The French bulldog is now the most popular dog in the United States, according to the American Kennel Club (which defines popularity by the number of purebred dog registrations). This result is no surprise; Frenchies have been rising in the popularity ranks for several years. But these little dogs have a host of potential health problems, just like other animals bred to have flat faces and short noses.
 
Brachycephalic Head Shape
Short-headed (brachycephalic) animals like English bulldogs, French bulldogs, pugs, and Persian cats have a shortened upper jaw and nose. The lower jaw is typically not shortened, so when they close their mouths, their lower incisor teeth might stick out in front of the upper incisors.
 
Brachycephaly affects only the bones, not the soft tissues (skin, tongue, soft palate, and so forth), so brachycephalic animals have too much soft tissue for their face size. This is why brachycephalic animals have skin folds between their nose and eyes. They have the skin to cover a nose that just isn’t there.
 
Respiratory Problems
In a brachycephalic animal, the soft tissues inside the mouth and throat are crammed into an upper jaw that’s too short to hold them. All of this excess tissue blocks the airway, causing a cascade of problems related to the increased effort of breathing.
 
The term brachycephalic airway syndrome describes problems caused by anatomic abnormalities that are common in brachycephalic animals. These abnormalities include narrowed nostrils, an elongated soft palate, and everted laryngeal saccules (tissue near the vocal cords that is pulled into the airway because of labored breathing over time). Brachycephalic animals might also have an enlarged tongue. Some have an abnormally narrow trachea, which increases the work of breathing and the risk of problems during anesthesia.
 
Other Problems
Brachycephalic animals are more likely than others to have heat stress. Their relatively shallow eye sockets and large eyelid openings increase their chance of developing corneal ulcers, dry eye, and other eye problems. Infections can develop between skin folds. Some brachycephalic animals have digestive tract problems like chronic vomiting, possibly related to gastric reflux caused by chronic labored breathing. They usually have crowded or malpositioned teeth. Natural birth is not possible for some brachycephalic dogs because the mom’s pelvis is too narrow for the puppies’ heads. Some breeds—including French bulldogs—usually require cesarean (surgical) delivery.
 
Signs
If you have a brachycephalic pet, watch for these signs of trouble:

• Snorting, snoring, or noisy breathing
• Intolerance to exercise
• Panting excessively, especially in warm weather
• Tongue or gums turning blue or purple—a medical emergency (lack of oxygen)
• Fainting or collapse
• Red eyes, squinting, or discharge from the eyes
• Moisture, discharge, redness, or odor from skin folds

 
Treatment
Anatomic problems like narrowed nostrils, elongated soft palate, and everted laryngeal saccules can be corrected with surgery. You can see photos of these problems and more information about surgery on the American College of Veterinary Surgeons website: https://www.acvs.org/small-animal/brachycephalic-syndrome.
 
One “treatment” for brachycephalic airway syndrome is to stop breeding dogs for extreme face shape. If you’re thinking of getting a French bulldog or another brachycephalic pet, reward breeders who breed for good health: choose a dog with round (not slit-like) nostrils, minimal or no skin folds near the eyes, and the ability to run, play, and sleep while breathing freely without snorting or gagging.
 
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Eyelid problems are common in dogs and cats. Some eyelid disorders cause damage to the eyeball itself and can affect vision. A pet with eye redness, eye drainage, eyelid swelling, an eyelid lump that is new or changing, or signs of eye discomfort (squinting, pawing at the eyes, rubbing the face) should see a veterinarian.
 
Benign Masses
In dogs, most eyelid masses are benign tear gland tumors called meibomian gland adenomas. These masses are located along the lid margin and typically look like raised, bumpy, pink or dark brown lumps. Other types of benign tumors also occur in dogs and cats.
 
A chalazion is a firm lump caused by a blocked tear gland. This type of lump is near the lid margin under the skin, not right on the lid margin like a meibomian gland adenoma.
 
Benign eyelid masses can irritate the cornea (the clear structure at the front of the eye) and can enlarge over time. These masses are usually removed surgically. Removing an eyelid mass means removing part of the eyelid, so it’s best to do the procedure while the mass is still small.
 
Cancerous Masses
Most eyelid masses in cats, and some in dogs, are malignant cancers. Many types of cancer affect the eyelids, just like the rest of the skin; some examples are squamous cell carcinoma, melanoma, and mast cell tumor.
 
The only way to know for sure if an eyelid lump is benign or malignant is to send it to a laboratory for analysis. If an eyelid mass is large or located near the inner corner of the eye, referral to a veterinary ophthalmologist is often the best option in case the patient needs reconstructive eyelid surgery.
 
Cherry Eye
The term cherry eye is an informal name for prolapse of the gland of the third eyelid. The third eyelid (nictitating membrane) is a pink structure at the inner corner of dogs’ and cats’ eyes. In animals with cherry eye, a tear gland protrudes out of its normal location behind the third eyelid; it looks like a smooth pink or red lump. Cherry eye is treated by surgically replacing the gland in its normal position. The prolapsed gland shouldn’t be removed entirely because it produces tears. Removal of the gland would put the animal at risk of dry eye (keratoconjunctivitis sicca).
 
Swollen Eyelids
Eyelid swelling could be caused by an allergic reaction, a benign or cancerous mass, inflammation, or infection. Eyelid swelling due to an allergic reaction is sudden and often affects both eyes. Because eyelid swelling is sometimes the first sign of a more serious reaction called anaphylaxis, it always warrants a call or visit to a veterinary clinic. An animal that has swollen eyelids along with other concerning symptoms like vomiting or wheezing should be taken immediately to an emergency clinic.
 
Entropion (Rolled-in Eyelids)
In animals with entropion, one or more eyelids are rolled inward so eyelashes and hair rub on the cornea. Entropion can be genetic or breed associated, especially in animals with loose facial skin and animals that are brachycephalic (short faced). The condition can also be caused by scarring, other eyelid disorders, or excessive squinting from eye discomfort. The damage to the cornea is uncomfortable at best and can eventually impair vision. Entropion is corrected with surgery. Young animals with entropion can sometimes be treated with a simple tacking procedure to help the eyelids roll back out to the normal position as they grow.
 
Abnormal Hairs
Occasionally hairs similar to eyelashes grow in the wrong location, either along the eyelid margin (distichia) or inside the eyelid (ectopic cilia). These hairs can cause significant pain and corneal ulcers. They’re hard to see and are typically found only with magnification during an ophthalmic examination to find out why an animal has a corneal ulcer. If they’re causing discomfort, the hairs and their follicles need to be removed.
 
Eyelid Inflammation
Inflamed eyelids are red and swollen, sometimes with oozy discharge and visible sores along the margins. The hair on the eyelid might be thin or missing. Eyelid inflammation has many possible causes, including immune-mediated disease, parasites (like mange mites), bacterial or fungal infections, and irritants. Diagnosis might require skin scrapings, cultures, and biopsy. Treatment depends on the underlying cause.
 
More Information
You can see photos of some of these conditions on the American College of Veterinary Ophthalmologists website: https://www.acvo.org/common-conditions1
 
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