I was at the last Yappy Hour and a couple Pug owners said they had gotten surgery to improve the breed's standard breathing issues. Has anyone gotten such surgery for their Frenchie? Did it help? How major a surgery is this? Would you recommend it? At what age? Poor Chocula sounds like a percolator. If I can help him breathe easier, I must.

Hi there. I just got my first Frenchie and my vet recommended it. Of course I was aware of both surgical approaches and was hesitant...especially because my vet had never done the "wedge procedure" before. With much discussion I decided to go ahead with it. I'm glad I did, but I think Maizy is much happier than me! Even with the edema she was breathing better the same day. She was going in to be spayed so she would have to go under anyway. This will be 2 weeks on Friday and she still has stitches in her nose but they don't seem to bother her, tough little girl that she is. By the way, she's about 6.5 months old. My vet is Dr. Connie White at Fremont Veterinary Clinic in NE. Both Dr. White and the other vets were so pleased with her results during her checkup last week! This is just my opinion though...

Once I had some medical terms I could do a Google search. The medical term for short-nosed breathing problems is "brachycephalic airway syndrome". The two main problems are "stenotic nares" (narrowed nasal pasages) and "elongated soft palate". Crossroads vet does the stenotic nares correction, or "naresplasty" (the "wedge procedure") for $300 and they have a lot of experience with it (Dr Kent Smith). NW Vet and Cascade Vet do both procedures together ("naresplasty" and "soft pallette resection") for the amazing price of $1700-$2300. Crossroads does not do the "soft pallette resection" as that is a more involved procedure requiring a specialist and special equipment.

From what I have read and asked the vets, "naresplasty" will improve regular breathing that currently sounds like a percolator. It is not likely to have a significant effect on snoring or sleep apnea as that requires "soft pallette resection". Assuming my girlfriend agrees, I am thinking we will do the "naresplasty" as that is likely to be improvement enough and then re-evaluate from there. We definitely need to do something, as he sounds like he is struggling to breathe normally and from what I have read uncorrected "stenotic nares" can lead to "everted saccules", "laryngeal collapse", and "tracheal collapse" later in life. Scary!

I can tell by looking at him that he has a pretty strong case of "stenotic nares", as per the photos here:

http://www.acvs.org/A...

-Mike

Good research Mike! By the time I had time to reply to you this moring you already figured everything out. Watch for the soft palette issue in the future, sometimes as Frenchies get older it can become a problem. But I think you are starting off in the right direction.

Good luck with the stenotic nares surgery, and don't forget to take your French Bulldog anesthesia protocol with you so they will use the correct medicines :) If you haven't had him neutered yet, you could probably have both procedures done at once and save a little bit of money

Gracian

>> don't forget to take your French Bulldog anesthesia protocol with you so they will use the correct medicines

What does that mean?

We had him neutered at 6 months, so too late to save the dough.

-Mike

Here is the protocol, sorry, I thought I sent it to you before. I also emailed it directly to you. Is he over 6 months old already??!

Wherever you go for the surgery, PLEASE print this out and show it to the vet. If they roll their eyes, but agree, fine. If they tell you they have used Ace on frenchies without problems and want to use it on yours- go elsewhere. Some frenchies are okay with Ace - others die, and you won't know until it's too late.

Anesthesia Protocol For Frenchies

ADVISE STRONGLY AGAINST USING:
Ace promazine
Pentobarbital aka Pentathol (injectable anesthesia)
Metofane (inhalant gas)
Halothane (gas anesthesia)

USE WITH CAUTION:
Dormitor (reversible anesthesia/sedative)

SATISFACTORY CHOICES FOR FRENCHIES:
Ketamine (usually used in combo with valium as an injectable anesthesia/sedative)
Valium (see above)
Torbutrol (analgesia)

OPTIMUM CHOICES:
Propofol (injectable)
with either of the following 2 gas anesthetics as a maintenance:
Isoflurane(aka IsoFlo) OR Sevoflurane (aka SevoFlo)

ANESTHESTIC EXTRAS:
(These would be in addition to the Optimum anesthetic protocol listed above, and are highly recommended for c-sections or longer procedures)
Atropine given at induction
IV catheter & fluids
Famotidine (Pepcid) injection (helps cut down on nausea and pot-op vomiting, hence aspiration)
Dexmethasone injection (may be given if palate if very long or irritated from ET tube; this can reduce post-op swelling and make recovery easier)


INTUBATION vs. MASKING/CONING DOWN:
EVERY brachycephalic dog that goes under anesthesia should have an endotracheal tube (ET) placed in his or her trachea! Always! That airway must be protected at all times. The tube should be left in until they are VERY awake and trying to chew it out. Use the intravenous propofol to induce anesthesia (which puts them under) and allows sufficient time to place the ET tube. From then on, anesthesia is maintained with sevo or iso.

Be Careful when masking a frenchie down. Masking can be harder on brachycephalic dogs because they struggle to hold their breath, which can irritate the airways and deplete their oxygen levels (which you do not want before surgery). It is my opinion that using injectable and then tubing them gives them the optimum oxygen supply that is ideal for frenchies.

Lori Hunt, DVM
AssisiFrenchies@aol.com

This is super helpful! Thanks Gracian!

Hi,
Our frenchie Oswald is now almost 2. He had lots of breathing issues and vomiting from the time we got him. At 8 months or so we had him neutered and they found that he had an elongated palate. We took him to a specialist and had is palate reduced as well as the wedge procedure for his nares. Initially we were reluctant due to the cost but after having the procedure done he was like a new dog. We had always thought his lack of energy as a puppy was just his breed and his personality but once he could breath properly he was a new man, suddenly very playful and running around the yard like a puppy should. We still have some issues if he gets to rowdy and have still not completely fixed the regurgitation issues but we are so glad we had the surgery as we hope this will give him a long and healthy life.
Good luck with your dog.
Mary

Chocula update:

When we took him in for the naresplasty, the vet told us that his sinus issues weren't that bad - the breathing noises were a sign of elongated soft palette. Ugh! Did I mention I am currently unemployed? He suggested Cornell Road Vet and Laser Center as being recommended by the local English Bulldog Rescue and the estimate was significantly lower than the previous quotes mentioned above - anywhere from $700 to $1300 depending on what they find and how well he recovers. His total ended up being $980 for the surgery plus $250 for an overnight stay at Dove Lewis, $1230 total. The vet told me he had one of the longest soft palettes she'd seen. It was three times larger than another photo she showed me. He also had to be treated for everted laryngeal saccules, another breathing issue in brachycephalic breeds. Had the saccules treatment not been needed, he possibly could have been released without overnight care and the end total would have been less. The main advantage of the uber expensive folks mentioned previously is that they also do the overnight care themselves, whereas I had to drive a drugged up Chocula from the vet in Hillsboro to Dove Lewis in NW. Saved a lot of dough, though, and the vet has been great with followup. She also said she'd be happy to give a presentation on the procedure at a meeting sometime if the club is interested.

Here is a web site with some highly detailed info:

http://www.vin.com/pr...

Note the percentages of brachycephalic dogs with these issues listed in that article:

Stenotic Nares: 48%
Elongated Soft Palette: 80% (yes, you read that correctly)
Everted Laryngeal Saccules: 48%

These numbers include all brachycephalic breeds, some of which may be more likely than Frenchies to have these issues, but the numbers are quite high. Note that if left untreated, they lead to another condition, Laryngeal Collapse.

So how do you tell what your dog needs? There are web sites that show what a "normal nose" and "stenotic nares nose" look like, such as this one and many others:

http://en.wikipedia.o...

For soft palette, you can't see it until the dog is under anesthesia. Best to have this examined while the dog is in for spay/neuter, though that's also the best time to treat it since the sooner it's done the more complications due to negative pressure in the breathing system can be avoided. You can generally hear if the dog has a problem. If your dog is above average in snorty, grunty, snory, and other breathing noises, chances are he/she will need surgery either now - or later after more complications have developed. A couple other symptoms Chocula had included heavy panting for a half-hour after leaving the dog park, as recently as a couple weeks ago (not just mid summer), even though I do not let him play TOO long because I know he can't handle overextending himself at the park. Also, he would occasionally spit up some food. And then of course are the above normal levels of Frenchie Flatulence and burping. Note that when he was a puppy and we looked at the litter, I could tell his breathing was noisier than the other pups in the litter even then. He was also by far the most adorable, of course.



I'm a bit broker and really need a job soon, but very happy that my furry son can breathe much easier now. If you know of any project management openings in software, web, or IT, please let me know!

-Mike

I wanted to add some followup on this. Chocky is doing great. However, if I had this to do again, there is one thing I would do different.

Generally when they laser the soft pallette, they also laser the nose to correct stenotic nares, as they did with Chocula. The "old" method of correcting the soft pallette requires sutures whereas the laser does not and thus recovery is easier on the patient. However, I do NOT recommend laser to correct stenotic nares. Anyone who does bracheocephalic surgery can also do other methods of correcting stenotic nares, which include the "wedge procedure". The laser procedure basically removes some of the nostril rather than pushing it open, which looks a bit like a cat took a swipe at him. Sure, he's still healing, and you likely wouldn't notice it if you weren't looking for it, but I would have prefered a less intrusive method of widening his nostrils. I also suspect the lack of smoothness created by cutting a chunk out of his nostrils is why I can hear his nasil breathing now (though I'll get an official opinion from my regular vet).

So in conclusion, I recommend only using the laser for correcting elongated soft palette, not for correcting stenotic nares.