Laryngeal Collapse

By: Dr. Roy Kraemer |
DVM, Bulldog Specialist Veterinarian

Laryngeal Collapse In Bulldogs and French Bulldogs INTRODUCTION:

Laryngeal collapse is an irreversible, secondary, end-stage condition that results from progressive, chronic, and severe untreated BOAS (Brachycephalic Obstructive Airway Syndrome). The most common BOAS primary conditions that lead to this collapse are

French bulldog stenotic nares-001

BULLDOG LARYNX ANATOMY

The bulldog’s larynx is a cartilaginous box-like structure that connects the mouth and nose to the trachea (windpipe) and lungs.

Bulldog Laryngeal Collapse 5 X MUST KNOW

  1. Laryngeal collapse late stage is irreversible narrowing, causing severe labored breathing
  2. The early stage offers a better prognosis by repairing BOAS including the elongated palate and everted saccules.
  3. The late-stage prognosis is poor, surgical repair is impossible, and permanent tracheostomy is the only surgical option.
  4. Management includes weight control, a stress-free environment, a cool temperature, supplements, and surgery
  5. Prevention & Care includes Dr. Kraemer’s Obstrcative Airways Bundles 

Bulldog Breathing and Anesthesia Therapeutic Bundle

Why Bulldogs and French Bulldogs Suffer from Laryngeal Collapse?

Airway resistance and increased negative pressure in the larynx are caused by obstructive airway anatomical problems in bulldogs with flat faces (brachycephalic), such as extended soft palates and stenotic nares. The laryngeal cartilage is worn down over time by the attempts to counteract those stresses, which compromises its structural integrity and leads to deformity, atrophy, and collapse.

Overweight bulldogs tend to experience a more rapid progression of the condition.

fit healthy bulldog after weight loss

The Three Stages of Laryngeal Collapse in Bulldogs

Laryngeal collapse progresses through three pathological stages, each presenting increasing clinical severity, treatment challenges degree of difficulties, and a worsening prognosis:

bulldog and Fr bulldog NORMAL larynx

 

PHASE 1: LARYNGEAL EVERSION

Everted Laryngeal Saccules are considered the first phase,  the mildest form of collapse, and carry the best prognosis.

Everted saccules are caused by chronic negative pressure that forces the bottom of the larynx to evert, forming right and left obstructions that resemble small balloons.

Bulldog everted laryngeal saccules

PHASE 2: LARYNGEAL EARLY COLLAPSE

The laryngeal cartilages begin to fatigue and atrophy, causing a mild collapse that further restricts airflow.

PHASE 3: FINAL LARYNGEAL COLLAPSE

Total collapse of the laryngeal cartilage leads to irreversible narrowing of the airway.

Laryngeal collapse is the most severe form of BOAS and it carries a poor prognosis

bulldog and French bulldog laryngeal collapse

What Are The Symptoms of Laryngeal Collapse in Bulldogs?

  1. Noisy Breathing: Stridor, honking, labored breathing, and stertor that worsens during excitement, activity, or in hot weather
  2. Exercise intolerance
  3. Difficulty sleeping: interrupted sleeping
  4. Gastrointestinal: Vomiting, gagging, retching, and regurgitation, which can lead to aspiration pneumonia
  5. Overheating: Prone to overheating
  6.  Collapse and, tragically, sudden death

Laryngeal Collapse in Bulldog and Fr. Bulldog DIAGNOSIS:

diagnosis begins with an analysis of the dog’s clinical signs and history, followed by:

  1. Visual Inspection: Sedation or anesthesia is required to examine the larynx and surrounding tissues (palate, pharynx, tonsils).
  2. Laryngoscopy: Provides visualization of both the upper and lower airway.
  3. Imaging: Radiographs, CT scans, or MRIs.
  4. Laryngeal Cartilage Function Test: A dynamic test using Doxapram to assess how the larynx responds. This requires an experienced clinician (plane of anestesia, the risk involved.

Laryngeal Collapse in Bulldogs: PREVENT & TREAT

Treatment options depend on the stage of the condition. Nevertheless, all BOAS and all laryngeal collapse stages will benefit from

 BOAS and secondary laryngeal complications are progressive and can become irreversible over time

Eng Bulldog V4B StressLess Formula Handou

🩺Performing laryngeal exams and correcting BOAS issues within the first year is critical for success

LARYNGEAL COLLAPSE STAGE 1 SURGERY

Early, timely surgical correction of primary BOAS conditions (stenotic nares and elongated soft palate) and removal of the everted saccules and prolapsed tonsils.

🚨Timing is critical for a successful outcome.

fr. bulldog laryngeal problems

LARYNGEAL COLLAPSE STAGE 2 & 3 MEDICAL TREATMENT

Medical management involves

  • tranquilizers
  • Anti-vomiting rx: various anti-emetic tablets and injectables
  • Anti-reflux & anti-acid: to prevent regurgitation and prevent aspiration. includes antacids, H2 Blockers, and Proton Pump Inhibitors
  • Anti-inflammatories: usually steroids

LARYNGEAL COLLAPSE STAGE 2&3 SURGERY:

  1. Stenotic Nares and Elongated Soft Palate surgical correction may help but is usually insufficient.
  2. Laryngeal Tie-back surgery is generally not recommended due to the high risk of aspiration pneumonia.
  3. Permanent tracheostomy: The only worthy surgical option is a permanent tracheostomy, which bypasses the larynx. While the success rate is limited, it can provide a long-term solution.

⚠️ Permanent tracheostomy requires a lifelong owner commitment and careful management. Complications are common

Laryngeal Collapse in Bulldogs PROGNOSIS

While stage one laryngeal collapse has a good prognosis when timely BOAS repair is performed, the more advanced stages have a poor prognosis, often leading to diminished quality of life and complications such as aspiration pneumonia, cardiogenic, and pulmonary edema.

What Laryngeal Obstructive Conditions Can Mimic Collapse?

  • Laryngeal Paralysis: Uncommon in bulldogs
  • Polyps and Tumors: Pharyngeal and Laryngeal mass, polyps, tumors
  • Swelling: due to insect bites or allergic reactions
  • Incomplete BOAS Surgery: Insufficient removal of the elongated soft palate

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