I have a female Shih Tzu that has the brachycephalic syndrome typical with the breed, Vet says do nothing, what do you think?

The dog is 10 years old, he said it's a procedure not always successful, but if you're going to do it, it should be around age 2-4. Her breathing is stable, she's in good shape due to exercise, He said he could try the procedure to open airway up, but said I can't guarantee anything.

If her breathing is fine why the Hell would you operate on her? Just avoid having her in extreme or overworking her.

I think you should do what the vet says

If her breathing is fine, why would you put her through a surgery? The purpose of the surgery is to help a dog with breathing difficulties. It is not necessary for all brachycephalic dogs, and certainly I would not put a senior dog that is experiencing no particular problem, through a surgical procedure.

You are within your rights to take a second opinion but if you have a long-standing and trusted vet, why not listen to him. Surgery is surgery after all and she's not exactly young now. I'd leave well alone is she has come this far without breathing problems.

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