Despite abundant health challenges, people love these breeds

Analysis by Dr. Karen Shaw Becker

flat-faced dog

Story at-a-glance -

  • Brachycephalic dog breeds have flat or pushed-in faces that predispose them to serious health conditions, especially brachycephalic airway syndrome
  • Dogs with brachycephalic airway syndrome require special handling to ensure they don’t develop respiratory distress or heatstroke; undergoing anesthesia is also a risk for these breeds
  • Brachys also commonly deal with eye problems resulting from shallow eye sockets, and dental issues that result from teeth crowding
  • Veterinarians are publicly expressing their concerns about the harm being done to brachys and other dogs bred exclusively to achieve a certain look, with little regard for their health or quality of life
  • Brachycephalic breeds require special knowledge and skill to care for, but they make very special companions who are smart and full of personality

Flat-faced or short-headed dogs — scientific name, brachycephalic breeds ("brachis" = short, "cephalus" = head) — are hugely popular and undeniably adorable. Depending on which list you consult there are between 20 and 30 brachy dog breeds, including the following:


Chihuahua (apple-headed)

King Charles Spaniel

Boston terrier

Chow Chow

Neapolitan Mastiff


Dogue de Bordeaux


Brussels Griffon

English Mastiff



French bulldog



Griffon Bruxellois

Shih Tzu

Cane Corso

Japanese Chin

Valley bulldog

Sadly, the appeal of these dogs comes at a cost, especially, it seems, in the case of the Boston terrier, English bulldogs, Frenchies, the King Charles Spaniel, the Pekingese, Pugs and Shih Tzus.

Brachycephalic airway syndrome

It's important to realize that brachy breeds are intentionally bred to look the way they do, with a normal lower jaw but a compressed upper jaw. Due to their altered facial construction, a majority of these dogs have a condition called brachycephalic airway syndrome to varying degrees.

Brachycephalic airway syndrome describes a number of upper respiratory problems affecting the nose, mouth and throat of dogs as a result of abnormal skull structure. The issues start with the dog's nostrils, which are often very small, scrolled tight and so narrow it can be hard to move air in through them.

There's also an elongated soft palate, which involves a big flap of skin at the back of the throat that causes a lot of the characteristic snorting and other respiratory sounds often heard in brachy breeds.

Often the windpipe is very narrow in places, which leads to a condition called tracheal stenosis, or narrowing of the trachea. This problem can predispose these dogs to tracheal collapse, as well as problems with anesthesia. If you have a flat-faced dog, be sure he or she has been cleared to undergo anesthesia before you agree to any veterinary surgery or other procedure that requires your pet to be anesthetized.

Because of the upper airway challenges of brachy dogs, they often don't pant efficiently. Panting is how dogs cool their bodies down (they don't sweat, they pant). This issue makes brachys prime candidates for heatstroke, and it's important to take precautions if your pet has to travel by car, since he'll have more difficulty in a hot vehicle than other dogs.

And air travel may not even be an option, since due to the risks involved and a number of tragic incidents in recent years, some airlines have started banning flat-faced pets from flying.

Helping your flat-faced dog breathe better

Sadly, breathing difficulties can prevent your furry companion from being able to enjoy the very things all dogs love to do, like eating, sleeping, play and exercise. Dogs with severe brachycephalic airway syndrome can have almost continuous difficulty getting enough air. It's not unusual for these dogs to collapse from lack of oxygen. Left untreated, the problems tend to progress over time, with worsening symptoms.

It's important to learn the difference between normal and abnormal breathing sounds in your pet, and to make an appointment with a veterinarian if you notice any unusual breathing or other signs of respiratory distress. Unfortunately, surgery is often the only option to resolve significant breathing difficulties resulting from brachycephalic airway syndrome. The treatment goal is to surgically remove the tissues or structures causing airway obstruction.

Things you can do as your dog's guardian include keeping her fit and trim. Overweight and obese animals have much more serious respiratory difficulties than those who are kept at an ideal weight.

Keeping your dog out of hot, humid environments is also important to support normal respiration and prevent overheating. And since stress exacerbates every health problem, especially breathing difficulties, keeping your dog's life as stress-free as possible is also important to support her health and quality of life.

Brachycephalic airway syndrome can be a progressive condition, so your dog may over time develop problems with the trachea or larynx. It's important to get such issues addressed as soon as possible rather than waiting until a pet develops significant respiratory distress.

Eye conditions are also common in brachycephalic dogs

The way the brachy head is constructed means these dogs' eyes often don't fit properly in their heads. The eye sockets are shallow, which makes the eyes more pronounced, giving the dogs a sort of bug-eyed or bulgy eyed appearance (which is, of course, part of their appeal).

But if your brachy takes a blow to the back of his head, or experiences some other kind of head trauma, it can dislodge an eye. These breeds are at high risk of having an eye pop out of the socket. Obviously if this happens, you need to call your veterinarian or an emergency animal hospital right away because immediate surgery will be required.

Flat-faced dogs should always be walked with a harness and leash rather than a leash attached to a collar. It's best to avoid putting anything around the neck that might increase cerebral pressure or pressure in the eyes. Another common problem with shallow eye sockets is the eyelids don't always close completely. This can result in corneal irritation and damage. Many brachys have chronic problems with the corneas of their eyes.

You can tell if your dog has the problem by watching him sleep. If his eyes appear slightly open, the lids probably aren't closing completely. In this situation the eyelids can dry out, as can the cornea, and surgery is sometimes needed to correct the problem in severe cases.

If you notice your pet's eyes are drying out, you can provide additional lubrication with a saline gel, which may also reduce the need for surgical correction.

It's also very common for brachy breeds to have constant watering of the eyes or wetness around the eyes. This can be the result of the eyelids not closing completely, or by the upper or lower lid turning inward. Entropion, or curling in of the eyelids, can cause eyelashes to rub against the cornea, creating tremendous, chronic irritation. It's like having an eyelash in your eye you just can't get out. This situation typically causes pets to squint. Surgical correction is often necessary.

Mouth problems

Another facial construction problem many brachycephalic breeds face is teeth crowding. Brachy dogs have 42 teeth like every other dog, but due to the abbreviated upper jaw, the teeth are crowded into a relatively small area. Your dog can end up with teeth at odd angles and overlapping teeth, which can result in dental and gum problems that often develop at a very young age.

If you have a flat-faced pet, it's important to start home dental care as early as possible. I recommend you start desensitizing your dog's mouth as soon as you bring her home. Get her accustomed to having your fingers in her mouth at a very young age so you can keep up with her dental care throughout her life.

Keep in mind that brachys are often high-risk anesthesia patients, so it's really important to keep your dog's mouth clean and disinfected at home so you can hopefully avoid dental procedures requiring anesthesia.

Also remember that a raw diet can be very beneficial in keeping your dog's mouth healthy. Raw ground bone is a gentle dental abrasive, acting like fine sandpaper when chewed, which helps remove debris stuck on teeth. The meat contains natural enzymes, and in addition, raw food doesn't stick to teeth, unlike starchy kibble.

Other common problems

Because the upper jaw of brachy breeds is pushed in, they are also prone to facial fold infections. You might see redness or irritation in the folds, and sometimes even yeast growth. It's a good idea to use colloidal silver or witch hazel to clean your dog's face a few times each week.

In addition, thanks to their broad heads, litters of brachy puppies can be difficult for the mother dog to deliver. Labor is frequently problematic, and many of these moms require C-sections.

Veterinarians are sounding the alarm about the serious harm being done to dogs as a result of breeding for looks only

The British Veterinary Association (BVA) is now warning prospective pet parents that brachycephalic dogs often deal with multiple debilitating health problems, and "breeding them just encourages more pain and suffering."1

"What that means for vets working in clinics," says Dr. Sean Wensley, president of the BVA, "is that we are having to treat many of the health consequences of these breeds which have flattened faces, particularly some of the breathing difficulties. We would liken it to us as humans having to spend our entire life breathing through a drinking straw."2

The breathing through a straw comparison is what many U.S. veterinarians also use to describe for owners how difficult it can be for dogs with brachycephalic airway syndrome to breathe. As Wensley makes clear, the health problems these dogs are suffering are man-made.

"We are deliberately breeding dogs for physical characteristics that we as humans find appealing, like a flat-face," he says. "But importantly, that means they are preventable problems because if we could breed for healthier shapes instead, then we are going to have, in turn, healthy, happy dogs that enjoy a good quality of life, which we feel strongly ought to be the case."

Wensley believes U.K. veterinarians have a duty not only to treat the dogs dealing with breed-related health problems, but also to raise awareness with the public that as a society, we are creating entirely preventable suffering in these animals.

The Canadian Veterinary Medical Association (CVMA) also opposes selective breeding for physical characteristics that can cause health problems in pets. Breeds the CVMA has identified as being of concern include Doberman Pinschers and Boxers for heart disease; Dachshunds, Corgis and Bassett Hounds for back problems; German shepherds for their uneven gait; and Bulldogs for their wide heads.3

In 2017, the American Veterinary Medical Association (AVMA) approved a new policy on the responsible breeding of companion animals. From the AVMA news release:4

"Inherited Disorders in Responsible Breeding of Companion Animals

To maximize the health and welfare of companion animals, the AVMA supports research in genetic and inherited disorders to better educate the profession and breeders on identifying and minimizing inherited disorders in companion animal breeding programs.

To assist with this, the AVMA encourages veterinarians to pursue continuing education in the emerging area of genetic disease in companion animals. The AVMA also encourages veterinarians to educate breeders, companion animal owners, and the public on the responsibilities involved with breeding and selecting companion animals."

The intent of the new policy, which addresses responsible breeding for all companion animals, not simply dogs and cats, is to support responsible breeding practices that reduce or eliminate the health and welfare concerns associated with inherited conditions, not to condemn or stigmatize specific breeds.

Some of you may at this point be wondering, with all the potential health problems brachycephalic breeds can experience, why so many people have them.

It's because they love their brachys. Despite their health challenges, these dogs are very intelligent and full of personality. Many devoted brachy parents will tell you they would never consider any other breed. But these dogs do require special knowledge and extra skill when it comes to keeping them optimally healthy, with an excellent quality of life.