our 4 year old french bulldog had BOAS soft palate surgery 8 months ago, sharing the honest version of recovery and outcomes because the post op content online is mostly success montages and skips the ugly middle months that almost broke us

Pierre is a 4 year old french bulldog, we got him at 10 weeks from a breeder who tested for the things you are supposed to test for but did not do BOAS grading on her dogs, which i now know is a red flag i did not know to look for at the time. He was a happy normal puppy and we did not really see the BOAS signs as BOAS, we thought we had a normal frenchie who snored, snorted, got loud when excited, slept on his back with his tongue out, and could not handle heat. Looking back now at videos from when he was 2 years old, his breathing was clearly labored at rest and we just normalized it because every frenchie owner around us had the same thing.

The thing that pushed us to the surgery decision. Summer of last year he had a heat stress episode in 78 degree weather (not even particularly hot) where he collapsed in the yard after maybe 4 minutes of mild activity, his tongue turned purple, and we ended up at the emergency vet for a 6 hour stay with cooling protocols and IV fluids. The ER vet was direct with us, said his airway grading at intake suggested moderate to severe BOAS and that he had been compensating his whole life and was running out of margin as he got older and gained some adolescent weight. The grade 3 stenotic nares plus an elongated soft palate that the ER vet could partially see on exam were the visible issues, and the diagnostic CT later confirmed everted laryngeal saccules and mild laryngeal collapse stage 1.

The surgery and the first month, which was the part we were prepared for. We chose a board certified ACVS surgeon at a specialty hospital rather than the option to do it locally with a general practitioner who said she had done "lots" of these. That call cost us $5800 instead of $2400 and it was the best money we have ever spent. The surgery was a soft palate resection (folded flap palatoplasty technique), a saccule resection, and a wedge resection of the stenotic nares. Pierre stayed overnight on a temporary tracheostomy tube which was scary to look at but standard for moderate to severe cases. The first week home was hard, he was on a soft diet, harness only, sedated rest, the incision sites in the back of his throat looked terrible (they always do) but were healing normally. The first month i would call physically miserable for him but psychologically expected for us, we knew it would be like this and we had support and information.

The part nobody tells you, which is months 2 through 5. This is where i think the online content fails frenchie owners considering BOAS surgery the most. The acute recovery ends around week 4 to 6, the dog is eating normally, the airway is healing, the surgeon does the post op recheck and signs off, and you are sent into the world expecting a "new dog" that the testimonials all describe. What we actually got was a complicated middle period that lasted from month 2 to month 5 where Pierre was clearly breathing better at rest (huge win) but was not yet the dog he was going to become, he had developed some odd behavioral patterns we attribute to the recovery period (resource guarding food he had not guarded before, some new anxiety around the harness and the front door, reduced willingness to play that we initially read as residual surgery discomfort but the surgeon said should have resolved by then), and he had two minor setbacks that involved emergency vet visits and a lot of late night panic, one was post operative scar tissue causing intermittent obstruction that needed a small followup procedure, the other was a respiratory infection that took six weeks to fully clear because his anatomy was still adjusting. We were not warned about either of these. They are not rare. The surgeon later said maybe 25 percent of his BOAS cases have some kind of complication in months 2 to 6, and i wish that had been part of the pre op conversation.

Where we are now at month 8 and what the actual outcome looks like. Pierre is meaningfully better than pre surgery. His resting respiratory rate is in the normal range for the first time in his life (we measured it pre surgery at 35 to 45 breaths per minute resting, now it is 22 to 28). He can do moderate exercise in 70 degree weather without distress (he could not do this at all before). His sleep is dramatically improved, no more sleep apnea episodes, no more waking himself up coughing. We have not had a heat related scare since the surgery. He still snores some. He still cannot do what a non brachycephalic dog would call normal exercise tolerance. He will always be a frenchie with frenchie limits. But he is alive and comfortable in a way he visibly was not before, and the comparison is not subtle.

What i would tell someone making this decision. The surgery is worth it if you have moderate or worse BOAS, full stop. Do not do it locally with a generalist, find an ACVS surgeon at a specialty hospital, the technique difference matters enormously and the complication rates are not comparable. Budget for $4500 to $7000 depending on what needs to be done. Plan for 6 months of recovery not 6 weeks, and find a rehab vet now not later because the recovery is faster and cleaner with structured rehab and almost nobody is told this on day one. Talk to people who are 12 to 18 months post op not just 6 weeks post op, because the early post op stories are all glowing and they have not lived through the middle yet. And do not be afraid of the decision, the dogs who get the surgery live longer, more comfortable lives than the dogs who do not, the data on this is now pretty clear. Pierre is sleeping next to my desk right now breathing quietly and three years ago that sentence would have been impossible