Complications, prognostic factors, and long-term outcomes for dogs with brachycephalic obstructive airway syndrome that underwent H-pharyngoplasty and ala-vestibuloplasty: 423 cases (2011-2017).

Abstract

OBJECTIVE: To describe the H-pharyngoplasty procedure, report the outcomes of dogs with brachycephalic obstructive airway syndrome (BOAS) treated with ala-vestibuloplasty and H-pharyngoplasty with a CO2 laser, and identify prognostic factors. ANIMALS: 423 dogs. PROCEDURES: Medical records of dogs admitted for BOAS from 2011 to 2017 were reviewed. Dogs were included if they were treated with ala-vestibuloplasty and H-pharyngoplasty with a CO2 laser. Signalment, physical examination findings, grades at admission of clinical signs associated with respiratory and digestive systems, diagnostic test results, postoperative treatments, and short-term follow-up results were extracted from medical records. Long-term follow-up of > 12 months was evaluated via questionnaire. Generalized ordered logistic regression was used for bivariable and multivariable analyses. RESULTS: Overall mortality rate was 2.6%. Median duration of follow-up was 36 months (12 to 91 months), and 341 (80.6%) dog owners completed the questionnaire. Major complications included respiratory distress (2.1%), heatstroke (0.5%), and bronchopneumonia (0.5%). No dogs required revision surgery. Improvement in signs associated with the respiratory and digestive systems was reported in 72% and 34% of the dogs, respectively, and owners' satisfaction was high (97.1%). Risk of death increased by 29.8% (95% CI, 11.8% to 50.7%) for every 1-year increase in age. CONCLUSION AND CLINICAL RELEVANCE: H-pharyngoplasty was possible in all dogs with BOAS, including those previously treated with conventional surgery and was associated with low morbidity and improved respiratory and digestive signs. H-pharyngoplasty combined with ala-vestibuloplasty may be an alternative treatment for even the most severely affected dogs.