BOAS review highlights grading, earlier assessment, and treatment

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A 2022 review in Veterinary Clinics of North America: Small Animal Practice pulls together a practical framework for grading, assessing, and treating brachycephalic obstructive airway syndrome, or BOAS, in dogs. The authors, Kelley M. Thieman, Kathleen M. Ham, and Bryden J. Stanley, describe BOAS as a progressive disorder driven by primary airway abnormalities that increase resistance and turbulent airflow, then trigger secondary changes that further narrow the airway. Their clinical approach emphasizes careful respiratory auscultation, assessment of inspiratory effort, and exercise tolerance testing to sort dogs by disease severity and guide treatment decisions. That approach aligns with the University of Cambridge respiratory function grading system, now also offered in North America through OFA, which uses a brief exam plus a three-minute exercise test to classify dogs from grade 0 to grade III. (cir.nii.ac.jp)

Why it matters: For veterinary professionals, the review reinforces that noisy breathing in brachycephalic dogs shouldn't be dismissed as breed-normal. Current reference sources from Cornell and ACVS note that BOAS can worsen over time, impair exercise, sleep, eating, and thermoregulation, and is associated with secondary problems including laryngeal collapse, aspiration risk, and gastrointestinal disease. Conservative management still matters, especially weight control, heat and stress avoidance, and harness use, but earlier surgical intervention is generally linked to better outcomes in appropriately selected patients. (vet.cornell.edu)

What to watch: Expect continued uptake of standardized BOAS grading in general practice, breeding programs, and referral workflows, especially as North American screening expands to more brachycephalic breeds. (ofa.org)