Quality of life improvement in 3 dogs with sleep-disordered breathing managed by permanent (crico)tracheostomy.

Objective: To retrospectively describe the management of sleep-disordered breathing (SDB) via permanent (crico)tracheostomy (PT).

Methods: The sample was 3 client-owned dogs. Each of the dogs had variable clinical signs related to their SDB with all having severely affected quality of sleep and experiencing multiple apneic episodes a night in the study period from January 1, 2019, to December 31, 2023. Two of the 3 dogs showed minimal daytime clinical signs, with 1 owner reporting no noticeable changes in breathing, activity, or alertness, while another noted only mild alterations. Despite previous brachycephalic airway surgery, clinical signs persisted or recurred, and all owners considered euthanasia secondary to nighttime signs. Permanent (crico)tracheostomy was elected in all cases.

Results: Medical records were reviewed, and a standardized survey was administered to owners. All cases demonstrated variable degrees of improvement in the severity and frequency of clinical signs relating to SDB following PT, and overall quality of life improved from poor to good in all cases. All cases experienced surgical complications ranging from moderate to severe following PT, with 2 of 3 dogs requiring revision surgeries for skin-fold occlusion and stenosis of the PT.

Conclusions: Sleep-disordered breathing may be an underrecognized component of brachycephalic obstructive airway syndrome, with nighttime clinical signs significantly impacting quality of life.

Clinical relevance: Permanent (crico)tracheostomy may be considered in cases that either do not respond to initial brachycephalic airway surgery or in cases where clinical signs recur years after initial surgery. Owners should be aware of the likelihood of revision surgeries to achieve optimal outcomes.