Flat-faced dogs are adorable and make wonderful, cuddly companions. However, these brachycephalic dog breeds often suffer from a cluster of health problems collectively known as brachycephalic airway syndrome.

The word Brachycephalic means short-headed, with the prefix “brachy” meaning shortened, and “cephalic” meaning head. The term brings to mind popular breeds such as Pugs, French Bulldogs, and Shih-Tzus.

But these dogs are known for more than just their squishy faces and signature snorts. Hundreds of years of selective breeding have drastically transformed the shape of their faces causing them to struggle with breathing problems and difficulty regulating their body temperature.

What Is Brachycephalic Syndrome?

The shortened skull bones of brachycephalic dogs cause the soft tissue structures of their noses and throats - most notably the airways - to be constricted. Their cute snorts and naptime snores are actually signs of labored breathing.

Brachycephalic airway syndrome (also known as brachycephalic respiratory syndrome, brachycephalic syndrome, or congenital obstructive upper airway disease) refers to the following upper airway abnormalities.

Note: Dogs with brachycephalic syndrome do not necessarily suffer from all the conditions on this list, but most have some combination of these abnormalities.

Stenotic Nares

This is a fancy term for the abnormally narrow nostrils commonly seen in flat-faced dog breeds. Breathing through these narrow airways is akin to living with a permanently stuffy nose. As you may notice when you have a cold, the reduced airflow through your nose causes you to get winded much faster during physical activity.

That’s how brachycephalic dogs with stenotic nares feel every day.

Extended Nasopharyngeal Turbinates

Dogs have ridges of tissue-covered bone called nasopharyngeal turbinates inside their noses that help them warm and humidify air as it’s inhaled. When these structures extend too deeply into the cavity behind the nose and mouth, they can obstruct airflow, affecting the dog’s ability to breathe and regulate their body temperature.

Elongated Soft Palate

For many flat-faced dog breeds, the soft tissue structures of the head are average-sized, while the bones of the skull are shortened, resulting in overcrowding and obstruction. This is the case in dogs with elongated soft palates. The soft, fleshy part of the roof of the mouth becomes too long, partially blocking the windpipe at the back of the throat. Dogs with elongated soft palates often suffer from exercise intolerance, becoming winded and overheating very quickly during activity.

Laryngeal Collapse

Your dog’s voice box or larynx is made up of cartilage. The oversized structures of the head in brachycephalic dogs cause compression of this cartilage, slowly collapsing the larynx and restricting airflow.

Everted Laryngeal Saccules

Just inside the larynx there are small pouches that help lubricate the vocal cords. The increased respiratory effort of dogs with brachycephalic syndrome causes pressure on these structures, resulting in the saccules being forced outwards or sucked into the airway. Again, this leads to further obstruction of the airway.

Hypoplastic Trachea

Hypoplastic trachea is the medical term for a narrowed windpipe. Flat-faced dog breeds are prone to narrow or collapsing tracheas. The reduced diameter of the windpipe can lead to major respiratory distress in times of physical exertion.

Common Symptoms In Flat-Faced Dogs

Most people are familiar with the snorts and snores of brachycephalic dogs. While these symptoms are characteristic, they are certainly not normal or healthy. Like humans who snore, flat-faced dog breeds often suffer from sleep apnea, which can damage the heart. Noisy, labored breathing is common in these dogs, especially during exercise, times of stress, and when the weather is hot. Not only do they tire more easily, but these dogs may also collapse or face life-threatening heat stroke since their ability to lower body temperature through panting is compromised.

Since brachycephalic syndrome can also affect the gastrointestinal tract, some flat-faced dog breeds may have symptoms such as retching, vomiting, or lack of appetite.

Flat-Faced Dog Breeds That May Suffer From Brachycephalic Syndrome

Affenpinscher
American Bulldog
Boston Terrier
Boxer
Brussels Griffon
Bulldog
Bullmastiff
Cane Corso
Cavalier King Charles Spaniel
Chow Chow
Dogo Argentino
Dogue de Bordeaux
French bulldog
Japanese Chin
Lhasa Apso
Mastiff
Neapolitan Mastiff
Newfoundland
Pekingese
Pug
Shar Pei
Shih Tzu
Staffordshire Bull Terrier
Tibetan Spaniel

How Is Brachycephalic Airway Syndrome Diagnosed?

If you have a flat-faced dog breed, it is important to have your pup assessed by a veterinarian before they show symptoms of brachycephalic airway syndrome. While some signs such as stenotic nares and labored breathing are obvious, the best way to assess your dog’s airway is under sedation.

Using general anesthesia, your vet can manipulate the tongue and view the back of the throat and airways. Some people opt to have their dogs’ nostrils widened and/or soft palate shortened surgically at the time of their spay/neuter procedure. This is also a convenient time for your veterinarian to assess the airway.

Due to their respiratory problems, flat-faced dogs and those with brachycephalic symptoms have increased anesthesia risks. For this reason, your vet may recommend (or even require) pre-anesthetic blood work and chest X-rays to ensure your dog’s safety while under anesthesia.

Are There Treatments For Flat-Faced Dogs With Brachycephalic Syndrome?

Surgery

Unfortunately, there are few non-surgical treatments for flat-faced dogs with brachycephalic airway syndrome. Steroids and oxygen therapy may provide short-term relief, but will not cure the underlying conditions.

The best corrective option is one or more surgical procedures to reduce the strain on the airways. There are tried and true procedures to widen the nostrils and trachea, as well as shorten the soft palate. Everted laryngeal saccules can also be surgically removed.

The sooner these surgeries are performed, the better the prognosis is for the dog, so have your veterinarian assess your new flat-faced pup right away. Other than that, having a brachycephalic dog means making lifestyle accommodations and closely monitoring their symptoms.

Diet & Exercise

Since exercise intolerance and overheating are the root cause of most brachycephalic syndrome symptoms, it is very important that flat-faced dog breeds maintain a healthy weight. Many of these breeds are prone to obesity, so talk to your veterinarian about proper diet and safe exercise practices.

Long walks and extended outdoor play should be avoided in hot weather. You can help reduce the strain on your dog’s trachea by using a harness during walks instead of a collar.

Why Breeding Is So Important For Preventing Brachycephalic Syndrome In Flat-Faced Breeds

The popularity of flat-faced dog breeds such as French Bulldogs has encouraged unscrupulous breeders to produce unhealthy puppies with compromised airways and other deformities. These breeders are just looking to make a quick buck and lack the knowledge, skill, or concern to safely and responsibly represent the breed.

You may be tempted to “rescue” a dog from an irresponsible breeder, puppy mill or pet store, but keep in mind that every dollar they make only encourages them to continue producing sickly puppies.

Finding A Responsible Breeder

If you have your heart set on a flat-faced breed, do your research. Choose an AKC-certified breeder, and insist on meeting both the sire (father) and the dam (mother) of your pup’s litter. Responsible breeders will happily welcome you into their home to see how their dogs live. They will not have multiple puppies available at all times because they understand the dangers of overbreeding. The animals in their care will appear healthy and well-socialized like members of the family.

A good breeder will also insist their pups stay with their mothers for at least eight weeks and have basic vaccines and deworming medications appropriate for their age. He or she should be able to produce veterinary records and referrals from happy clients upon request.

Responsible breeders do exist. In fact, some dedicated individuals are working to restore certain flat-faced dog breeds to their original physical specifications. Selective breeding works both ways, and by choosing healthier dogs with larger skeletal structures, they can help restore the vitality and longevity of these breeds.

Brachycephalic Syndrome: Why Flat Face Dogs Have So Many Health Problems