Health Concerns of Brachycephalic Pets

Laurie Anne Walden, DVM

Brachycephalic (flat-faced) dogs and cats are popular, but those cute squashed noses can cause some serious health problems. If you have a brachycephalic pet, watch for breathing trouble (snoring and grunting are not normal). These pets are also prone to heat stress, especially if they’re overweight.
 
Brachycephalic means “short-headed.” Brachycephalic animals have short noses, round heads, and large, low-set eyes. Examples are English and French bulldogs, pugs, Boston terriers, shih tzus, and Persian cats. If you think these pets are adorable, you're not alone. Studies have shown that many people are attracted to facial features in animals that are similar to those of human infants.[1]
 
Unlike dog breeds that were developed for tasks like hunting, brachycephalic dogs have been bred over time for looks. Unfortunately, breeding for form over function has compromised the health of many of these dogs.
 
Earlier this year the British Veterinary Association released a policy position on the welfare of brachycephalic dogs. Their aims are to improve the health of future generations of these dogs and to increase awareness of the problems caused by breeding for extreme brachycephaly.[2] The association highlighted 5 of the most common medical concerns: respiratory, eye, reproductive, skin, and dental problems.
 
Impaired breathing
Many brachycephalic animals cannot breathe normally. Although the bones of the face are shortened, the soft tissues are not, leaving excess tissue that can block the airway. Signs of impaired breathing include snoring, snorting, and exercise intolerance. Brachycephalic animals are at risk for heat stroke, respiratory distress, and collapse. Long-term labored breathing can also cause digestive tract problems like gagging and vomiting. Obesity makes all of these problems worse.[3]
 
Brachycephalic obstructive airway syndrome includes 3 main anatomic abnormalities: narrow nostrils, elongated soft palate (excess tissue at the roof of the mouth), and everted laryngeal saccules (tissue that blocks airflow through the trachea, or windpipe). Some animals require surgery to correct these problems. Brachycephalic animals may also have an abnormally narrow trachea, which gives the effect of constantly breathing through a small straw.[4]
 
Eye disease
Brachycephalic animals have shallow eye sockets and large eyelid openings, so their eyes are not as well protected as those of other animals. Many also have impaired tear production (dry eye), reducing their defense against eye irritants. Skin folds at the top of the nose may cause hair to rub against the eyes. These problems can cause eye ulcers and eventual blindness.[5]
 
Reproductive problems
Some brachycephalic breeds have trouble giving birth naturally because the puppies’ heads are too large to fit through the mother’s pelvis. One study found that over 80% of English bulldog, French bulldog, and Boston terrier litters born in the United Kingdom were delivered by cesarean section.[6]
 
Skin and dental disease
Folds of loose skin give bacteria and yeast a handy place to grow, so brachycephalic animals are prone to skin fold infections. Because of their shortened upper jaw, they often have crowded or maloccluded teeth.
 
If you have a brachycephalic pet:

• Consult your veterinarian if your pet has symptoms of impaired breathing, such as snoring and snorting.
• Keep your pet at an ideal weight.
• Keep your pet indoors in warm weather. Pets with extreme brachycephaly should not be left outdoors in summertime in the South. Even those with mild brachycephaly are at risk of heat stroke.
• Use a harness, not a collar, for leash walks.
• Monitor skin folds for signs of infection (redness, moisture, unpleasant odor).[7]

 
If you are thinking of getting a brachycephalic pet:

• Choose carefully. Look for round (not slit-like) nostrils and small or no skin folds next to the eyes. The pup with the longest nose in the litter will have the easiest time breathing.
• Do not buy puppies of dogs that have had surgery to treat brachycephalic airway syndrome. One way to improve the welfare of these breeds is to discourage people from breeding animals with severe health problems.
• Brachycephalic pets often need more medical care than non-brachycephalic pets. Be prepared for the extra expense.
• Consider getting a mixed-breed pet whose nose is not as flat.

 
References
1. Archer J, Monton S. Preferences for infant facial features in pet dogs and cats. Ethology. 2011;117(3):217-226.
2. Health and welfare of brachycephalic dogs. British Veterinary Association website. https://www.bva.co.uk/news-campaigns-and-policy/policy/companion-animals/brachycephalic-dogs/. Accessed March 27, 2018.
3. Packer RM, Hendricks A, Tivers MS, Burn CC. Impact of facial conformation on canine health: brachycephalic obstructive airway syndrome. PLoS One. 2015;10(10):e0137496.
4. Brachycephalic syndrome. American College of Veterinary Surgeons website. https://www.acvs.org/small-animal/brachycephalic-syndrome. Accessed March 27, 2018.
5. McNabb NT. Top 5 threats to vision in the brachycephalic dog. Paper presented at: North American Veterinary Conference 2017; February 6, 2017; Orlando, FL.
6. Evans KM, Adams VJ. Proportion of litters of purebred dogs born by caesarean section. J Small Animal Pract. 2010;51(2):113-118.
7. Caring for brachycephalic dogs. MSPCA Angell website. https://www.mspca.org/angell_services/caring-for-brachycephalic-dogs/. Accessed March 27, 2018.

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