Who doesn’t love bulldogs? That cute, squashy face and those sad eyes are enough to melt the coldest heart. But before you go out and buy a puppy, have a heart and consider the health problems that are becoming increasingly common (and increasingly severe) in bulldogs and other brachycephalic (flat-faced) dog breeds.

Dr. Becker, a respected writer on pet hBrachycephalic dogs - Sleepy bulldogealth, cites a recent article which reported that pedigree dog owners are surrendering their pets to shelters due to severe breedrelated health problems that they can’t cope with or can’t afford to treat. The breeds most commonly surrendered are all brachycephalic, with pugs and shih tzus leading the way. They aren’t the only brachy or short-headed, short-muzzled breeds that are in trouble though; Boston terriers, boxers and Pekingese are all victims of dangerously selective breeding which results in ineffable cuteness and untold suffering.

Now, let’s be clear: Not all breeders are irresponsible, choosing cuteness-for-profit over their dogs’ health. Some breeders care greatly about their dogs and do whatever they can to keep their breeding lines healthy, so they can live long and comfortable lines.

However, there are breeders out there who will do anything to keep their puppy numbers ticking over and if that means breeding shorter, flatter faces, and tighter, curlier tails with no regard for the consequent health problems, then so be it.

Inherent health problems faced by brachycephalic dogs


What’s in a nose? Life-giving oxygen, for a start. Dogs’ noses also play an important role in their cooling system. So, if you shorten their noses, they’re obviously going to have some difficulties in the breathing and cooling departments.

The technical term for their breathing problem is brachycephalic respiratory syndrome and it affects all flat-nosed dogs, although some are more severely affected than others.

The more compact the muzzle, the worse the syndrome. Another aggravating factor that affects most snub-nosed dogs is small, closed nostrils (stenotic nares) that barely allow any air to flow in and out of the nose.

Brachycephalic respiratory syndrome is a progressive condition, so it gets worse as dogs get older. It’s very important that visit your veterinarian to discuss treatment options as soon as you notice your Boston terrier, pug or bulldog has breathing problems because the longer you wait to begin treatment, the more complicated the treatment. Also remember, that older dogs take longer to respond to treatment and also don’t necessarily recover as well after surgery.

Other health problems that are caused by brachycephalic respiratory syndrome include high blood pressure, heart problems, dental problems and skin infections that thrive in difficult to clean facial wrinkles – and in excessively curly tails. Dogs with severe problems may also suffer from malnutrition or starvation because they aren’t able to eat and breathe at the same time; eating becomes too stressful.

Why do short noses and flat faces cause problems?

Their noses (muzzles) are shortened and their faces flattened, but all the features that go into a normal canine face, still have to fit. Brachy dog breeds end up with elongated soft palates, which means that the extra bit of palette that doesn’t fit makes a flap at the back of throat which hampers breathing and also causes the snorting and snoring common in the breeds.

Their windpipes are also narrow which can cause the trachea to collapse – tracheal stenosis – which also increases the risks associated with anaesthesia.

Furthermore, the short airway, closed nostrils, elongated soft palette and narrow trachea all make it difficult for dogs to pant efficiently, which means they can’t regulate their body temperature and get heatstroke very easily.

How to treat brachycephalic respiratory syndrome

Flat face Boston terrierSurgery is often the only solution to brachycephalic respiratory syndrome, which is unfortunate considering the risks associated with anaesthesia. This is also why it’s best to treat the problem as soon as possible, before your dog becomes a senior citizen.

There are two options which your vet will discuss with you. In some cases one or the other will suffice, but in particularly severe cases, both types may be necessary.

  • Surgery to widen the nostrils. Dr. Shaun Opperman, veterinary surgeon at Battersea Dogs & Cats Home, describes the procedure as taking a wedge out of the nostrils to open them up.
  • Surgery to shorten the elongated soft palette which eases breathing and lessens snorting and snoring.

Living with brachycephalic respiratory syndrome

You can manage the condition to make your dog more comfortable either before or after surgery – if surgery becomes necessary.

First off, manage your dog’s weight. Bulldogs are notoriously overweight but that only increases their difficulties. The biggest favour you can do for your dog is to feed them nutritiously balanced meals in the right quantities.

Second, make sure your dog doesn’t overheat. Don’t take them for walks or play with them outdoors during the heat of the day, rather go out early in the morning or in the evening when it’s cooler. Invest in a cooling jacket and cooling mat, so that they can stay cool even when they are asleep inside. Use the cooling jacket when you take them out too, just to be safe. You can also use cooling mats in the car.

Get to know your dog’s breathing patterns. Some dogs snork and snort enough to bring down the heavens but are, in fact, fine, while others are in great distress when snorting gentle. If you know what is normal for your dog, you can tell when they are in distress and either take steps to make them comfortable or take them to the vet.

Manage your dog’s environment to keep her stress levels down. Stress brings breathing problems of its own and you don’t want to compound brachycephalic respiratory syndrome with additional stressors. This means bearing your dog’s nature in mind before inviting your married cousins and their 12 kids for lunch, and choosing quiet places to walk if your dog is anxious around strange dogs and people.

What you can do to eliminate brachycephalic respiratory syndrome

Boxer dog

If you are a fan of flat-nosed dogs, you can make a difference to the different breeds and help eliminate brachycephalic respiratory syndrome.

Be very selective when it comes to choosing a breeder. Avoid any breeder whose lines have extreme head shapes and double-curl tails.

If demand for these physical characteristics lessens and people start looking for dogs with healthier head shapes, then that is what breeders will start to provide.

When it comes to choosing your puppy, take the following advice from Pippa, from The Happy Puppy Site:

  • Look at both parents. All puppies, no matter what the breed, have similar facial features (they’re all squashed and cute), so you need to see the parents to get an idea of what their puppies will look like.
  • Avoid parents with closed nostrils. Nostrils should have a clear O shape; a crescent shape is bad, very bad.
  • Avoid parents with bulging eyes. Brachycephalic skulls have shallow eye sockets, which means the dogs’ eyes don’t always fit into the skull. Eyes that bulge out of the sockets are easily injured. Sometimes they protrude so much that eyelids can’t close and this opens the way for all sorts of problems.
    What’s worse is that their eyes can pop right out of their sockets at the slightest pressure. Slight pressure includes a good sneeze or a tug on their collar.
    Finally, if the skull is too small for the eyes, it is definitely too small for the brain. This can cause painful conditions like syringomyelia, and lead to behavior problems.
  • Avoid dogs with deep facial wrinkles. Wrinkly faces are undeniably cute, but the wrinkles are a breeding ground for germs and bacteria and need cleaning regularly. Heavy wrinkles also pull the skin downwards, which exposes eyes and eye lining and leads to even more infections. This is a common problem in bulldogs and some dogs need a facelift to treat the condition.
  • Avoid dogs with corkscrew tails. Corkscrew tails are often accompanied by malformed spinal bones called hemivertebrae. In severe cases the spine can twist which puts pressure on the spinal nerves. It can cause neurological problems, severe back pain and incontinence. Tightly curled tails are also breeding grounds for infection. In some cases the tail becomes ingrown – it grows into a skin pocket – which also causes infections.
  • Avoid dogs with flat faces. Not only can a flat face cause problems mentioned above, but it can also cause dental problems. Your dog’s teeth have limited space in which to grow. They often overlap or grow at different angles and can even emerge from the palette.

If we’ve put the fear of dog in you and you don’t want to touch a breeder with a barge pole, but you still really, really want a pug, bulldog, boxer or Boston terrier, don’t worry. You can save a life by adopting a dog from a breed-specific rescue organisation. Even your local shelter may have purebred pug-nosed dogs for you to take home. Bear in mind that the health risks will be the same. So prepare yourself for all the challenges that brachycephalic respiratory syndrome might throw at you.