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Brachycephalic Breeds: They are awfully cute but boy do they have a lot of problems!

I finally did it.  After enjoying from a far, I finally took the plunge and purchased a French Bulldog!  As a veterinarian I thought this was somewhat crazy, brachycephalic breeds have a whole host of problems.  But from an animal lover’s standpoint, I wanted one of these funny looking, clown-like dogs to share my life!  I did my research, asked a lot of pointed questions to a lot of Frenchie breeders and selected one that I thought bred problem free dogs.  So I purchased a puppy and got a puppy with - wait for it - brachycephalic syndrome! white bulldog


What exactly is Brachycephalic Syndrome and what problems are associated with this condition?  Brachycephalic means short head.  Dogs with short, pushed in faces are brachycephalics.  This includes not only all types of bulldogs but Pugs, Boston Terriers, Shih Tzus, Pekingese and Boxers.  There are even brachycephalic cats - think Himalayan and Persian.  These breeds have been bred so that the lower jaw is normal but the upper jaw is compressed leading to the smushed face appearance.  This cosmetic appearance can lead to issues with the respiratory system, eyes and cause dental issues.


Brachycephalic syndrome is a compilation of anatomic abnormalities that can lead to respiratory problems and airway obstruction.  These dogs make a lot of snorting sounds, often gag when eating/drinking and are known snorers.  One or more of the following abnormalities comprise brachycephalic syndrome:   


  1. Stenotic Nares:  This is narrowing of the nostrils, often to the point where the nasal openings are just slits.  This makes breathing difficult so many dogs will open mouth breath or pant to move air in/out.  

  2. Enlarged Tongue:  The tongue is large and thick which can further lead to airway obstruction.

  3. Elongated Soft Palate:  The soft palate separates the nasal passage from the oral cavity.  In a dog with brachycephalic syndrome, this tissue is elongated falling down loosely into the throat blocking the airway.

  4. Hypoplastic Trachea:  The trachea or windpipe can be narrower than normal inhibiting airflow into the lungs.

  5. Everted Lateral Saccules:  There are 2 pockets/saccules in the normal larynx.  When a dog has increased effort to breathe because of the above abnormalities, these saccules will turn turn inside out, become swollen and inflamed, causing further blockage of the airways.


All of the above abnormalities, whether individually or collectively, can lead to breathing difficulties, respiratory distress, chronic respiratory infections and make the pet more susceptible to heat stroke as they cannot cool their body efficiently.  Heat stroke is a life threatening condition.


Stenotic nares, elongated soft palate and everted lateral saccules can be surgically corrected.  These are usually done after the dog reached maturity.  Stenotic nares may be performed earlier (at time of neuter or spay) as this won’t change much as your pet matures.  While some owner’s “love” to hear their dog snort and snore, it is important to realize that this is abnormal and can have serious impact on overall health.  Think of how difficult it would be to breath through a straw.  Well, the brachycephalic dog is essentially breathing through a straw continuously.  So while you may find the noisy respiration endearing, your pet is struggling to bring air into his lungs.


I know the thought of surgery is worrisome but it should be seriously considered/performed.  The most common procedure is to correct the stenotic nares.  In most cases this provides significant and immediate improvement.  The procedure entails removing the “alar fold”, the excess tissue that is obstructing the nasal passage.  Removing this tissue opens up the nostrils allowing improved airflow.  Cosmetically it will change the look of your pet slightly.  Instead of having slits for nostrils, he/she will have a normal opening.  It may take a little time to get used to this look but it is well worth it in the long run. The recovery time for stenotic nares is short and there is little post operative care.  My Frenchie had stenotic nares and had the classic snort/snore.  And even though I do this for a living, I was nervous about his impending surgery.  His surgery went well and he was breathing easier immediately.  I no longer have to listen to his snores but more importantly, he can breath without any problems.  He runs and plays with his partner in crime and his recovery time from his various escapades is rapid.  He’s happy, healthy and looks great!


At the same time we correct the stenotic nares, we evaluate the length of the soft palate to see if surgical correction is necessary.  In patients with long standing respiratory issues, we also evaluate the lateral saccules.  If your pet has not reached full maturity and the palate appears to be enlongated, we will wait on performing surgery until he is fully grown.  Then if the palate is still excessively long, we will remove a portion of the palate to open up the airway.  The lateral saccules will be removed as well if they are swollen and inflamed.  Again, recovery is rapid and improvement is noticed  immediately.   


Other concerns with the brachycephalic breeds involve the eyes.  Due to the shape of the skull, the eye sockets are shallow making the eyes prominent and vulnerable to injury.  This can lead to increased susceptibility to trauma (scratch or ulceration of the cornea), proptosis of the eye (the eye pops out of the socket, usually secondary to head trauma), and lagophthalmos.  With lagophthalmos, the eyelids cannot completely close due to the prominent eyes.  This leads to irritation and drying of the center part of the eye (cornea).  If the eyelids cannot protect the eyes, hyperpigmentation (dark discoloration of the cornea) will occur, can be severe and actually lead to loss of vision.  Entropion (where the eyelids roll in) is also a problem for these breeds.  When this happens, eyelashes or haired skin can rub on the eye leading to chronic irritation and possible damage to the cornea.  There is a surgical correction for this problem.  Prominent nasal folds are often present  The nasal fold is a ridge of skin between the nose and the eyes.  Debris and moisture can collect in the folds leading to infection and if the folds are large enough, the skin may actually rub on the eyes causing chronic irritation.  Surgical correction may be necessary.


Brachycephalics also have wrinkles, some times lots of them!  From the face to around their corkscrew tails, there are wrinkles everywhere, and wrinkles lead to skin folds.  Infection in skin folds can be a problem so it is important to monitor for redness, foul odor or discharge.  If any of these occur, treatment will likely be required.  Cleaning skin folds on a regular basis with an antiseptic product can minimize the development of infections.


And last but not least, brachycephalic dogs are prone to dental disease.  Normal dogs have 42 adult teeth in the mouth.  So do brachycephalics but those 42 teeth are in a much smaller space.  This leads to crowding and teeth growing at odd angles.  Food debris gets trapped and that leads to periodontal disease.  Home dental care is important to minimize progression of periodontal disease.  


So, as you can see, brachycephalic breeds can have a whole host of problems.  That does not mean you shouldn’t get one but you need to be aware of the possible breed related issues and make an informed decision before bringing one of these dogs into your home.  For me, well, I’m delighted to have my Frenchie, Puck, as part of the family.  He a quirky, silly, loving boy and brings smiles to my face on a daily basis.  I just make sure I clean his skin folds as needed, brush his teeth daily and monitor his closely for any of the other aforementioned problems.  Oh yeah, he also had “a nose job” when he was neutered - it’s a lot quieter at night now which makes me breath easier too!

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