Black and white brachycephalic dog with a pink collar against a blurred background of lights.

Breaking Down Brachycephalic Airways Syndrome in Flat Faced Dogs


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Brachycephalic dog breeds like Pugs and French Bulldogs are extremely popular. Sadly, these flat faced dogs (along with flat faced cats) are prone to brachycephalic obstructive airway syndrome. This syndrome makes it hard to breath and can really impact their quality of life. Often it also shortens their lifespan.

They can often be perfectly healthy puppies and kittens, often developing symptoms as they grow. So, if you’re a brachycephalic breed pet parent (or becoming one soon) it’s worth understanding these health issues. A better understanding helps you plan well, or maybe even get a puppy with a lower chance of developing symptoms.

A brachycephalic dog, specifically a black pug wearing a yellow beanie and a gray sweater.

What is a brachycephalic dog or cat breed?

What is a brachycephalic dog or cat? Simple! These are pets that have been bred to have flatter faces, kind of like a baby-faced look. Babies have flatter faces than adults with small noses and bigger eyes. Brachycephalic dogs and cats do too and some studies suggest this makes us want to instinctively care for these breeds.

But what does the term brachycephalic mean? In short, it’s a combo of two Greek words:

‘Brachy’ (short – or in this case flat) + ‘cephalic’ (head) = basically, a shortened, flatter head or face.

While brachycephalic obstructive airway syndrome (more on this further down) might be the most common health issue in flat faced breeds, it’s not necessarily the only one. Thankfully, pet insurance can help you cover a wide range of other unexpected vet costs for accidents, illness and dental, depending on the level of cover you choose.

Did you know? Some airlines place restrictions on flying with pets if they're brachycephalic breeds. That's because brachycephalic obstructive airway syndrome is so common in these breeds and can cause them to overheat and suffocate.
a pet owner lies in a field with her dog helping to calm it down from anxiety

Flat faced dogs over time

Brachycephalic breeds haven’t always had flat faces. At least not as flat as they are today and here’s how this unusual look developed:

  • Genetic mutation

Their brachycephalic look comes from a genetic mutation that alters the way the bones in the skull grow. It makes the skull wide and short. By continually breeding this mutation, people created dogs with extremely flattened faces. Unfortunately, breeding dogs to have such 90-degree angle faces means we’ve bred them to be unhealthy.

  • Kindchenschema

As we’ve already mentioned, humans tend to adore the cute proportions of baby’s broad foreheads and comparatively small flat noses. In fact, there’s even a word for this set of features: ‘Kindchenschema’. But babies grow out of this look and these brachycephalic dogs don’t. They don’t get bigger airways and as they age, they often suffer from breathing difficulties, overheating and much more.

  • A dog’s nose

Dogs have longer noses and nostrils for a reason. Most importantly, it’s to breathe which is of course, an essential part of their everyday life. Looking cute is great, but perhaps not at the expense of breathing. While we love these flatter faces it’s important to understand that comes with their cuteness can come great risk.

A brachycephalic French bulldog sits on a fence next to two people.

What is brachycephalic airway syndrome?

You may be wondering, “Surely, shortening your head can’t be comfortable?” And you’d be right. Just because your nose doesn’t stick out, doesn’t mean it goes away or isn’t needed any longer.

Instead, brachycephalic dog breeds have noses that protrude into their heads and this can cause radical breathing issues. All the soft tissues that you’d find in a normal doggy snout essentially get squished inside their head.

There are quote a lot of soft tissues that make up the breathing system, for example:

  • soft palate
  • nares
  • laryngeal saccules 
  • larynx
  • trachea

These start to press together inside a poor pup’s head making it feel sometimes like they’re breathing in a wet blanket. When this becomes clinically unsafe for your dog, it’s called brachycephalic obstructive airway syndrome (BOAS for short).

A leashed bullmastiff flat faced dog looking back over its shoulder while it waits for its owner to finish shopping as it sits on the pavement alongside a city street.

Symptoms of brachycephalic obstructive airway syndrome

As the name suggests, brachycephalic obstructive airway syndrome is a full range of problems, otherwise known as a syndrome. (A syndrome being a collection of symptoms and one or more can be experienced as part of the condition).

The French Bulldog is the cutest breed you could ever meet. I have a special interest in treating them. The reality though – they are bred for the cute squishy faces and not for health.

– Abbie Tipler, small animal specialist surgeon

Here’s a brief look at what happens to dogs with brachycephalic obstructive airway syndrome:

  • Eyes. The added internal pressure on the inside of brachycephalic breeds’ skulls causes their eyes to bulge. This can contribute to problems with eye functionality and eye health. This is most common in Pugs.
  • Spine. The inward protrusion also causes abnormal vertebrae that often leads to back injuries. After all, the head connects to the spine and the spine in turn connects most other areas of our body. Spinal health is key to living well.
  • Breathing. In brachycephalic breeds the soft tissues are densely packed in. Consequently, it squashes up around the sinuses, making it hard to breathe. Their elongated soft palette doesn’t have enough room and ends up squashing the larynx, also obstructing the airflow. In addition, brachycephalic breeds are prone to experiencing a collapse of the larynx.

Watch this video to find out what scientists are doing to help brachycephalic breeds:

What dogs are brachycephalic breeds?

As it happens there are quite a few well-known brachycephalic breeds, both in the dog and cat world. Let’s take a look at which pets are flat faced dogs and cats.

Brachycephalic dog breeds

Here’s a list of most of the brachycephalic dog breeds:

  • Affenpinscher
  • Boxer
  • Boston Terrier
  • Brasileiro
  • Brussels Griffon
  • Cavalier King Charles Spaniel
  • Dogue de Bordeaux
  • English Bulldog
  • French Bulldog
  • Japanese Chin
  • Lhasa Apso
  • Mastiff
  • Pekingese
  • Pug 
  • Shih Tzu

Not all of these breeds have the same degree of brachycephaly. Even within the same breed, some pets will be more brachycephalic than others. If your heart is set on one of these breeds, then be sure to read further on about getting as healthy a flat faced dog or cat as possible.

Now check out the cat crew…

Like flat faced dogs, this Himalayan cat with blue eyes could be prone to brachycephalic obstructive airways syndrome due to its flatter face

Brachycephalic cat breeds

There aren’t quite as many brachycephalic cats as dogs:

Speaking of cats, find out about seven different cat breeds and their pawsonalities. Also find out what unexpected vet tests and treatments our cat insurance covers your pet and pocket for.

Close-up of a Cavalier King Charles spaniel with a pensive expression.

How to help the health of brachycephalic dog breeds

There are several things you can do to protect brachycephalic breeds. The first step is to research the breed you want. This is important with any breed – regardless of whether they’re brachycephalic or not.

We’ve outlined this along with two other steps below:

  • Research your breed

Do some research on the breed and learn what brachycephalic obstructive airway syndrome could mean for their outlook on life. Most brachycephalic breeds that suffer have shortened lives and need lots of vet care. Understand the possible commitment beforehand in terms of financial and emotional output.

  • Buy from an ethical breeder

If you’re set on getting a one of these ‘baby-faced’ brachycephalic breeds, then make sure you’re buying from a registered dog breeder. Ethical dog breeders who belong to national kennel clubs are more likely to do health testing on parents before breeding.

  • Learn about breeding for health

Brachycephalic obstructive airway syndrome is a recognised problem in flat faced dogs. Many national kennel clubs are implementing breeding schemes to test the level of brachycephaly in dogs before they’re bred. The healthier the mum and dad dog, the better likelihood of puppies having a good life too.

A French bulldog puppy is healthy as it sits contentedly on a lawn in the afternoon, but as it matures it could be prone to developing brachycephalic obstructive airways syndrome

Is brachycephalic syndrome hereditary or congenital?

It’s both! Here’s why:

  • Hereditary conditions in pets. Hereditary conditions are passed from parent to puppy through the genes. That said, even when a gene gets passed down, it doesn’t result in the health condition every time. In other words, the genes that carry a likelihood of certain health conditions don’t always cause them but often do.
  • Congenital conditions in pets. Congenital conditions are those pets are born with – but they’re also tricky. That’s because a pet could be born with a health condition but no symptoms. Some conditions can only be traced back to being congenital after symptoms become evident as a pet grows while other times they’re clear from birth.
  • A combo. Some conditions can be both. They’re hereditary and congenital. Keeping in mind that congenital conditions also might not become symptomatic or be detected until later in life, it’s worth knowing that brachycephalic obstructive airway syndrome is a combination of both.

Find out what the differences between hereditary and congenital conditions are in more detail. Also be sure to read more about dog insurance and pre-existing conditions.

a flat faced boxer is one of the flat faced breeds of dogs prone to brachycephalic obstructive airways syndrome will soon need to have surgery to help him breathe better

Pet insurance cover for other unexpected vet costs

Whether you’re buying or adopting your pet, consider protecting them now and into the future. Pet insurance helps cover the cost of unexpected vet bills, provided they’re not for pre-existing or congenital conditions (similar to medical aid for humans).

Pet insurance gives you cover for a wide range of otherwise costly vet treatments. These include prescription medication, X-rays, surgery and even dental – you choose the level of cover. Each of our three plans covers third party liability too. Plenty more opportunity to reduce your pet’s health and wellbeing costs.

PD Insurance gives you one or more months of FREE pet insurance when you buy online. Click below to get a quote today.

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