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


METHODS
Prospective clinical study.


METHODS
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.
Department of Veterinary Medicine, University of Cambridge, Cambridge, United Kingdom.
Nai-Chieh
NC
Liu
Small Animal Department, Ear Nose and Throat Unit, Faculty of Veterinary Medicine, University of Leipzig, Leipzig, Germany.
Gerhard U
GU
Oechtering
Vet Epi, Norfolk, United Kingdom.
Vicki J
VJ
Adams
Department of Veterinary Medicine, University of Cambridge, Cambridge, United Kingdom.
Lajos
L
Kalmar
Department of Veterinary Medicine, University of Cambridge, Cambridge, United Kingdom.
David R
DR
Sargan
Department of Veterinary Medicine, University of Cambridge, Cambridge, United Kingdom.|Queen's Veterinary School Hospital, University of Cambridge, Cambridge, United Kingdom.
Jane F
JF
Ladlow
D000402:Airway Obstruction / Q000601:surgery / Q000662:veterinary*; D000818:Animals; D003398:Craniosynostoses / Q000601:surgery / Q000662:veterinary*; D004283:Dog Diseases / Q000601:surgery*; D004285:Dogs; D005260:Female; D008297:Male; D010375:Pedigree; D011183:Postoperative Complications; D011379:Prognosis; D011446:Prospective Studies; D012372:ROC Curve; D012129:Respiratory Function Tests / Q000662:veterinary