Jan82025
Dog

Brachycephalic Obstructive Airway Syndrome (BOAS) is a condition that affects many of the flat-faced (brachycephalic) dog breeds we know and love, such as Bulldogs, Pugs, and French Bulldogs. While their unique appearance may appeal to some, it’s essential to understand the serious health challenges these breeds often face due to their anatomy.

Why Do Brachycephalic Dogs Look the Way They Do?

The brachycephalic gene was likely originally selected for fighting dogs, assuming that a flat face increased biting force. However, these breeds have gained popularity in modern times because their flat faces and large eyes resemble human babies, triggering a nurturing response. Despite their charm, these features come with significant health challenges.

The Reality of BOAS

BOAS is an umbrella term that covers various anatomical abnormalities obstructing airflow through the upper airways. These include:

  • Narrow nostrils (nasal stenosis)
  • Elongated soft palate
  • Excessive pharyngeal tissue
  • Tracheal hypoplasia
  • Laryngeal collapse
  • Hypertrophy of the tonsils

These skeletal changes result in severe compression of the nasal and pharyngeal passages, making it difficult for affected dogs to breathe normally.

BOAS Anatomy in a pug

Common Signs of BOAS

Unfortunately, many owners mistakenly believe the following symptoms are “normal” for brachycephalic dogs:

  • Loud breathing or snoring
  • Exercise and heat intolerance
  • Vomiting or regurgitation
  • Sleep apnea
  • Fainting episodes (syncope)

These signs indicate that the dog is struggling to breathe and may require medical intervention.

Misconceptions About Health

A staggering 70% of brachycephalic dog owners believe their pets are in good health despite these breeds experiencing high levels of disease at relatively young ages. This unrealistic perception of health is often set against the backdrop of a strong human-animal bond, making it even more important to educate owners about the risks.

Predicting BOAS: Nasal Stenosis as a Key Indicator

The degree of nasal stenosis (narrowing of the nostrils) is one of the most reliable indicators of whether a dog will likely be affected by BOAS. Suppose your dog’s nose falls into the moderate or severe categories of stenosis, as illustrated below. In that case, we strongly recommend considering reconstructive surgery.

Nasal Stenosis Grading Examples

The image below shows examples of nostril grading in Pugs, French Bulldogs, and Bulldogs. Brachycephalic dogs with moderate to severe nasal stenosis are up to 20 times more likely to develop BOAS, which can lead to life-threatening complications and significantly reduced quality of life.

To learn more, check out the poster below for detailed nostril grading examples and additional information on BOAS:

dog nostril grading poster

Prophylactic Surgery: What It Involves

Evaluation for BOAS should be done within the first year of a dog’s life. The surgery is typically performed between 1 and 2 years of age but can be done at any age if needed. At Panacea Vets, this procedure is a day surgery and can often be paired with a spay or neuter procedure. Most dogs go home the same day unless otherwise indicated.

After surgery, dogs will need to:

  • Wear a collar for a few days
  • Take antibiotics and anti-inflammatory medications
  • Return for follow-up to ensure stitches are healing well

Owners usually notice significant improvements once the stitches are resolved.

Potential Complications

While the procedure is generally safe, one possible but rare complication is exaggerated swelling of the tissues, which may require a temporary tracheostomy to ensure proper breathing. Fortunately, such cases are uncommon and are managed with close post-operative care.

The assessment of BOAS includes:

  • Preoperative grading of nasal stenosis
  • An exercise tolerance test
  • Intraoperative visualization of pharyngeal tissues

At Panacea Vets, we perform this surgery using the latest advancements, ensuring the best outcomes for your pet.

Additional Health Issues in Brachycephalic Breeds

In addition to BOAS, brachycephalic dogs are prone to:

  • Skin allergies
  • Corneal ulcers
  • Skin fold infections
  • Ingrown tails
  • Hiatal hernias

Advocating for Awareness and Prevention

While we are genuinely against owning and breeding brachycephalic dogs, especially in hot regions like ours, our priority is to help them lead better lives. The only way forward is to spread awareness about their health issues, actively promote prophylactic reconstructive surgery, and make these procedures affordable for owners.

By addressing these challenges, we can improve the quality of life for brachycephalic dogs and prevent unnecessary suffering.