Characterization of Brachycephalic Obstructive Airway Syndrome in Cats Using Barometric Whole-Body Plethysmography

Objectives: To confirm the utility of barometric whole-body plethysmography (BWBP) as a non-invasive, clinical diagnostic test for brachycephalic obstructive airway syndrome (BOAS) in cats. Methods: Client-owned cats belonging to brachycephalic breeds were enrolled and classified into two clinical severity grades of upper airway obstruction (UAO). Brachycephalic cats with high-grade UAO severity (Brachy-H-UAO) represented those with clinically evident effects on clinical signs or physical examination findings, whereas brachycephalic cats with low-grade UAO severity (Brachy-L-UAO) represented those without clinically evident problems. A group of non-brachycephalic (NB) cats that were respiratory disease-free and with neither a history of cardiac or systemic diseases nor exposure to cigarette smoke was used as the control group. Cats were placed in the BWBP chamber, and breathing signals were obtained after an adaptation period in a quiet and silent environment. The ventilatory variables obtained were respiratory rate (RR; [bpm]), tidal and minute volume per kilogram bodyweight (MV/BW and TV/BW; [mL/kg]), inspiratory (Ti; [s]) and expiratory (Te; [s]) intervals, airway obstruction index enhanced pause (Penh), and peak inspiratory and expiratory flows per kilogram (PIF and PEF; [mL/s/kg]). Results: Forty-three client-owned cats (11 Brachy-H-UAO, 7 Brachy-L-UAO, and 25 NB) were included. Brachycephalic cats (Brachy-H-UAO: 311 mL/kg; Brachy-L-UAO: 253 mL/kg) showed significantly lower median MV/BW than NB cats (503 mL/kg) (p = 0.01). Brachy-H-UAO cats demonstrated significantly higher median PEF/PIF ratios (Brachy-H-UAO: 1.46, minimum-maximum 0.82-2.48; Brachy-L-UAO: 0.76, 0.52-1.11; NB: 0.73, 0.56-1.00) and Penh (Brachy-H-UAO: 2.37, minimum-maximum 0.57-23.82; Brachy-L-UAO: 0.57, 0.27-1.11; NB: 0.53, 0.21-0.68) than Brachy-L-UAO and NB cats (p < 0.001). No significant differences were observed among the three groups for RR, TV/BW, Ti, Te, or Te/Ti. Conclusions and Relevance: Cats affected by BOAS demonstrate impaired ventilatory function, with reduced minute ventilation and a distinctive flow pattern and parameters reflecting limited inspiratory flow and increased upper airway resistance. BWBP can serve as a useful tool to diagnose and characterize the severity of BOAS in cats.