Folded Flap Palatoplasty and Incisional Dehiscence Rate in Brachycephalic Dogs

Enrollment Status: Currently Enrolling

Inclusion Criteria: A brachycephalic breed that has been diagnosed with BOAS and has not had corrective surgery for their obstructive airway syndrome in the past.

Exclusion Criteria: If your pet has undergone prior surgery for BOAS (staphylectomy, folded flap palatoplasty, tonsillectomy, sacculectomy, vestibuloplasty, etc.) or has had a prior respiratory distress episode, they will be excluded from participation in this study.

Treatment: Your dog will undergo a complete physical examination, and blood will be collected via venipuncture for complete blood count and serum biochemistry prior to admittance in this study. Following inclusion, your dog will undergo a sedated oral examination before surgery to assess their anatomic abnormalities that need to be corrected. A camera will be used in their mouth to document any abnormalities. The primary investigator (Dr. J. Brad Case) has vast experience with BOAS and has performed many successful folded flap palatoplasty procedures. Your pet will be placed under general anesthesia for their procedure. The soft palate will be measured and determine how much tissue to remove. Following careful removal of a section of the soft palate, the end will be folded forward to the front most edge of the soft palate and sutured there. Following the folded flap palatoplasty, your dog will be assessed for other anatomic abnormalities such as narrowed nares, that will also be corrected. All enrolled patients will be hospitalized post-operatively in the intensive care unit for a minimum of 24 hours for monitoring, respiratory watch, and for additional oxygen support if needed following BOAS corrective surgery. A sedated recheck examination of your pets’ incision of their soft palate correction will be done 12-24 hours post-operatively and documented with a specialized camera. Your pet will be discharged once they are voluntarily eating and drinking, and their pain is deemed appropriately controlled with oral medications. As part of your agreement to enter this study, all dogs must be re-evaluated at the UF Small Animal Hospital 10-14 days post-operatively for an incision check of the soft palate that will be documented with a specialized camera. They will be sedated for this incision recheck and will need to be fasted the night before (no food after 12 am) for the recheck examination.

Cost: On average, the estimated total cost of diagnostic work-up and surgical treatment for BOAS is $2,800-3,500. The study will provide a $500 stipend towards the cost of the initial workup. You will be responsible for the costs of diagnostics (bloodwork/imaging), anesthesia, surgical procedures, and any required medications and hospitalization exceeding $500. The stipend will be awarded only after surgery is performed. You will be responsible for all fees associated with follow-up, as is standard for BOAS patients. A recheck examination 10-14 days after surgery is required to check the incision and is necessary for the study to document the incision healing. The cost of this recheck examination is covered, unless any additional medications, diagnostics, or therapies are deemed necessary. You will be responsible for fees associated with post-operative complications that may develop, or additional medications/treatments needed at the time of recheck.

Contact: Email caseb@ufl.edu

PI: Dr. J Brad Case

Background: Many brachycephalic dogs of breeds such as English bulldogs, French bulldogs, Boston Terriers, Pugs, and Boxers etc. are diagnosed with brachycephalic obstructive airway syndrome (BOAS). The four main abnormalities causing BOAS in these breeds include an elongated and thickened soft palate, narrowed nostrils, everted laryngeal saccules, and narrowed trachea. Having all or some of these anatomical variations makes it harder for dogs to breathe properly and can lead to breathing crises. An elongated and thickened soft palate can be surgically corrected with a folded flap palatoplasty which thins and shortens the soft palate. A rectangular section of the soft palate is removed and then the end is folded forward and sutured it in place resulting in a shorter and thinner soft palate. Although complications of wound healing and opening of the incision have been reported, this procedure is routinely performed here at UFVH with minimal to no complications. Our goal is to perform this procedure in dogs requiring soft palate shortening and examine their incision 12-24 hours and 10-14 days post-operatively during a sedated examination using a specialized camera. We hypothesize that incisional complications will not occur following folded flap palatoplasty. Our main goal is to report any wound healing complications that occur with this procedure so we can verify its validity as a technique for surgical correction of elongated palate in BOAS patients.This study will provide insight and follow patients in real time throughout their pre- and post-operative surgical periods requiring oral examinations