I recently adopted Fergus, a sweet and rather large French Bulldog, who just celebrated his first birthday. The French Bulldog is one of the more popular breeds at CityPaws Animal Hospital, and while I am very conscious of the health concerns associated with brachycephalic breeds, I have always been enamored by their quirky and loveable personalities.

Brachycephalic breeds include dogs like Fergus, as well as English Bulldogs, Pugs, Boxers, Boston Terriers, Pekingese, Lhasa Apsos, Shih Tzus, Bull Mastiffs, and their mixes. The term brachycephalic means short-headed, and indeed these dogs have been bred to have a compressed face. The degree to which the altered anatomy affects these dogs on a day to day-to-day basis is highly individual, but all have limitations, which should be acknowledged.

The term brachycephalic syndrome is used to describe the range of abnormalities that can occur in these breeds associated with a flat face and short-nose. There can be airway obstruction and dysfunction including Stenotic Nares – meaning narrowed nostrils, which restricts the amount of air that can be inhaled; Enlarged Tongue – a thick and large tongue, which contributes to restriction of the airway; Elongated Soft Palate – the soft palate tissue separates the mouth from the nasal passage – a shorter face results in the soft palate hanging down loosely into the throat obstructing the airway and creating snorting sounds; Hypoplastic Trachea – the trachea or windpipe in some of these breeds can be unusually narrowed; and Everted Laryngeal Saccules – the larynx, or voicebox which normally has two small pockets – at times of increased respiratory effort, these pockets can turn inside out and partially obstruct the throat. These conditions predispose these breeds to breathing difficulties and, in turn, are more at risk for heat stress.

The syndrome can be progressive, and excess weight gain can further compound the issue. Stress, anxiety, excessive panting, and or barking can also contribute to an increased risk of airway swelling and further airway narrowing and obstruction. Chronic obstructive airway problems can also lead to acid reflux and delayed emptying of stomach contents increasing their risk for aspiration pneumonia and gastric ulceration. Special precautions should be taken in warm weather, when traveling and when planning anesthesia in these breeds to minimize the increased risks.

These dogs should be trained to remain calm and tolerate medical procedures and restraint. There are surgical procedures that can be undertaken to improve airflow in the more affected individuals, so the sooner and earlier these are identified and corrected the better. Changes associated with the bones of the skull can often mean the eyes sit in a very shallow eye socket. This means they have a higher risk of proptosis (protrusion of the eyeball) associated with head-trauma or extreme pulling against a leash. A harness is recommended for walking all brachycephalic breeds.

Sometimes the eyes protrude to such an extent that the eyelids cannot even completely close. There can also be prominent folds of skin or abnormal eyelids resulting in eyelashes that rub against the cornea. This can lead to chronic drying and or irritation of the eye. In some dogs, this is worsened by a condition called keratoconjunctivitis sicca, where inadequate lubricating tears are produced. Over time these conditions can lead to blindness, so again earlier detection and appropriate medical and or surgical correction is recommended. The prominent facial folds themselves can accumulate oil and moisture and can experience recurrent yeast and bacterial infections warranting frequent cleaning.

The brachycephalic dog has 42 teeth like all other dog breeds; however, they have less space to accommodate this dentition. This predisposes to malocclusions, crowding, and advanced periodontal disease. At home, dental brushing is even more important in these breeds to limit the frequency of dentistry procedures needed under general anesthesia.

The extent to which your dog may suffer from one or more of these problems is highly variable. Please discuss any specific concerns with your veterinarian.

By: Dr. Alan Power