Introduction
Rigs, a 4-year-old, neutered male English Bulldog has presented to Veterinary Specialists of Birmingham several times over the past few years for various common conditions associated with the breed. Most recently, Rigs presented for evaluation and treatment options for a very large nasal skin fold that had resulted in chronic dermatitis and traumatic corneal disease.
Background and Symptoms
Nasal folds can be a desirable feature in many brachycephalic breeds. Nasal folds are a secondary consequence of disproportionate amounts of skin overlying a very short muzzle or facial skeleton (brachycephalic breeds). Obesity can exacerbate the symptoms. This leads to the very characteristic fold of skin across the bridge of the nose. These prominent skin folds trap moisture which can result in chronic, non-responsive, localized pyoderma and odor. The severity of the nasal folds can vary significantly between patients. With severe cases, ocular diseases such as traumatic keratitis and corneal ulceration can develop. In many cases medical therapy is only palliative and rarely curative.
Surgical Correction
The most effective treatment in severe cases is skin fold resection with simultaneous weight reduction in obese cases. Careful estimation of the amount of skin to be removed is inherent to a successful surgical outcome. Excessive tension on the surgical site and surrounding tissues can result in ectropion and/or incisional complications, such as dehiscence.
Rigs was admitted into the hospital for surgical removal of the nasal skin fold. Preoperative diagnostics consistent for brachycephalic breeds were performed and found to be unremarkable. Rigs was placed under general anesthesia and the surgical site was clipped and prepped in a routine fashion. Careful estimation of the amount of skin to be removed was performed. Care not to create excessive tension was taken. An elliptical incision around the skin was performed. Care was taken to stay an adequate distance from the medical canthus of the eyes to avoid creating ectropion. The skin fold was undermined and removed en-bloc. Hemorrhage was controlled using a combination of ligation, electrocautery and digital pressure. Closure of the surgical site was performed using interrupted subcutaneous sutures and continuous intradermal skin sutures.
Post Operative Care
Rigs was discharged with post operative pain meds and antibiotics. Recommendations of strict confinement for 2 weeks to a kennel or small room. Outside activity was limited to short leash walks to urinate and defecate. An Elizabethan collar was recommended for 2 weeks post op.
Recheck Evaluation and Outcome
A 2-week post operative recheck was performed. His incision had healed well. The owner reported that Rigs’ quality of life had improved dramatically with the surgical treatment of the chronic skin fold. Rigs was discharged with no further restrictions.
Conclusion
This case illustrates how surgery has been used to successfully treat redundant nasal skin folds in dogs. Redundant skin folds can affect dogs in many different locations of the body. Commonly seen locations include the lip, nasal, vulva and tail regions. With appropriate case selection and treatment plan these patients’ quality of life can be improved dramatically.
