An elongated soft palate is a

congenital A birth defect, also known as a congenital disorder, is an abnormal condition that is present at birth regardless of its cause. Birth defects may result in disabilities that may be physical, intellectual, or developmental. The disabilities can ...

hereditary disorder A genetic disorder is a health problem caused by one or more abnormalities in the genome. It can be caused by a mutation in a single gene (monogenic) or multiple genes (polygenic) or by a chromosomal abnormality. Although polygenic disorders ...

that negatively affect

dog The dog (''Canis familiaris'' or ''Canis lupus familiaris'') is a domesticated descendant of the wolf. Also called the domestic dog, it is derived from the extinct Pleistocene wolf, and the modern wolf is the dog's nearest living relative. Do ...

s and

cat The cat (''Felis catus'') is a domestic species of small carnivorous mammal. It is the only domesticated species in the family Felidae and is commonly referred to as the domestic cat or house cat to distinguish it from the wild members of ...

breathing Breathing (or ventilation) is the process of moving air into and from the lungs to facilitate gas exchange with the internal environment, mostly to flush out carbon dioxide and bring in oxygen. All aerobic creatures need oxygen for cellular ...

and

eating Eating (also known as consuming) is the ingestion of food, typically to provide a heterotrophic organism with energy and to allow for growth. Animals and other heterotrophs must eat in order to survive — carnivores eat other animals, herbi ...

. A

soft palate The soft palate (also known as the velum, palatal velum, or muscular palate) is, in mammals, the soft tissue constituting the back of the roof of the mouth. The soft palate is part of the palate of the mouth; the other part is the hard palate. ...

is considered elongated when it extends past the top of the

epiglottis The epiglottis is a leaf-shaped flap in the throat that prevents food and water from entering the trachea and the lungs. It stays open during breathing, allowing air into the larynx. During swallowing, it closes to prevent aspiration of food int ...

and/or past the middle of the

tonsillar crypts The human palatine tonsils (PT) are covered by stratified squamous epithelium that extends into deep and partly branched tonsillar crypts, of which there are about 10 to 30. The crypts greatly increase the contact surface between environmental inf ...

. The soft palate is made up of muscle and connective tissue located in the posterior portion on the roof of the mouth. The soft palate creates a barrier between the mouth (oral cavity) and nose (nasal cavity). This continuation between the cavities makes it possible to chew and breathe at the same time. The soft palate only blocks the nasal cavity while swallowing. At rest the soft palate should only stretch caudally from the hard palate to the tip of the epiglottis leaving an opening between the nasal and oral cavities. When the soft palate is elongated, it partially blocks the throat thereby creating breathing and feeding-related issues. The elongation and other accompanying symptoms occur in breeds characterized with “smooshed faces” such as pugs, bulldogs, and Persian cats. This condition is a congenital, meaning it is present when the animal is born. The “smooshed” characteristics is the result of a genetic mutation. The animal’s genetic code causes the bones in their skull to grow to a smaller size. Because the bones are smaller, muscles and other tissues that surround the bones of the skull are out of proportion. These animals are often referred to as brachycephalic, derived from the Greek words for “short” and “head”. An elongated soft palate is a symptom of Brachycephalic Obstructive Airway Syndrome (BOAS) and is common in

brachycephalic Brachycephaly (derived from the Ancient Greek '' βραχύς'', 'short' and '' κεφαλή'', 'head') is the shape of a skull shorter than typical for its species. It is perceived as a desirable trait in some domesticated dog and cat breeds, ...

dog breeds and has been reported in brachycephalic cat breeds as well. Some of the other BOAS related symptoms include

stenotic nares Stenotic nares means the nares (nostrils) are pinched or narrow, making it more difficult for an animal to breathe, and resulting in a lot of open-mouth breathing and panting. The condition is part of the brachycephalic airway obstructive syndro ...

, everted

laryngeal saccules The laryngeal saccules are soft tissue masses that are extensions of the laryngeal ventricles in the larynx. Their function is not well understood, but they may lubricate the vocal cords, and increase the resonance of vocalisation. They may be in ...

, and laryngeal collapse.

Signs and symptoms

Some of the signs and symptoms of an elongated soft palate are loud and/or labored breathing and eating difficulties. Some of the breathing symptoms include stridor, snoring, wheezing, gasping, and reverse sneezing. Some of the eating symptoms include gaging and trouble swallowing. Severely affected pets may develop apnea, syncope, cyanosis. In extreme cases, the animal may be exercise intolerant and may collapse, when overly exerted. Many brachycephalic pet owners may see these symptoms as "normal" for that breed. Recognizing different sounds during the animals breathing can help to diagnose BOAC and the presence of an elongated soft palate. - Pharyngeal Noise: This noise is termed ‘stertor’ and occurs when a dog cannot ‘pant’ normally due to blockage. So, the dog breathes partially through the nose, creating negative pressure which triggers a low-pitched, snoring sound, or “awake snores”. - Laryngeal Noise: this noise is termed ‘stridor’ and typically affects pugs. It is characterized as a noise similar to wheezing and is higher pitched. This sound occurs when there is a narrow or collapsed larynx. A collapsed larynx can occur from leaving an elongated soft palate untreated. - Nasopharyngeal Noise: noise created due to stenotic nares; a nasal obstruction caused by altered growth of the scrolls within the nose. It includes a combination of low- and high-pitched noises similar to grunting. - Reverse Sneezing: related to when the elongated soft palate irritates the back of the throat. It is a low grunting sound, similar to clearing your throat. Episodes usually last for a few seconds or up to a few minutes.

Diagnosis

Pets can be diagnosed via physical examination, which involves observation and detection of the symptoms associated with altered breathing due to an elongated soft palate and BOAC. Another diagnostic option is an oral examination. Oral examinations are performed under sedation and includes determining the position of the soft palate. It also involves assessing other symptoms that often accompany an elongated soft palate such as, checking for masses or redundant pharyngeal tissue, evaluating the laryngeal structures and checking for tonsil inflammation. CT scans can also be performed.

Treatment

There are medical and surgical options once a diagnosis is made. Weight loss, controlling allergies, staying in a cool environment, and avoiding neck leads. For gastrointestinal issues, a combination of antacids and prokinetic drugs can be used. The specific medication is depended on the severity of the gastrointestinal issues present upon examination. Packer RM and Tivers M found that after about a 6 month follow up, 72.1% of owners stated that their dog’s digestive status was excellent and 75% no longer needed treatment or a special diet . An elongated soft palate can be treated surgically by resection, meaning the excess soft palate tissue is removed. A surgical risk could be removing too much of the soft palate. If the soft palate, then becomes too short, it will no longer be able to block off the nasal and oral cavities during swallowing. Surgical options include: * Soft palate resection: a surgical option for shortening the elongated soft palate. The surgery can be performed with a scalpel, electrocautery, or a CO₂ laser. Using a scalpel involves cutting away the excess soft palate and suturing where it was cut from. Choosing the electrocautery option poses some risks. Electrocautery can cause severe tissue edema (excess fluid in your tissues) and a large band of necrosis (cell and tissue death). CO₂ laser surgery causes little to no bleeding and it is a quicker procedure when compared to other treatment methods. Sutures are often not required.

Electrocautery Cauterization (or cauterisation, or cautery) is a medical practice or technique of burning a part of a body to remove or close off a part of it. It destroys some tissue in an attempt to mitigate bleeding and damage, remove an undesired growth, or ...

and

diode laser The laser diode chip removed and placed on the eye of a needle for scale A laser diode (LD, also injection laser diode or ILD, or diode laser) is a semiconductor device similar to a light-emitting diode in which a diode pumped directly with e ...

surgery results in little to no bleeding, but due to excessive heat and their burning nature, these methods may cause tissue

edema Edema, also spelled oedema, and also known as fluid retention, dropsy, hydropsy and swelling, is the build-up of fluid in the body's Tissue (biology), tissue. Most commonly, the legs or arms are affected. Symptoms may include skin which feels t ...

. Sutures are often not required.

Scalpel A scalpel, lancet, or bistoury is a small and extremely sharp bladed instrument used for surgery, anatomical dissection, podiatry and various arts and crafts (either called a hobby knife or an X-acto knife.). Scalpels may be single-use disposa ...

scissors Scissors are hand-operated shearing tools. A pair of scissors consists of a pair of metal blades pivoted so that the sharpened edges slide against each other when the handles (bows) opposite to the pivot are closed. Scissors are used for cutti ...

surgery takes longer than with the CO₂ laser, there is bleeding, and suturing is required. * Rhinoplasty: surgical enlargement of the stenotic nares in order to improve airflow. This procedure often accompanies soft palate surgery. This reduces the chances of secondary airway changes happening. It has also shown that the two surgeries paired together it has a better outcome than just the soft palate surgery alone. Packer RM and Tivers M found that the results of this surgery showed that about 25% of dogs were “breathing normally” after the procedure and about 53.6% saw much improvement. * Laryngeal saccule resection: when there is a grade I laryngeal collapse, the laryngeal saccules are everted. This causes another obstruction that blocks the airway. Treatment for this involves cutting out the everted saccules. This also usually occurs in pair with the soft palate resection and rhinoplasty. Packer RM and Tivers M found that out of a group of dogs who received this procedure, 78% showed some sort of improvement in their breathing. Early intervention and correction is recommended. The majority of patients show improvement after elongated soft palate surgery.

References

{{Reflist

External links

Brachycephalic Obstructive Airway Syndrome - Cambridge Veterinary School
Dog anatomy Dog diseases Veterinary procedures