they may be cute but

flat faced dogs can have

serious health problems

Learn About Them Here
French Bulldogs, Pugs and other flat faced dog breeds are more popular than ever thanks to celebrity ownership and massive exposure on social media platforms such as Instagram. Although they are cute and attract a lot of attention, many of these dogs have serious health problems which aren’t spoken about online.

Dogs are for life, not just for Instagram.

What Are Flat Faced Dogs?

Flat faced dogs are commonly referred to by vets as ‘brachycephalic’ (pronounced brackee-cef-alik). Brachycephalic comes from the Greek ‘brachy’ meaning short and ‘cephalic’ meaning head, therefore describing ‘short-headed’ dogs. Today we recognise brachycephalic breeds of dogs as having flat faces, significantly shortened muzzles and wide domed skulls. 

What’s The Appeal of Flat Faced Dogs?

Brachycephalic dogs have been selectively bred for years to have domed skulls, flat faces and large eyes that closely resemble the facial features of human babies, which explains why many people find flat faced dogs irresistibly cute. The other big appeal of brachycephalic dogs is that they are relatively low-energy and require less exercise than many other breeds. This is because many of these dogs have health issues which make sustained aerobic exercise such as long walks or play sessions impossible.
The skull of brachycephalic dogs (left) has been flattened to the point where it is almost unrecognisable compared to a normal dog's anatomy (right). The flat faced dog's skull is now more similar to a human baby's skull than to a dog's skull.
Which breeds are affected?
Any breed of dog with a brachycephalic head conformation can be affected. Swipe left to see some of the most common brachycephalic breeds.
Pug
French Bulldog
Boxer
Shih Tzu
Cavalier King Charles Spaniel
Lhasa Apso
Chihuahua
Bulldog
Pekingese
Bullmastiff
Boston Terrier

Health Problems

Selective breeding to achieve more extreme versions of the characteristic ‘baby-faced’ appearance of brachycephalic dogs has been to the detriment of many aspects of their general health, from their ability to breath and regulate heat to the ways in which they are able to communicate with other dogs. Many of these breeds are being seen by vets with serious health problems at a young age, and their lifespan is often significantly reduced compared to similar breeds with normal head anatomy.

Breathing Difficulties

Unfortunately, whilst the skull of brachycephalic dogs has shortened drastically the soft tissues of the face and mouth have not shrunk sufficiently to adapt to the reduced space. These soft tissues include the soft palate (the fleshy part of the roof of the mouth), turbinates (cartilage inside the nose) and the tongue, which are crammed into a smaller space where they obstruct airflow through the upper airways. Additionally, a lack of underlying nasal bones causes the nostrils to narrow into small slits instead of large open holes. If you watch these dogs closely, you will see many of them are forced to breath through their mouth and pant, or use their abdominal muscles to force air in and through their narrowed airways during normal breathing.

Vets call this syndrome ‘Brachycephalic Obstructive Airway Syndrome’ or BOAS for short. Four anatomical features of flat faced dogs are commonly recognised to cause BOAS:

  1. Narrowed nostrils
  2. Overlong soft palate
  3. Secondary effects such as laryngeal collapse
  4. Narrowed windpipe (most commonly seen in Bulldogs)
THE KNOCK-ON EFFECTS OF LABOURED BREATHING
  • Laryngeal Collapse

    Increased breathing effort eventually creates a suction effect in the back of the throat, which causes it to collapse inwards further narrowing the already small airway. This can cause very serious breathing difficulties and tends to get progressively worse over time.

  • Heart Failure

    Forced breathing also causes swelling in small nasal cavities and airways, eventually leading to fluid accumulating in the lungs. This can progress to right sided heart failure, as the heart struggles to pump blood around the damaged lungs.

  • Acid Reflux

    The increased effort to breath can result in vomiting or regurgitation of stomach acid. In severe cases efforts to breath can be so forceful that they can displace part of the stomach into the chest cavity through a hole in the diaphragm during breathing. This is known as a hiatal hernia and requires surgical correction.

  • Sleep Apnoea

    Obstructive sleep apnoa occurs when the airway becomes blocked whilst dogs are sleeping, causing them to wake up abruptly. This can occur multiple times in a night for some dogs and severely impact their quality of life.

What does it feel like to be a brachycephalic dog?

Click the links below to try it yourself

Try pinching the top of your nose to partially block your nostrils, then breath in and out through your nose only. This is quite unpleasant after a few minutes or less, but many brachycephalic dogs are doing this every minute of every day for their entire lives!

What’s it like to be an active brachycephalic dog? Try running on the spot or jumping up and down for a few minutes, then put a drinking straw in your mouth and breath only through the straw. You’ll probably struggle to breath through the straw and have to quickly remove it to take big gasp of air. Remember brachycephalic dogs don’t have the option to do that!

Clinical signs

Loud snoring when asleep

Noisy breathing and snorting

Excessive panting

Reluctance to exercise

Tendency to overheat or become very distressed when hot

Choking on food

Retching and regurgitating

Blue gums and tongue

Fainting

#DONTIGNORETHESNORE

Snoring, snorting and noisy breathing might seem cute or harmless but it is a sign that a dog is suffering from respiratory disease! Many breeders, owners and even some vets think that these noises are normal for their dog or for the breed, but this is far from the truth. Dogs with breathing problems are at high risk of choking on food, collapsing and heat stroke, and may require major surgery.

Noisy breathing is not cute, it is abnormal. Please #dontignorethesnore!

Treatment

  • Surgery is possible to widen narrowed nostrils and cut back the elongated soft palate which can improve airflow in some dogs, as well as slowing the progression of secondary complications such as complete airway collapse.
  • The cost of surgery is very expensive, and many insurance policies do not cover congenital diseases such as Brachycephalic Airway Obstructive Syndrome (BOAS).
  • Many people do not realise the medical complications associated with brachycephalic breeds before they buy a dog and may not be able to afford treatment. As a result, dogs may end up euthanised, rehomed, or in the worst case scenario left to suffer for the remainder of their ultimately shortened lifetime.

Other Health Problems

Eye Disease

The flattened skull of brachycephalic dogs causes their eye sockets to become shallow and their eyes to protrude significantly. As a result, the outer surface of the eye is more exposed and is prone to becoming dry and irritated or directly traumatised which can lead to painful ulcers (holes in the sensitive surface of the eyeball). In some dogs, the eye sits so prominently outside of the socket that their eyelids cannot fully close over it, leading to the eye becoming incredibly dry and painful. Many breeds have the additional irritation of exercise skin folds around the eyes and nose, which can rub directly onto the eyes. Finally, as less of the eye is sat within the flattened socket of the head, brachycephalic dogs are far more prone to the eye prolapsing out of its socket. Only minor knocks and bumps can cause this is extreme brachycephalic breeds. The combination of eye problems is called ‘Brachycephalic Ocular Syndrome’ and can lead to constant irritation, pain and eventually blindness.

Heat Stroke

Dogs can’t sweat like we do, and instead have developed a clever way of losing heat by drawing air rapidly back and forth across the moist surfaces in their mouths. This is why you will see dogs panting in hot weather or when they have been running for a long time. However, panting is only effective when there is a large enough surface area in the mouth proportional to the size of the dog. In brachycephalic dogs, we have shrunk the mouth and the moist tissues within it, without reducing body size in proportion! As a result, in hot weather brachycephalic dogs cannot lose heat fast enough to regulate their temperature effectively. This can make these dogs feel very ill and uncomfortable, and can lead to collapse, heat stroke and death if they are not cooled rapidly and sufficiently!

Skin Disease

In breeds such as the Pug and the Bulldog, the skull getting shorter and flatter has resulted in excessive skin covering the face which forms thick folds and wrinkles. The deep crevices between the folds create the perfect warm, moist environment for bacteria and yeast to grow and cause infections. Whilst antibiotics, antibacterial shampoos and pain relief can help, infections often relapse and can become chronic lifelong conditions because the underlying cause is not removed. In cases where the skin folds occlude the eyes and rub on the surface of the eyeball causing irritation, surgery may be necessary to prevent painful eye ulcers developing.

Behavioural Problems

One way in which altering the face and skull of brachycephalic dogs has impacted their health is their reduced intrinsic ability to communicate with other dogs. Dogs use visual communication to signal their intent to others, from bowing down on their front legs to invite playtime, to widening their eyes to show fear and curling their lips to indicate aggression. Pugs and other small brachycephalic breeds with their shortened legs are unable to crouch, French Bulldogs with their stump tails have lost all ability to signal their intention with their tails, and all flat faced breeds struggle to communicate normally with their drastically altered facial conformation. It has been shown that the Cavalier King Charles Spaniel has only one ‘dog-to-dog’ signal out of a possible twenty visual signals used by dogs closer in appearance and genome to the wolf. Dogs whose repertoire of visual signals is restricted are often avoided by other dogs, and can become anxious, isolated and even dog-aggressive due to inadequate socialisation.

Birth Problems

Birth problems are very common in brachycephalic breeds due to the mismatch between puppies having large domed heads due to brachycephaly, and mothers having relatively narrow pelvises. This results in very few natural births, with many dogs undergoing serious life-threading caesarian surgery to deliver their puppies. 86% of English Bulldog pregnancies have been found to end in delivery due to caesarean section.

Dental disease

As we bred brachycephalic dogs to have smaller and flatter skulls, their soft tissues failed to reduce in size and so did their teeth! The small squashed face of brachycephalic dog has the same number of teeth as a dog with a normal muzzle, all crowded into a much smaller space. As a result, teeth might stick out at right angles, or grow inwardly towards the roof of the mouth where they cause horrendous pressure sores. This results in food getting stuck between the much reduced space between teeth leading to infection, gum disease and eventual tooth loss. It is also common for brachycephalic dogs to fail to lose their baby teeth as they are crammed so tightly together they remain. In these cases if not surgically removed in time, the permanent teeth may erupt alongside these teeth at uncomfortable angles worsening the overcrowding in the mouth. In worst case scenarios these dogs can struggle to eat, and may need to have many teeth surgically removed just to make their mouths comfortable.

High Anaesthetic Risk

The narrowed airways and increased risk of overheating associated with brachycephalic breeds predisposes them to complications during anaesthesia. The stress from hospitalisation and anaesthetic drugs can cause their already restricted airways to narrow further and increase the risk of life-threatening airway obstruction. This can make all surgery, from neutering and routine procedures, to high-risk airway operations, more dangerous in comparison to dogs with normal skull anatomy.

Obesity

Brachycephalic dogs suffering from obstructive airway sydrome are prevented from performing normal canine behaviours such as sustained running and exercising due to their respiratory compromise. This forced low-energy lifestyle makes brachycephalic dogs prone to obesity which further aggravates their respiratory disease as well as increasing their risk for a host of other health problems, from heart disease and strokes to arthritis and diabetes.

the cost of caring

for brachycephalic dogs
Many people fail to recognise how expensive dog ownership can be. We’ve calculated the lifetime costs of caring for several common brachycephalic breeds of dog in the UK. Keep in mind these are extremely conservative estimates based on dogs being entirely healthy their entire lives!
Pug
Average lifetime cost of owning a Pug: £ 0
AVERAGE LIFESPAN: 0 YEARS

INITIAL COST: £1150

LIFETIME INSURANCE COVER: £2880

Many insurance policies exclude genetic disease such as obstructive airway syndrome in flat faced dog breeds. This can lead to extremely expensive veterinary fees for treatment and surgical correction.

ANNUAL VETERINARY CARE: £480

Including vaccinations, boosters, annual health checks and veterinary fees not covered by insurance or below policy excess, for a healthy dog.

NEUTERING AND MICROCHIPPING: £200

FOOD: £4788

TOYS AND ACCESSORIES: £1452

GROOMING: £240

WORMING AND FLEA TREATMENTS: £600

French Bulldog
Average lifetime cost of owning a French Bulldog: £ 0
AVERAGE LIFESPAN: 0 YEARS

INITIAL COST: £1740

LIFETIME INSURANCE COVER: £2400

Many insurance policies exclude genetic disease such as obstructive airway syndrome in flat faced dog breeds. This can lead to extremely expensive veterinary fees for treatment and surgical correction.

ANNUAL VETERINARY CARE: £400

Including vaccinations, boosters, annual health checks and veterinary fees not covered by insurance or below policy excess, for a healthy dog.

NEUTERING AND MICROCHIPPING: £200

FOOD: £3990

TOYS AND ACCESSORIES: £1210

GROOMING: £200

WORMING AND FLEA TREATMENTS: £500

Shih Tzu
Average lifetime cost of owning a Shih Tzu: £ 0
AVERAGE LIFESPAN: 0 YEARS

INITIAL COST: £572

LIFETIME INSURANCE COVER: £3120

Many insurance policies exclude genetic disease such as obstructive airway syndrome in flat faced dog breeds. This can lead to extremely expensive veterinary fees for treatment and surgical correction.

VETERINARY CARE: £520

Including vaccinations, boosters, annual health checks and veterinary fees not covered by insurance or below policy excess, for a healthy dog.

NEUTERING AND MICROCHIPPING: £200

FOOD: £5187

TOYS AND ACCESSORIES: £1573

GROOMING: £3172

WORMING AND FLEA TREATMENTS: £500

Resources

  • Initial purchase cost based on average prices from Pets4Homes.co.uk in February 2017
  • Lifetime insurance cover based on £20 monthly policy
  • All other expenses based on research commissioned by Sainsbury’s Finance and carried out by ICM Research on the average costs of dog ownership in the UK (2030 British adults were questioned via online omnibus between 8th and 10th April 2011).

Brachycephalic dogs suffer from severe respiratory and other congenital disease, and will continue to do so for generation after generation until dogs selected for breeding have less extreme physical features

The only way to stop the suffering is to stop the demand

PLEASE THINK TWICE ABOUT BUYING A FLAT FACED DOG

Can you afford comprehensive lifetime insurance to afford potentially extensive veterinary bills?

Is it right to encourage the continued breeding of dogs which may face a lifetime of suffering?

Have you considered the impact owning a chronically ill dog could have on you and your family?

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