Brachycephalic for Life: Clinical Management Strategies
Brachycephalics are fun, yet they’re also high-risk patients in almost every sense. You could say they’re the poster children for anaesthetic complications, gastro-oesophageal disease, skeletal issues and, obviously, respiratory compromise.
What extra precautions do you take to manage these patients?
Every clinician has an opportunity to improve the welfare and quality of life of brachy patients – if the client allows us.
This 5-week online course shows you how.
Brachycephalic obstructive airway syndrome (BOAS)
BOAS is a chronic, lifelong and inherited disorder of brachycephalic breeds. In the long term, it is hoped that conscientious breeding will improve the welfare of these patients. In the short to medium term, the veterinary industry is forced to meet a range of social, surgical and medical challenges to help these animals survive.
This online course prepares general practice and referral hospital veterinarians to coordinate and manage brachycephalic cases, including owner education, surgical case selection, anaesthesia and preoperative care, recovery and discharge, and long term control.
It’s not just the airways…
If a brachy is booked to see you, it’s a reasonable assumption that it’s got an obvious issue like heat stress, exercise intolerance or respiratory collapse. Yet aside from the well-known respiratory issues and sensitivity to heat, brachies can present with other life-limiting issues such as gastro-oesophageal reflux, hiatal hernia, skin disease, a tendency to develop corneal ulcers and MSK issues like luxating patellae, screw tails and hemivertebrae.
These are complex patients.
As a clinician in charge of any difficult case, you also need to be alert to subclinical disease and the likely progression of brachy-specific medical issues. Early intervention and supportive care can make a significant difference to your patient’s quality of life.
Important: this course covers medical and surgical aspects of brachycephalic care, but it is not a guide on how to perform specific airway procedures.
Q&A EACH WEEK
PROFESSIONAL & SUPPORTIVE FORUM
DOWNLOADABLE NOTES
JOIN LIVE & ONLINE
REPLAYS AVAILABLE
Brachies need veterinary support
- Understand how you can make a difference
- See what gains you can achieve in primary care
- Planning airway surgery in-house
- Hear the evidence for change
- Get access to reliable resources
Get a handle on BOAS
- Making welfare your priority
- Controlling risk while the patient is in the clinic
- How to suggest surgery if it’s indicated
- Reducing the potential for lifelong suffering
- Why timing is everything
BONUS MODULE – BOAS is a Major Health Issue
BOAS should be a major concern for you in GP or referral practice, both in terms of patient welfare and because of the clinical risk while they’re in your care. It’s a delicate topic. We introduce how to talk to your clients about BOAS, red flags for the highest-risk patients, and how to go about case selection for surgery.
Course schedule
BONUS MODULE – BOAS is a Major Health Issue
Most of us are familiar with respiratory disease and heat stress in brachycephalics. But early in life, there are other serious and subclinical health issues. Do you know what to look for?
This introductory module outlines why BOAS should be a major concern for you in GP or referral practice, both in terms of patient welfare and because of the clinical risk they carry. It’s a delicate topic. We introduce how to talk to your clients about BOAS, red flags for the highest risk patients, and how to go about case selection for surgery.
Module 1 – Perioperative Risks
Brachycephalic breeds are head shy, highly strung and highly bonded to their owners. Many brachy dogs experience spontaneous regurgitation, and some pets (and their owners) take stress and separation anxiety to epic levels. This is not an anaesthetic patient to take lightly, and the stakes are highest when you’re the one responsible for surgery and anaesthetic safety. This module outlines why a standard perioperative protocol lacks the scope to protect a brachycephalic heading to surgery.
- How a stressed patient sabotages its own recovery
- Using previsit pharmaceuticals (PVPs) to improve patient safety
- Regurgitation & aspiration risks
- The role of antacid therapy in your perioperative plan
Module 2 – General Anaesthesia
It’s been said that a pug’s best breathing is achieved through an ET tube. These patients can wait a long time before they’re ready to extubate – and fair enough!
Brachycephalic anaesthesia is a challenge. Add a long, thickened soft palate. Intubate past those swollen laryngeal saccules and engorged tonsils. Reduce your ET tube size to accommodate the hypoplastic trachea. There’s more.
- Preoxegenate, preoxygenate, preoxygenate
- Your guide to prompt & safe intubation
- Managing the airway during BOAS surgery
- Appropriate GA maintenance for patients with complex premeds
Module 3 – Airway Surgery
Airway surgery is a challenging and rewarding undertaking. Procedures covered include wedge resection, Trader’s, ala-vestibuloplasty, laryngeal sacculectomy, folded flap palatoplasty, free edge staphylectomy, H-pharyngoplasty, tonsillectomy, and temporary tracheostomy. With experience comes a set of life-hacks to reduce stress, improve outcomes, and reduce complications. This module is all about sharing the hard-won experience with you.
- How the order of procedures makes a huge difference to success
- Embracing common sense in surgical planning
- Setting up for airway procedures
- Local anaesthesia blocks
- Positioning of mouth gags, props & airway equipment
Module 4 – Recovery & Discharge
Taking a brachycephalic patient from admission to discharge is a success, but it requires keen observation, individual care and a lot of TLC! How do you feel about having the owner present for recovery?
- Owner-assisted recoveries reduce stress & complications
- Your obligations to the pet & owners
- Homecare instructions
- Preparing the owner for the postoperative period at home
- Helpful notes for your local emergency centre
Module 5 – Long Term Management & Pricing of BOAS Care
Brachycephalic pets often require significant financial commitment from their owners. The increased level of care they need can push up the cost of diagnosing and treating brachy-specific health issues.
- Helping owners to manage their pets at home
- Teaching owners to recognise warning signs
- Planning long term clinical care
- Pricing discussion for brachy-specific care
A VETPRAC COURSE WILL PAY FOR ITSELF
INVEST
5 x Thursday evenings, a curious mind & just $597 towards your career development
LEARN
Reduce risk & tailor your anaesthsia management to each individual patient
RETURN
Plan for anaesthesia & provide excellent monitoring, troubleshooting & support
Your educator
Dr Ema Bowman
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Your Questions Answered
Do I need to attend specific session times?
Are there group discounts available?
Absolutely! Work together, learn together, we say. If 3 or more participants register from the same clinic under the same booking, you’ll receive a 5% discount at checkout when you book on our website. For 4+ registrations, the discount increases to 10%. This isn’t valid with any other promotion.
Can I pay in instalments, or do you offer payment plans?
Yes, we have a payment plans available; scroll up and you will find them!
Will I get CPD points and a CPD certificate?
Of course! Each participant will receive a CPD certificate via email. We do this after you’ve provided feedback and completed the quiz questions at the end of the course.
What kind of learning materials are included?
All live online courses include live and recorded video presentations. Our educators also provide a variety of other resources so you can expect supporting materials like images, diagrams, course notes, slide presentations, journal articles, links to further reading, and more.
How long is course access open?
24/7 access is available for the duration of the course, plus an additional 4 months from the date of the first session. You can access recordings, references and reading materials via your course library at any point during this period. We’ll remind you to download and review the course materials before the time is up.
What happens if the course is cancelled?
If we cancel a course, we will refund your course fees. It’s a simple as that.