defect seen in toy breed dogs such as Yorkies, Poodles, Pomeranians, and Chihuahuas.  This defect can be mild to severe and usually occurs in middle age. But it can be seen young or old, and it is worsened by stress/anxiety, obesity, anesthesia/endotracheal tube placement, respiratory infections, respiratory irritants (cigarette smoke, dust, scented candles/oils, etc), or heart disease (enlarged heart).

Treatments range from reducing weight, eliminating respiratory irritants, antibiotics for secondary infections, cough medications, to steroids, bronchodilators, or even surgery.  Tracheal collapse can become so severe that emergency  treatment may be required – oxygen supplementation, sedatives, cough suppressants, etc. Liver disease has also been associated with dogs with tracheal collapse due to oxygen deprivation, so some patients may need liver support medications if they have tracheal collapse. When surgically corrected, a dog’s liver values typically improve confirming this association.

Reverse Sneezing

Reverse Sneezing refers to a reflex/spasm of the soft palate and throat that results in a honking noise like a dog is trying to inhale a sneeze.  Although it sounds bad, it usually does not require any treatment.  It is usually caused by an irritation of the soft palate/throat that results in a spasm causing the dog to extend its neck and expand its chest to get more air.  Anything that irritates the throat can cause a reverse sneeze – excitement, eating or drinking, pulling on a leash, dust/pollen, perfume, cigarettes, household chemicals, oil diffusers, etc.

Brachycephalic dogs with elongated soft palates are also prone to reverse sneezing. If the irritant is removed and the sneezing stops then no treatment is needed.  If massaging the throat/calming of the pet, or covering the nostrils to make the pet swallow makes the sound stop, again no treatment is needed. Bear in mind that these simple remedies will not work with tracheal collapse or other severe issues. Usually reverse sneezing does not require any treatment. If it becomes more frequent or chronic, your veterinarian may recommend evaluation with an endoscope to look for other issues or discuss treatments for allergies, etc.

Elongated Soft Palate

Elongated soft palate refers to the soft tissue that separates the nasal cavity from the oral cavity. In brachycephalic breeds, or any breed, if the tissue is excessive it can cover the epiglottis (covering the trachea). Usually this causes snorting noises, but in severe cases it can cause respiratory distress. In such cases surgical intervention is needed to trim the excess tissue. Unfortunately Bulldogs are famous for this condition.

Laryngeal Paralysis

Laryngeal paralysis refers to the muscles of the larynx (voicebox in humans) not working properly. The larynx is basically the covering of the respiratory tract that prevents food and water from getting into our airways and lungs, and helps us to take deep breaths.  Laryngeal paralysis is most common in older, large breed dogs. It is associated with other neurological problems such as leg muscle weakness, esophageal weakness or megaesophagus.

To determine if a dog has laryngeal paralysis, the dog’s larynx must be examined under sedation with or without an endoscope.  X-rays should be taken to rule out other underlying issues such as pneumonia, megaesophagus, and tumors. Bloodwork including thyroid testing should also be done.  Conservative treatment involves changing from a collar to a harness, avoiding heat, and very stressful situations where the dog may pant. Sometimes anti-anxiety medications are needed.  If the paralysis is not treated, a respiratory crisis may occur and the dog may need emergency treatment.  Ideal treatment is surgery, but as with any surgery there is risk involved. Your surgeon will go over these risks with you.

Bam Bam – A Case Study

Bam Bam presented with breathing issuesHere at Compassionate Animal Care we  recently had a little eight year old miniature Yorkie – Bam Bam – come in with breathing problems. The poor little sweetheart was born with many issues including an overbite, a malformed front leg, luxating patellas, dental disease, and his aforementioned breathing issues.  He snores, snorts, reverse sneezes, and has difficulty drinking water, etc.

We had him come in for sedation to examine his airway, get chest X-rays, and do a dental cleaning.  We discovered he had severe elongation of the soft palate that was covering his epiglottis and tracheal collapse.  When he was stressed this caused him respiratory distress. We took care of his bad teeth and sent him to a surgeon to fix the palate issue.  Bam Bam is doing well after both procedures, and is our March Pet of the Month! (Yay Bam Bam!)


If any of these symptoms sound familiar…

As with any other disease or structural abnormality, you should always consult your veterinarian as to how best to treat your pet. Some of these issues may require the help of a specialist in surgery to give your pet the best possible outcome.

For further information, feel free to schedule an appointment with us at your home or in our clinic, or consult, the AVMA, or your own local veterinarian.

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