The Brachycephalic Dog – Part 2: Beyond the Airway

In week 1 of this course, you will be focusing on how to perform a thorough physical examination on brachycephalic dogs, key characteristics and “red flags” to look out for and how to communicate with owners on managing care of their dog over its lifetime. 

Learning Outcomes  

By the end of this week, course you will be able to:

• Perform a thorough physical exam on brachycephalic patient and understand key physical characteristics that differ to mesocephalic breeds, that can predispose to disease syndromes; 
• Understand how conformation-related comorbidities can impact the welfare of brachycephalic dogs; 
• Implement low-stress / fear free handling techniques and pre-visit anxiolytics to reduce anxiety in hospitalised brachycephalic patients; 
• Navigate client expectations and utilise the veterinary team for managing lifelong care of brachycephalic patients; 
• Communicate with owners about anaesthesia risk and implement measures to reduce complications during and after anaesthesia; and
• Awareness of cardiac disorders sometimes encountered in brachycephalic breeds and options for diagnostic investigation and treatment. 

In week 2 of the course, we will discuss the impact of having a “squishy face” on dental health, as well as revising common and not so common gastrointestinal tract disorders seen in brachycephalic dogs.

Learning Outcomes

By the end of week 2, you will be able to:

• Understand the impact of dental and oral health issues commonly encountered in brachycephalic dogs, including malocclusions, crowding, rotation, unerupted teeth and oral neoplasia;
• Recognise tips and tricks for performing dental procedures in brachycephalic dogs;
• Perform local anaesthesia nerve blocks for dental procedures in brachycephalic dogs; 
• Recognise differential diagnoses of gastrointestinal symptoms in some brachycephalic dogs, including:
  • Gastro-oesophageal reflux disease (GORD)
  • Hiatal hernia
  • Oesophageal disorders
  • Inflammatory bowel disease
  • Pyloric stenosis
  • Portosystemic shunts
• Create a diagnostic plan for investigation of gastrointestinal symptoms in brachycephalic dogs;
• Implement non-invasive interventions for chronic regurgitation and vomiting in brachycephalic dogs, including medications and lifestyle modifications;
• Understand surgical treatment options for some gastrointestinal disorders commonly seen in brachycephalic dogs. 

In week 3 of this course, we will be discussing common skin and eye problems seen in brachycephalic dogs and understand treatment and management options to improve patient welfare.

Learning Outcomes

By the end of this week, you will be able to:

• Understand the impact of extreme conformation in brachycephalic dogs for predisposing to skin and ocular disease; 
• Recognise clinical signs of dermatological problems in brachycephalic dogs;
• Perform a dermatological workup for a brachycephalic patient; 
• Understand both medical and surgical treatment options for common dermatological conditions for brachycephalic patients, including:
  • Skin fold reduction surgery
  • Vulvoplasty for “hooded vulva”
  • Corkscrew tail amputation
  • Interdigital cysts
  • Intertrigo
  • Otitis externa and otitis media
  • Skin tumours e.g. mast cell tumours 
• Recognise clinical signs of common ophthalmological problems in brachycephalic dogs;
• Perform a thorough eye examination for a brachycephalic patient; 
• Understand both medical and surgical treatment options for common ophthalmological conditions for brachycephalic patients, including:
  • Proptosis
  • Cherry eye (third eyelid prolapse) 
  • Eyelid abnormalities (entropion, ectropion & diamond eye) 
  • Cilia abnormalities
  • Keratoconjunctivitis Sicca (KCS) 
  • Corneal ulcer management 
  • Ocular neoplasia 

Finally in week 4 of the course, we will be discussing orthopaedic and neurological disorders that are associated with brachycephaly. Do you know when to recognise the warning signs of IVDD in a French Bulldog? Why is it that frenchie puppies fracture their elbows more than other breeds? This week will have those questions answered… plus more! 

Learning Outcomes

By the end of this week,you will be able to:

• Perform a thorough neurological, orthopaedic and spinal exam in brachycephalic breeds;
• Recognise breed related conformation that can predispose to:
  • Vertebral malformations including hemivertebrae
  • Kyphosis and scoliosis
  • Corkscrew tail and tail fold pyoderma
  • Intervertebral disc disease
  • Syringomyelia and chiari-like malformation
  • Hydrocephalus
  • Humeral condular fracture
  • Caudal articular process dysplasia
  • Medial patella luxation 
  • Hip dysplasia 
• Understand the benefits and limitations of screening programs for vertebral malformations and hip dysplasia in breeding dogs; 
• Recognise the clinical signs of idiopathic head tremors in brachycephalic breeds. 
• Awareness of common neoplastic conditions seen in brachycephalic dogs.