Format

Send to

Choose Destination
Vet Surg. 2017 Feb;46(2):271-280. doi: 10.1111/vsu.12608.

Outcomes and prognostic factors of surgical treatments for brachycephalic obstructive airway syndrome in 3 breeds.

Author information

1
Department of Veterinary Medicine, University of Cambridge, Cambridge, United Kingdom.
2
Small Animal Department, Ear Nose and Throat Unit, Faculty of Veterinary Medicine, University of Leipzig, Leipzig, Germany.
3
Vet Epi, Norfolk, United Kingdom.
4
Queen's Veterinary School Hospital, University of Cambridge, Cambridge, United Kingdom.

Abstract

OBJECTIVE:

To determine prognostic indicators for the surgical treatment of brachycephalic obstructive airway syndrome (BOAS) and to compare the prognosis of 2 multilevel surgical procedures.

STUDY DESIGN:

Prospective clinical study.

SAMPLE POPULATION:

Client-owned pugs, French bulldogs, and bulldogs (n = 50).

METHODS:

Noninvasive whole-body barometric plethysmography (WBBP) was used to assess respiratory function before, 1 month and 6 months after upper airway corrective surgery. Postoperatively, BOAS indices (ie, ascending severity score generated from WBBP data, 0%-100%) that equaled to or exceeded the cut-off values of BOAS in the diagnostic models were considered to have a "poor prognosis." A multivariate logistic regression was used to assess predictors for prognosis.

RESULTS:

The median BOAS indices decreased after surgery (from 76% to 63%, P < .0001), although dogs with indices in this range would still be considered clinically affected. Age (odds ratios [OR] = 0.96, 95% confidence interval [CI]: 0.93-0.99, P < .05), body condition (OR = 0.06, 95% CI: 0.01-0.39, P < .01), laryngeal collapse (OR = 6.1, 95% CI: 1-37.22, P < .05), and surgical techniques (OR = 7.94, 95% CI: 1.17-54.01, P < .05) were associated with postoperative prognosis. The multivariate model suggests modified multilevel surgery (MMS) may have a better outcome than traditional multilevel surgery (TMS) (P = .034). The positive predictive value of the logistic model was 84% (95% CI: 68-94%) and the area under the receiver operating characteristic (ROC) curve was 89% (95% CI: 78-99%, P <.0001).

CONCLUSIONS:

Younger age, normal body condition, presence of laryngeal collapse, and treatment with TMS were negative prognostic factors after surgical treatment of BOAS. MMS is recommended, particularly in dogs with a higher probability of poor prognosis.

PMID:
28146288
DOI:
10.1111/vsu.12608
[Indexed for MEDLINE]

Supplemental Content

Full text links

Icon for Wiley
Loading ...
Support Center