Evidence collection10 February 2023

Health and welfare of Brachycephalic dogs

Evidence-based veterinary medicineSmall animals

Introduction

The health and welfare of brachycephalic breeds is an ongoing cause for concern. Despite this, they continue to enjoy high popularity as pets, leading to increasing number of these animals being presented to veterinary practice. Their popularity is also compounding the issues, due to the increase in breeding to meet demand.

The first sections of this evidence collection provide an introduction to the health status of brachycephalic dogs, providing links to published research on the prevalence of various disorders in the three main breeds (Pug, French bulldog and Bulldog) as well as some papers that provide comparisons to the prevalence of disorders in other dogs. This will be followed by a section which looks at research relating to understanding the appeal of brachycephalic dogs to their owners.

Although the primary focus relating to the health of brachycephalic dogs relates to brachycephalic airway disease, as a result of selection for the characteristic flat face, there are other issues that are prevalent in these animals which can impact on their health and welfare. Therefore, the following sections will provides link to current relevant evidence divided into sections relating to different body systems, before looking at the evidence relating to anaesthesia and caesarean section in these breeds.

While the emphasis on brachycephaly has been focused on dogs the final section will bring together the developing evidence of issues relating to brachycephaly in other species.

The health and welfare of brachycephalic dogs

Rautala, E., et al. (2025) Association of extreme brachycephaly with persistent fontanelles in adult Chihuahuas. Journal of Veterinary Internal Medicine, 39 (2), no. e70009. https://doi.org/10.1111/jvim.70009
Tomlinson, F. et al. (2024) BOAS in the Boston Terrier: A healthier screw-tailed breed? PLOS ONE, 19 (12): e0315411. https://doi.org/10.1371/journal.pone.0315411
Åsbjer, E., Hedhammar, Å. and Engdahl, K. (2024) Awareness, experiences, and opinions by owners, breeders, show judges, and veterinarians on canine Brachycephalic Obstructive Airway Syndrome (BOAS). Canine Medicine and Genetics, 11, no. 3. https://doi.org/10.1186/s40575-024-00137-4
Ekenstedt, K.J., Crosse, K.R. and Risselada, M. (2020)Canine brachycephaly: anatomy, pathology, genetics and welfare. Journal of Comparative Pathology, 176, pp. 109-115. https://doi.org/10.1016/j.jcpa.2020.02.008
Roedler, F.S., Pohl, S. and Oechtering, G.U. (2013) How does severe brachycephaly affect dog’s lives? Results of a structured preoperative owner questionnaire. The Veterinary Journal, 198 (3), pp. 606-610. https://doi.org/10.1016/j.tvjl.2013.09.009
Wiles, B.M. et al. (2017) Large-scale survey to estimate the prevalence of disorders for 192 Kennel Club registered breeds. Canine Genetics and Epidemiology, 4, no. 8. https://doi.org/10.1186/s40575-017-0047-3
Pegram, C. et al (2021) Frequency, breed predisposition and demographic risk factors for overweight status in dogs in the UK. Journal of Small Animal Practice, 62 (7), pp. 521-530. https://doi.org/10.1111/jsap.13325
Teng, K.T.Y. et al. (2022) Life tables of annual life expectancy and mortality for companion dogs in the United Kingdom. Scientific Reports, 12, no. 6415. https://doi.org/10.1038/s41598-022-10341-6
O’Neill, D.G. et al. (2020) Unravelling the health status of brachycephalic dogs in the UK using multivariable analysis. Scientific Reports, 10, no. 17251. https://doi.org/10.1038/s41598-020-73088-y
O’Neill, D.G. et al. (2016) Demography and health of Pugs under primary veterinary care in England. Canine Genetics and Epidemiology, 3, no. 5. https://doi.org/10.1186/s40575-016-0035-z
O’Neill, D.G. et al. (2022) Health of Pug dogs in the UK: disorder predispositions and protections. Canine Medicine and Genetics, 9, no. 729. https://doi.org/10.1186/s40575-022-00117-6
O’Neill, D.G. et al (2018) Demography and disorders of the French Bulldog population under primary veterinary care in the UK in 2013. Canine Genetics and Epidemiology, 5, no. 160. https://doi.org/10.1186/s40575-018-0057-9
O’Neill, D.G. et al. (2021) French Bulldogs differ to other dogs in the UK in propensity for many common disorders: a VetCompass study. Canine Medicine and Genetics, 8, no. 13. https://doi.org/10.1186/s40575-021-00112-3
O’Neill, D.G. et al. (2019) Disorders of Bulldogs under primary veterinary care in the UK in 2013. PLoS One, 14 (6), e0217928. https://doi.org/10.1371/journal.pone.0217928
Packer, R., Hendricks, A. and Burn, C. (2014) Conference Report: Building Better Brachycephalics 2013. North Mymms: Royal Veterinary College. Available from: https://www.ufaw.org.uk/downloads/welfare-downloads/building-better-brachycephalics-2013-report.pdf [Accessed 2 February 2023]
Packer, R.M. and Tivers, M.S. (2015) Strategies for the management and prevention of conformation-related respiratory disorders in brachycephalic dogs. Veterinary Medicine: Research and Reports, 6, pp. 219-232. https://doi.org/10.2147/VMRR.S60475
Packer, R. and O’Neill, D. (eds.) (2021) Health and welfare of brachycephalic (flat-faced) companion animals: a complete guide for veterinary and animal professionals. Boca Raton: CRC Press.

Owner perception of brachycephalic dogs

Youens, E. et al. (2025) Beauty versus the beast: The UK public prefers less‐extreme body shapes in brachycephalic dog breeds. Veterinary Record, 197 (6), no. e5671. https://doi.org/10.1002/vetr.5671
Martelli, G. et al. (2025) Owner awareness, motivation and ethical considerations in the choice of brachycephalic breeds: evidence from an Italian veterinary teaching hospital survey. Animals, 15 (15), no. 2288. https://doi.org/10.3390/ani15152288
Proschowsky, H.F. et al. (2025) Perception of dog health and attitudes towards BOAS grading among Danish owners of French bulldog. Frontiers in Veterinary Science, 12. https://doi.org/10.3389/fvets.2025.1605505
Smith, G. and Wills, A.P. (2025) Impact of an educational intervention on public perception of health problems in brachycephalic dogs. Veterinary Medicine and Science, 11 (3), no. e70399. https://doi.org/10.1002/vms3.70399
Cannas, S. et. al. (2025) Italians can resist everything, except flat-faced dogs! Animals, 15 (10), no. 1496. https://doi.org/10.3390/ani15101496
Pound, L. (2024) ‘All I do is fight fires’: Qualitative exploration of UK veterinarians’ attitudes towards and experiences of pre-purchase consultations regarding brachycephalic dogs. Veterinary Record, p. e3897. https://doi.org/10.1002/vetr.3897
Eretová, P. et al. (2024) Can my human read my flat face? The curious case of understanding the contextual cues of extremely brachycephalic dogs. Applied Animal Behaviour Science, 270, no. 106134. https://doi.org/10.1016/j.applanim.2023.106134
Packer, R.M.A., Murphy, D. and Farnworth, M.J. (2017) Purchasing popular purebreds: investigating the influence of breed-type on the pre-purchase motivations and behaviour of dog owners. Animal Welfare, 26 (2), pp. 191-201. https://doi.org/10.7120/09627286.26.2.191
Packer, R.M.A. et al. (2020) Come for the looks, stay for the personality? A mixed methods investigation of reacquisition and owner recommendation of Bulldogs, French Bulldogs and Pugs. PLoS ONE, 15 (8), p. e0237276. https://doi.org/10.1371/journal.pone.0237276
Paul, E.S. et al. (2023) Are brachycephalic dogs really cute? Evidence from online descriptions. Anthrozoös, https://doi.org/10.1080/08927936.2023.2176590
Bognar, Z. and Kubinyi, E. (2023) The brachycephalic paradox: the relationship between attitudes, demography, personality, health awareness, and dog-human eye contact. Applied Animal Behaviour Science, 264, no. 105948. https://doi.org/10.1016/j.applanim.2023.105948
Packer, R.M.A. et al. (2019) Great expectations, inconvenient truths, and the paradoxes of the dog-owner relationship for owners of brachycephalic dogs. PLoS ONE, 14 (7), p. e0219918. https://doi.org/10.1371/journal.pone.0219918
Plitman, L. et al. (2019) Motivation of owners to purchase pedigree cats, with specific focus on the acquisition of brachycephalic cats. Animals, 9 (7), p. 394. https://doi.org/10.3390/ani9070394
Packer, R.M.A., Hendricks, A. and Burn, C.C. (2012) Do dog owners perceive the clinical signs related to conformational inherited disorders as’ normal’ for the breed? A potential constraint to improving canine welfare. Animal Welfare, 21 (s1), pp. 81-93. https://dx.doi.org/10.7120/096272812X13345905673809
Ross, K.E. et al. (2023) What patterns in online classified puppy advertisements can tell us about the current UK puppy trade. Animals, 13, no. 1682. https://doi.org/10.3390/ani13101682
Kenny, D.D. et al. (2022) Impact of an educational intervention on public perception of brachycephalic obstructive airway syndrome in brachycephalic dogs. Veterinary Record, 190 (11), p. e1430. https://doi.org/10.1002/vetr.1430

Respiratory / Brachycephalic obstructive airway syndrome (BOAS)

The term Brachycephalic Obstructive Airway Syndrome relates to the respiratory distress caused as a result of the anatomical changes caused by selective breeding for extreme brachycephalic skull conformation, which leads to compression of the nasal and nasopharyngeal passages. This may be accompanied by mucosal hypoplasia and secondary airway collapse leading to multilevel obstruction and increasing the susceptibility of these breeds to heatstroke.

Brachycephalic obstructive airway syndrome (BOAS)

Rossanese, M. and Rutherford, L. (2025) Brachycephalic obstructive airway syndrome: diagnosis, surgical management and outcomes. Companion Animal, 30 (8), pp. 2-10. https://doi.org/10.12968/coan.2024.0051
Yuen, S.L. et al. (2025) Pterygoid bone malformation and its limitations on the effectiveness of brachycephalic airway corrective surgery in brachycephalic dogs. Journal of Small Animal Practice. https://doi.org/10.1111/jsap.70028
Nanda, A. and Hans, E.C. (2025) A comparison of surgical techniques with regard to short-term complication rates in brachycephalic dogs: a multi-institutional retrospective study of 413 cases. Journal of the American Veterinary Medical Association. https://doi.org/10.2460/javma.25.05.0332
Turner, A.A. et al. (2025) Objective measurement of respiratory loudness in dogs with brachycephalic obstructive airway syndrome before and after corrective surgery. Australian Veterinary Journal. https://doi.org/10.1111/avj.13456
Rossanese, M. and Rutherford, L. (2025) Decision making in BOAS surgery: what can you do to really make a difference to animal welfare? The Veterinary Nurse, 16 (5). https://doi.org/10.12968/vetn.2025.0012
Webb, C.D.L. et al. (2025) Evaluating the impact of a standardised pre-operative patient management protocol on major post-operative complications in dogs undergoing BOAS surgery. Journal of Small Animal Practice. https://doi.org/10.1111/jsap.13881
Cook, L.A., Hallowell, T.C., and Sun, J.A. (2025) Retrospective evaluation of the outcomes of advanced airway management in intubated patients with brachycephalic obstructive airway syndrome: 52 cases (2010-2020). Journal of Small Animal Practice. https://doi.org/10.1111/jsap.13907
Gallant, C. and Phipps, W. (2025) Prevalence and severity of laryngeal collapse in dogs undergoing surgery for brachycephalic obstructive airway syndrome: 80 dogs (2018–2022). Frontiers in Veterinary Science, 12. https://doi.org/10.3389/fvets.2025.1601466
Yoshida, S. et al. (2025) Vocal fold granuloma associated with brachycephalic obstructive airway syndrome in 13 dogs. Journal of the American Veterinary Medical Association. https://doi.org/10.2460/javma.24.12.0825
del Mar Bovis, M., Agthe, P., and Anderson, D. (2024). Abnormal shape of the pterygoid bone in French bulldogs: Prevalence and implication for cross-sectional area. The Canadian Veterinary Journal, 65 (11), pp. 1165–1171. Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC11488228/ [Accessed: 2 May 2025]
Goossens, J. et al. (2025) Short-term effects of brachycephalic obstructive airway syndrome surgery on fitness and exercise in brachycephalic dogs. Frontiers in Veterinary Science, 12. https://doi.org/10.3389/fvets.2025.1481717
Grimes, J. A. et al. (2025) Folded-flap palatoplasty is not superior to cut-and-sew staphylectomy for the treatment of brachycephalic obstructive airway syndrome in English Bulldogs. Journal of the American Veterinary Medical Association. https://doi.org/10.2460/javma.24.10.0686
Schmid, C. et al. (2025) Anatomical, functional, and blood-born predictors of severity of brachycephalic obstructive airway syndrome severity in French Bulldogs. Frontiers in Veterinary Science, 11. https://doi.org/10.3389/fvets.2024.1486440
Tamburro, R. et al. (2024) Histomorphological evaluation of thermal injury following palatoplasty performed with CO2 laser or LigaSure device in dogs with brachycephalic obstructive airway syndrome. The Veterinary Journal, 307, 106195. https://doi.org/10.1016/j.tvjl.2024.106195
Wallace, M.L. (2024) Surgical management of brachycephalic obstructive airway syndrome: An update on options and outcomes. Veterinary Surgery. https://doi.org110.1111/vsu.14131
Lilja-Maula, L.I.O. et al. (2024) Evaluation of brachycephalic obstructive airway syndrome breeding test results in Finland from 2017 to 2022. Acta Veterinaria Scandinavica, 66, no. 35. https://doi.org/10.1186/s13028-024-00755-9
Sharp, C.A.T. et al. (2024) The mobility of the brachycephalic canine nostril in relation to the degree of nostril stenosis. The Veterinary Journal, 304. https://doi.org/10.1016/j.tvjl.2024.106085
Niinikoski, I. et al. (2024) Evaluation of risk factors for sleep-disordered breathing in dogs. Journal of Veterinary Internal Medicine, 38 (2), pp. 1135–1145. https://doi.org/10.1111/jvim.17019
Ladlow, J. et al (2018) Brachycephalic obstructive airway syndrome. Veterinary Record, 182 (13), pp. 375-378. https://doi.org/10.1136/vr.k1403
Krainer, D. and Dupré, G. (2022) Brachycephalic obstructive airway syndrome. Veterinary Clinics of North America: Small Animal Practice, 52 (3), pp. 749-780. https://doi.org/10.1016/j.cvsm.2022.01.013
Packer, R.M.A. et al. (2015) Impact of facial conformation on canine health: brachycephalic obstructive airway syndrome. PLoS ONE, 10 (10), p. e0137496 https://doi.org/10.1371/journal.pone.0137496
Gallman, J. et al (2023) Evaluation of infrared thermography and 6-minute walk tests to assess airflow limitation, impaired thermoregulation, and exercise intolerance in dogs with brachycephalic obstructive airway syndrome. PLoS ONE, 18 (3), e0283807. https://doi.org/10.1371/journal.pone.0283807
Liu, N.C. et al. (2017) Conformational risk factors of brachycephalic obstructive airway syndrome (BOAS) in pugs, French bulldogs, and bulldogs. PLoS ONE, 12 (8), p. e0181928. https://doi.org/10.1371/journal.pone.0181928
Oechtering, G.U. et al. (2016) A novel approach to brachycephalic syndrome. 1. Evaluation of anatomical intranasal airway obstruction. Veterinary Surgery, 45 (2), pp. 165-172. https://doi.org/10.1111/vsu.12446
O’Neill, D.G. et al. (2015) Epidemiological associations between brachycephaly and upper respiratory tract disorders in dogs attending veterinary practices in England. Canine Genetics and Epidemiology, 2 (1), no. 10. https://doi.org/10.1186/s40575-015-0023-8
Haimel, G. and Dupré, G. (2015) Brachycephalic airway syndrome: a comparative study between pugs and French bulldogs. Journal of Small Animal Practice, 56 (12), pp. 714-719. https://doi.org/10.1111/jsap.12408
Jones, S.A. and Kennedy, S.C. (2023) Comparison of mortality of brachycephalic dogs undergoing partial staphylectomy using conventional incisional, carbon dioxide laser, or bipolar vessel sealing device. Veterinary Surgery,
Miller, A.K., Regier, P.J. and Colee, J.C. (2023) Complications and outcome following staphylectomy and folded flap palatoplasty in dogs with brachycephalic obstructive airway syndrome. Veterinary Surgery, https://doi.org/10.1111/vsu.13994
Kampf, S. et al. (2023) Differences in selected blood parameters between brachycephalic and non-brachycephalic dogs. Frontiers in Veterinary Science, 10. https://doi.org/10.3389/fvets.2023.1166032
Williams, P.J., De Gennaro, C. and Demetriou, J.L. (2023) Evaluation of the addition of adrenaline in a bilateral maxillary nerve block to reduce hemorrhage in dogs undergoing sharp staphylectomy for brachycephalic obstructive airway syndrome. A prospective, randomized study. Veterinary Surgery, https://doi.org/10.1111/vsu.14039

UFAW Animal Welfare Information:

Genetic welfare problems of companion animal. French Bulldog: Brachycephalic Obstructive Airway Syndrome (BOAS) [UFAW][online]. Available from: https://www.ufaw.org.uk/dogs/french-bulldog-brachycephalic-airway-obstruction-syndrome-baos [Accessed 8 February 2023]
Genetic welfare problems of companion animal. English Bulldog: Brachycephalic Obstructive Airway Syndrome (BOAS) [UFAW][online]. Available from: https://www.ufaw.org.uk/dogs/english-bulldog-brachycephalic-airway-obstruction-syndrome-baos [Accessed 8 February 2023]
Genetic welfare problems of companion animal. Pug: Brachycephalic Obstructive Airway Syndrome (BOAS) [UFAW][online]. Available from: https://www.ufaw.org.uk/dogs/pug-brachycephalic-airway-obstruction-syndrome [Accessed 8 February 2023]
Genetic welfare problems of companion animal. Boston Terrier: Brachycephalic Obstructive Airway Syndrome (BOAS) [UFAW][online]. Available from: https://www.ufaw.org.uk/dogs/boston-terrier-brachycephalic-airway-obstruction-syndrome [Accessed 8 February 2023]
Genetic welfare problems of companion animal. Pekingese: Brachycephalic Obstructive Airway Syndrome (BOAS) [UFAW][online]. Available from: https://www.ufaw.org.uk/dogs/pekingese-brachycephalic-airway-obstruction-syndrome [Accessed 8 February 2023]
Genetic welfare problems of companion animal. Shar Pei: Brachycephalic Obstructive Airway Syndrome (BOAS) [UFAW][online]. Available from: https://www.ufaw.org.uk/dogs/shar-pei-brachycephalic-airway-obstruction-syndrome [Accessed 8 February 2023]
Genetic welfare problems of companion animal. Shih Tzu: Brachycephalic Obstructive Airway Syndrome (BOAS) [UFAW][online]. Available from: https://www.ufaw.org.uk/dogs/shih-tzu-brachycephalic-airway-obstruction-syndrome [Accessed 8 February 2023]

Grading and severity

Ladlow, J. (2021) Brachycephalic obstructive airway syndrome: guide to the respiratory functional grading scheme. In Practice, 43 (10), pp. 548-555. https://doi.org/10.1002/inpr.149
Lilja-Maula, L. et al (2017) Comparison of submaximal exercise test results and severity of brachycephalic obstructive airway syndrome in English bulldogs. The Veterinary Journal, 219, pp. 22-26. https://doi.org/10.1016/j.tvjl.2016.11.019
Riggs, J. et al. (2019) Validation of exercise testing and laryngeal auscultation for grading brachycephalic obstructive airway syndrome in pugs, French bulldogs, and English bulldogs by using whole‐body barometric plethysmography. Veterinary Surgery, 48 (4), pp. 488-496. https://doi.org/10.1111/vsu.13159
Liu, N.C. et al. (2016) Whole‐body barometric plethysmography characterizes upper airway obstruction in 3 brachycephalic breeds of dogs. Journal of Veterinary Internal Medicine, 30 (3), pp. 853-865. https://doi.org/10.1111/jvim.13933
Liu, N.C. (2015) Characterisation of brachycephalic obstructive airway syndrome in French bulldogs using whole-body barometric plethysmography. PLoS ONE, 10 (6), p. e0130741. https://doi.org/10.1371/journal.pone.0130741

Outcomes of surgery

Seneviratne, M., Kaye, B.M. and Ter Haar, G. (2020) Prognostic indicators of short‐term outcome in dogs undergoing surgery for brachycephalic obstructive airway syndrome. Veterinary Record, 187 (10), p. 403. https://doi.org/10.1136/vr.105624
Ree, J.J. et al. ( 2016) Factors associated with major complications in the short-term postoperative period in dogs undergoing surgery for brachycephalic airway syndrome. The Canadian Veterinary Journal, 57 (9), pp. 976-980. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4982570/
Tarricone, J. et al. (2019) Development and validation of a brachycephalic risk (BRisk) score to predict the risk of complications in dogs presenting for surgical treatment of brachycephalic obstructive airway syndrome. Veterinary Surgery, 48 (7), pp. 1253-1261. https://doi.org/10.1111/vsu.13291
Torrez, C.V. and Hunt, G.B. (2006) Results of surgical correction of abnormalities associated with brachycephalic airway obstruction syndrome in dogs in Australia. Journal of Small Animal Practice, 47 (3), pp.150-154. https://doi.org/10.1111/j.1748-5827.2006.00059.x
Liu, N.C. et al. (2017) Outcomes and prognostic factors of surgical treatments for brachycephalic obstructive airway syndrome in 3 breeds. Veterinary Surgery, 46 (2), pp. 271-280. https://doi.org/10.1111/vsu.12608
Mercurio, A. (2011) Complications of upper airway surgery in companion animals. Veterinary Clinics of North America: Small Animal Practice, 41 (5), pp.969-980. https://doi.org/10.1016/j.cvsm.2011.05.016
Hughes, J.R. et al. (2018) Complications following laryngeal sacculectomy in brachycephalic dogs. Journal of Small Animal Practice, 59 (1), pp. 16-21. https://doi.org/10.1111/jsap.12763
Cantatore, M. et al. (2012) Medium term endoscopic assessment of the surgical outcome following laryngeal saccule resection in brachycephalic dogs. Veterinary Record, 170 (20), p. 518. https://doi.org/10.1136/vr.100289
Lindsay, B. et al. (2020) Brachycephalic airway syndrome: management of post‐operative respiratory complications in 248 dogs. Australian Veterinary Journal, 98 (5), pp. 173-180. https://doi.org/10.1111/avj.12926

Susceptibility to heatstroke

Hall, E.J., Radford, A.D. and Carter, A.J. (2022) Surveillance of heat-related illness in small animals presenting to veterinary practices in the UK between 2013 and 2018. Open Veterinary Journal, 12 (1), pp. 5-16. https://doi.org/10.5455/ovj.2022.v12.i1.2
Hall, E.J., Carter, A.J. and O’Neill, D.G. (2020) Incidence and risk factors for heat-related illness (heatstroke) in UK dogs under primary veterinary care in 2016. Scientific Reports, 10 (1), pp. 1-12. https://doi.org/10.1038/s41598-020-66015-8
Hall, E.J. et al. (2022) Risk factors for severe and fatal heat-related illness in UK dogs—A VetCompass study. Veterinary Sciences, 9 (5), p. 231.https://doi.org/10.3390/vetsci9050231
Hall, E.J., Carter, A.J. and O’Neill, D.G. (2020) Dogs don’t die just in hot cars—exertional heat-related illness (Heatstroke) is a greater threat to UK dogs. Animals, 10 (8), p. 1324. https://doi.org/10.3390/ani10081324
Hall, E.J., Carter, A.J. and O’Neill D.G. (2020) Dogs don’t die just in hot cars–exertional heat-related illness (heatstroke) is a greater threat to UK dogs. Animals, 10 (8), no. 1324. https://doi.org/10.3390/ani10081324
A journal watch summary of this article is available.
Ewers Clark, A. (2022) Heatstroke and brachycephalic dogs – is there an increased risk? Veterinary Evidence, 7 (4). https://doi.org/10.18849/ve.v7i4.534
Zgank, Z. et al. (2023) The effect of the surgical treatment of brachycephalic obstructive airway syndrome on the thermoregulatory response to exercise in French bulldogs: a pilot study. Frontiers in Veterinary Science, 10, no. 1229687. https://doi.org/10.3389/fvets.2023.1229687

Cardiac disease

Romito, G. et al. (2023) Electrocardiographic findings in healthy Cavalier King Charles Spaniels, Pugs, and English Bulldogs. Journal of the American Veterinary Medical Association. https://doi.org/10.2460/javma.22.12.0542
Brloznik, M. et al. (2023) Echocardiographic analysis of dogs before and after surgical treatment of brachycephalic obstructive airway syndrome. Frontiers in Veterinary Science, 10. https://doi.org/10.3389/fvets.2023.1148288
Bagardi, M. et al. (2023) Does the Cambridge classification alone predict the possibility to perform echocardiographic examination in lateral recumbency in dogs affected by brachycephalic obstructive airways syndrome? PLoS ONE, 18 (6), p. e.0286914. https://doi.org/10.1371/journal.pone.0286914
Wiegel, P.S. et al. (2022) Breed-specific values for vertebral heart score (VHS), vertebral left atrial size (VLAS), and radiographic left atrial dimension (RLAD) in pugs without cardiac disease, and their relationship to Brachycephalic Obstructive Airway Syndrome (BOAS). Plos ONE, 17 (9), e0274085. https://doi.org/10.1371/journal.pone.0274085
Wiegel, P.S. et al. (2022) Reference ranges for standard-echocardiography in pugs and impact of clinical severity of Brachycephalic Obstructive Airway Syndrome (BOAS) on echocardiographic parameters. BMC Veterinary Research, 18 (1), pp. 1-13. https://doi.org/10.1186/s12917-022-03348-8
Mach, R. et al. (2022) Evaluation of blood pressure and NT-proBNP in pugs with and without clinical signs of Brachycephalic Obstructive Airway Syndrome. Frontiers in Veterinary Science, 9. https://doi.org/10.3389/fvets.2022.1015157
Romito, G. et al. (2023) Electrocardiographic findings in healthy Cavalier King Charles Spaniels, Pugs, and English Bulldogs. Journal of the American Veterinary Medical Association. https://doi.org/10.2460/javma.22.12.0542
Genetic welfare problems of companion animal. English Bulldog: pulmonic stenosis [UFAW][online]. Available from: https://www.ufaw.org.uk/dogs/english-bulldog-pulmonic-stenosis [accessed 9 February 2023]

Alimentary disease and gastroesophageal regurgitation

Bottero, E. et al. (2025) Clinical evaluation and systematic classification of endoscopic gastrointestinal findings in 176 French bulldogs with brachycephalic airway obstructive syndrome. Animals, 15 (14), no. 2137. https://doi.org/10.3390/ani15142137
Swales, H. et. al. (2025) A multicenter observational study comparing survival of pugs and dogs of other breeds with protein‐losing enteropathy. Journal of Veterinary Internal Medicine, 39 (3), no. e70100. https://doi.org/10.1111/jvim.70100
du Toit, M. and Motta, L. (2024) Gut feelings: Gastrointestinal signs in French bulldogs undergoing spinal surgery. Frontiers in Veterinary Science. https://doi.org/10.3389/fvets.2024.1460092
Freiche, V. and German, A.J. (2021) Digestive diseases in brachycephalic dogs. Veterinary Clinics of North America: Small Animal Practice, 51 (1), pp. 61-78. https://doi.org/10.1016/j.cvsm.2020.09.006
Petchell, W.H. et al. (2022) Incidence of alimentary and respiratory disease in brachycephalic dogs presenting to primary care veterinary practices participating in the SAVSNET project. Veterinary Record, p. e1685. https://doi.org/10.1002/vetr.1685
Kaye, B.M. et al. (2018) Relationship between brachycephalic airway syndrome and gastrointestinal signs in three breeds of dog. Journal of Small Animal Practice, 59 (11), pp. 670-673. https://doi.org/10.1111/jsap.12914
Appelgrein, C. et al. (2022) Quantification of gastroesophageal regurgitation in brachycephalic dogs. Journal of Veterinary Internal Medicine, 36 (3), pp. 927-934. https://doi.org/10.1111/jvim.16400
Luciani, E., Reinero, C. and Grobman, M. (2022) Evaluation of aerodigestive disease and diagnosis of sliding hiatal hernia in brachycephalic and nonbrachycephalic dogs. Journal of Veterinary Internal Medicine, 36 (4), pp. 1229-1236. https://doi.org/10.1111/jvim.16485
Vangrinsven, E. et al. (2021) Diagnosis and treatment of gastro‐oesophageal junction abnormalities in dogs with brachycephalic syndrome. Journal of Small Animal Practice, 62 (3), pp. 200-208. https://doi.org/10.1111/jsap.13279

Skin disease

O’Neill, D.G. et al. (2022) Ironing out the wrinkles and folds in the epidemiology of skin fold dermatitis in dog breeds in the UK. Scientific Reports, 12 (1), pp. 1-13. https://doi.org/10.1038/s41598-022-14483-5
Hobi, S., Barrs, V.R. and Beczkowski, P. M. (2023) Dermatological problems of brachycephalic dogs. Animals, 13 (12), 2016. https://doi.org/10.3390/ani13122016
Wilhem, S., Kovalik, M. and Favrot, C. (2011) Breed‐associated phenotypes in canine atopic dermatitis. Veterinary dermatology, 22 (2), pp. 143-149. https://doi.org/10.1111/j.1365-3164.2010.00925.x
Anturaniemi, J., Uusitalo, L. and Hielm-Björkman, A. (2017) Environmental and phenotype-related risk factors for owner-reported allergic/atopic skin symptoms and for canine atopic dermatitis verified by veterinarian in a Finnish dog population. PLoS ONE, 12 (6), p. e0178771. https://doi.org/10.1371/journal.pone.0178771
O’Neill, D.G. et al. (2020) Juvenile‐onset and adult‐onset demodicosis in dogs in the UK: prevalence and breed associations. Journal of Small Animal Practice, 61 (1), pp. 32-41. https://doi.org/10.1111/jsap.13067
Genetic welfare problems of companion animal. Pug: Skin fold dermatitis [UFAW][online]. Available from: https://www.ufaw.org.uk/dogs/pug-skin-fold-dermatitis [Accessed 9 February 2023]

Skeletal and orthopaedic conditions

Congenital vertebral malformations are commonly diagnosed in brachycephalic dogs.

Picón, S. R. et al. Comparison of three surgical techniques used for managing congenital thoracic vertebral body malformations in brachycephalic dogs: 51 cases (2009-2023). Journal of Small Animal Practice. https://doi.org/10.1111/jsap.13871
Kerr, S. et al. (2025)Prevalence and breed predisposition for spinal diseases in pugs and French bulldogs. Veterinary Record, e5122. https://doi.org/10.1002/vetr.5122
Grapes, N. et al. (2024) Prevalence of discospondylitis and association with congenital vertebral body malformations in English and French bulldogs. Journal of Veterinary Internal Medicine, 38 (6), 3138-3143. https://doi.org/10.1111/jvim.17209
Capasso, M., Canal, S. and Balducci, F. (2024) Prevalence of neurological diseases associated with cervical pain and/or signs of cervical myelopathy in French bulldogs: a retrospective analysis of 105 cases. Frontiers in Veterinary Science, 11. https://doi.org/10.3389/fvets.2024.1431358
Moses, W.B. et al. (2024) Prevalence and classification of congenital thoracic vertebral body abnormalities in neurologically normal brachycephalic ‘screw-tail’ dog breeds in referral practice in Australia. Australian Veterinary Journal. https://doi.org/10.1111/avj.13361
Leu, D. et al. (2023) Recurrence rate of intervertebral disc disease in surgically treated French Bulldogs: a retrospective study (2009–2019). Acta Veterinaria Scandinavica, 65, no. 3. https://doi.org/10.1186/s13028-023-00667-0
La Rosa, C. et al. (2023) Prevalence, MRI findings, and clinical features of lumbosacral intervertebral disc protrusion in French Bulldogs diagnosed with acute thoracic or lumbar intervertebral disc extrusion. Frontiers in Veterinary Science, 10, no. 1302418. https://doi.org/10.3389/fvets.2023.1302418
Albertini, G. et al (2023) Clinical, magnetic resonance imaging, surgical features and comparison of surgically treated intervertebral disc extrusion in French bulldogs. Frontiers in Veterinary Science, 10, 1230280. https://doi.org/10.3389/fvets.2023.1230280
Jones, G.M.C. et al. (2023) A case series of 37 surgically managed, paraplegic, deep pain negative French bulldogs, with thoracolumbar intervertebral disc extrusion, from two English referral centres. Veterinary Record Open, 10 (1), p. e61. https://doi.org/10.1002/vro2.61
Wachowiak, I.J. et al. (2023) Thoracolumbar myelopathies in pug dogs. Journal of Veterinary Internal Medicine. https://doi.org/10.1111/jvim.16639
Foster, E. et al (2023) Respiratory compromise in French bulldogs presented with intervertebral disc extrusion. Veterinary Record, 193 (12) p. e3603. https://doi.org/10.1002/vetr.3603
Lackmann, F. et al. (2022) Epidemiological study of congenital malformations of the vertebral column in French bulldogs, English bulldogs and pugs. Veterinary Record, 190 (1), e509 https://doi.org/10.1002/vetr.509
Ryan, R. et al. (2017) Prevalence of thoracic vertebral malformations in French bulldogs, Pugs and English bulldogs with and without associated neurological deficits. The Veterinary Journal, 221, pp. 25-29. https://doi.org/10.1016/j.tvjl.2017.01.018
Bertram, S., Ter Haar, G. and De Decker, S. (2019) Congenital malformations of the lumbosacral vertebral column are common in neurologically normal French bulldogs, English bulldogs, and pugs, with breed‐specific differences. Veterinary Radiology & Ultrasound, 60 (4), pp. 400-408. https://doi.org/10.1111/vru.12753
Ryan, R. et al. (2019) Relationship between breed, hemivertebra subtype, and kyphosis in apparently neurologically normal French Bulldogs, English Bulldogs, and Pugs. American Journal of Veterinary Research, 80 (2), pp. 189-194. https://doi.org/10.2460/ajvr.80.2.189
De Decker, S. et al. (2019) Comparison of signalment and computed tomography findings in French Bulldogs, Pugs, and English Bulldogs with and without clinical signs associated with thoracic hemivertebra. Journal of Veterinary Internal Medicine, 33 (5), pp. 2151-2159. https://doi.org/10.1111/jvim.15556
Conte, A. et al. (2021) Thoracic vertebral canal stenosis associated with vertebral arch anomalies in small brachycephalic screw-tail dog breeds. Veterinary and Comparative Orthopaedics and Traumatology, 34 (3), pp. 191-199. https://doi.org/10.1055/s-0040-1721375
Gutierrez‐Quintana, R. et al. (2014) A proposed radiographic classification scheme for congenital thoracic vertebral malformations in brachycephalic “screw‐tailed” dog breeds. Veterinary Radiology & Ultrasound, 55 (6), pp. 585-591. https://doi.org/10.1111/vru.12172
Bertram, S., Ter Haar, G. and De Decker, S. (2018) Caudal articular process dysplasia of thoracic vertebrae in neurologically normal French bulldogs, English bulldogs, and Pugs: prevalence and characteristics. Veterinary Radiology & Ultrasound, 59 (4), pp. 396-404. https://doi.org/10.1111/vru.12609
Wyatt, S.E. et al. (2019) Gait analysis in French bulldogs with and without vertebral kyphosis. The Veterinary Journal, 244, pp. 45-50. https://doi.org/10.1016/j.tvjl.2018.12.008
Anderson, O.J., Langley‐Hobbs, S.J. and Parsons, K.J. (2023) Humeral condylar fractures and fissures in the French bulldog. Veterinary Surgery, 52 (1), pp. 134-145. https://doi.org/10.1111/vsu.13907
Genetic welfare problems of companion animals. French Bulldog: Hemivertebrae [UFAW][online]. Available from: https://www.ufaw.org.uk/dogs/french-bulldog-hemivertebrae [Accessed February 2023]
Genetic welfare problems of companion animals. Pug: Hemivertebrae [UFAW][online]. Available from: https://www.ufaw.org.uk/dogs/pug-hemivertebrae [Accessed February 2023]
Genetic welfare problems of companion animals. English Bulldog: Hemivertebrae [UFAW][online]. Available from: https://www.ufaw.org.uk/dogs/english-bulldog-hemivertebrae [Accessed from February 2023]

Ocular conditions

The anatomical changes associated with brachycephalic breeds may increase the frequency and severity of conditions of the eye, including corneal ulceration.

Lau, W.I. and Taylor, R.M. (2025) The prevalence of corneal disorders in pugs attending primary care veterinary practices in Australia. Animals, 15 (4), no. 531. https://doi.org/10.3390/ani15040531
Packer, R.M., Hendricks, A. and Burn, C.C. (2015) Impact of facial conformation on canine health: corneal ulceration. PLoS ONE, 10 (5), p. e0123827. https://doi.org/10.1371/journal.pone.0123827
O’Neill, D.G. et al. (2017) Corneal ulcerative disease in dogs under primary veterinary care in England: epidemiology and clinical management. Canine genetics and epidemiology, 4, no. 5. https://doi.org/10.1186/s40575-017-0045-5
Shin, S. et al. (2024) Oral bacteria may affect conjunctival microorganisms in brachycephalic dogs: a preliminary study. American Journal of Veterinary Research. https://doi.org/10.2460/ajvr.23.11.0260
Andrews, A.L.M.M. et al. (2023) A Review of clinical outcomes, owner understanding and satisfaction following medial canthoplasty in brachycephalic dogs in a UK referral setting (2016-2021). Animals, 13 (12), 2032. https://doi.org/10.3390/ani13122032
Palmer, S.V., Gomes, F.E. and McArt, J.A. (2021) Ophthalmic disorders in a referral population of seven breeds of brachycephalic dogs: 970 cases (2008–2017). Journal of the American Veterinary Medical Association, 259 (11), pp. 1318-1324. https://doi.org/10.2460/javma.20.07.0388
Krecny, M. et al. (2015) A retrospective survey of ocular abnormalities in pugs: 130 cases. Journal of Small Animal Practice, 56 (2), pp. 96-102. https://doi.org/10.1111/jsap.12291
Sebbag, L. and Sanchez, R.F. (2022) The pandemic of ocular surface disease in brachycephalic dogs: The brachycephalic ocular syndrome. Veterinary Ophthalmology. https://doi.org/10.1111/vop.13054
Costa, J., Steinmetz, A. and Delgado, E. (2021) Clinical signs of brachycephalic ocular syndrome in 93 dogs. Irish Veterinary Journal, 74 (1), no. 3. https://doi.org/10.1186/s13620-021-00183-5
Labelle, A.L. et al. (2013) Characteristics of, prevalence of, and risk factors for corneal pigmentation (pigmentary keratopathy) in Pugs. Journal of the American Veterinary Medical Association, 243 (5), pp. 667-674. https://doi.org/10.2460/javma.243.5.667
O’Neill, D.G. et al. (2022) Breed and conformational predispositions for prolapsed nictitating membrane gland (PNMG) in dogs in the UK: A VetCompass study. PLoS ONE, 17 (1), p. e0260538. https://doi.org/10.1371/journal.pone.0260538
White, C. and Brennan, M.L. (2018) An evidence-based rapid review of surgical techniques for correction of prolapsed nictitans glands in dogs. Veterinary Sciences, 5 (3), no. 75. https://doi.org/10.3390/vetsci5030075
Genetic welfare problems of companion animals. English Bulldog: Brachycephalic ocular syndrome [UFAW][online]. Available from: https://www.ufaw.org.uk/dogs/english-bulldog-brachycephalic-ocular-syndrome [Accessed 10 February 2023]
Genetic welfare problems of companion animals. Pug: Brachycephalic ocular syndrome [UFAW][online]. Available from: https://www.ufaw.org.uk/dogs/pug-brachycephalic-ocular-syndrome [Accessed 10 February 2023]
Genetic welfare problems of companion animals. Shih Tzu: Brachycephalic ocular syndrome [UFAW][online]. Available from: https://www.ufaw.org.uk/dogs/shih-tzu-brachycephalic-ocular-syndrome [Accessed 10 February 2023]
Genetic welfare problems of companion animals. Pekingese: Brachycephalic ocular syndrome [UFAW][online]. Available from: https://www.ufaw.org.uk/dogs/pekingese-brachycephalic-ocular-syndrome [Accessed 10 February 2023]

Anaesthetic risk

The prevalence of brachycephalic airway syndrome and gastro-oesophageal reflux can have important implications for anaesthesia, which can carry a higher risk of complications in these breeds.

Ossman, J.E. et al. (2025) Comparison of etiology and outcome of dogs undergoing cardiopulmonary resuscitation with different conformation: the Shepherd versus the Bulldog. Frontiers in Veterinary Science, 12. https://doi.org/10.3389/fvets.2025.1631569
Brady, E. et al. (2025) Use of ultrasound to estimate tracheal diameter in unclipped brachycephalic dogs: A pilot study. Veterinary Record, 12 (2), no. e70018. https://doi.org/10.1002/vro2.70018
Cooper, L.M., Grimes, J.A., and Davros, A.M. (2025) The brachycephalic risk (BRisk) score’s predictability for major postoperative complications varies between breeds undergoing brachycephalic obstructive airway surgery. Journal of the American Veterinary Medical Association. https://doi.org/10.2460/javma.25.03.0145
Hill, M. et al. (2025) Implementation of a standard perioperative protocol reduces postoperative respiratory distress events in dogs undergoing surgical correction of brachycephalic obstructive airway syndrome. Journal of the American Veterinary Medical Association, 263 (5), pp. 590–598. https://doi.org/10.2460/javma.24.09.0598
Filipas, M.C., Owen, L. and Adami, C. (2024) A retrospective observational cohort study on the postoperative respiratory complications and their risk factors in brachycephalic dogs undergoing BOAS surgery: 199 cases (2019-2021). Journal of Small Animal Practice, 65 (5), pp. 329-337. https://doi.org/10.1111/jsap.13707
Downing, F. and Gibson, S. (2018) Anaesthesia of brachycephalic dogs. Journal of Small Animal Practice, 59 (12), pp. 725-733. https://doi.org/10.1111/jsap.12948
Shoop-Worrall, S.J. et al. (2022) Mortality related to general anaesthesia and sedation in dogs under UK primary veterinary care. Veterinary Anaesthesia and Analgesia, 49 (5), pp. 433-442. https://doi.org/10.1016/j.vaa.2022.03.006
Shoop-Worrall, S.J.W. et al. (2022) Mortality related to general anaesthesia and sedation in dogs under UK primary veterinary care. Veterinary Anaesthesia and Analgesia, 49 (5) pp. 443-442. https://doi.org/10.1016/j.vaa.2022.03.006
A journal watch summary of this article is available.
Scales, C. and Clancy, N.J. (2019) Brachycephalic anaesthesia, part 1: the pre-anaesthetic period. Veterinary Nursing Journal, 34 (6), pp. 146-150. https://doi.org/10.1080/17415349.2018.1553643
Scales, C. and Clancy, N.J. (2019) Brachycephalic anaesthesia, part 2: the peri-anaesthetic period. Veterinary Nursing Journal, 34 (10), pp. 260-265. https://doi.org/10.1080/17415349.2019.1646618
Scales, C. and Clancy, N. (2020) Brachycephalic anaesthesia, part 3: the post-anaesthetic period. Veterinary Nursing Journal, 35 (1), pp. 16-18 https://doi.org/10.1080/17415349.2019.1694736
A journal watch summary of this series of articles is available.
Scales, C. and Clancy, N.J. (2019) Brachycephalic anaesthesia, part 1: the pre-anaesthetic period. Veterinary Nursing Journal, 34 (6), pp. 146-150. https://doi.org/10.1080/17415349.2018.1553643
Scales, C. and Clancy, N.J. (2019) Brachycephalic anaesthesia, part 2: the peri-anaesthetic period. Veterinary Nursing Journal, 34 (10), pp. 260-265. https://doi.org/10.1080/17415349.2019.1646618
Scales, C. and Clancy, N. (2020) Brachycephalic anaesthesia, part 3: the post-anaesthetic period. Veterinary Nursing Journal, 35 (1), pp. 16-18. https://doi.org/10.1080/17415349.2019.1694736
Camarasa, J.J. et al. (2023) Owner‐assisted recovery and early discharge after surgical treatment in dogs with brachycephalic obstructive airway syndrome. Journal of Small Animal Practice. https://doi.org/10.1111/jsap.13647
Gruenheid, M. et al. (2018) Risk of anesthesia-related complications in brachycephalic dogs. Journal of the American Veterinary Medical Association, 253 (3), pp. 301-306. https://doi.org/10.2460/javma.253.3.301
Oda, A. et al. (2022) Perianesthetic mortality in English Bulldogs: a retrospective analysis in 2010–2017. BMC Veterinary Research, 18, no. 198. https://doi.org/10.1186/s12917-022-03301-9
Hosford, L. (2023) Postoperative care of brachycephalic patients: airway management and cardiovascular support. The Veterinary Nurse, 14 (4), pp. 168-173. https://doi.org/10.12968/vetn.2023.14.4.168
Petruccione, I. et al. (2021) Comparison between dexmedetomidine and acepromazine in combination with methadone for premedication in brachycephalic dogs undergoing surgery for brachycephalic obstructive airway syndrome. Veterinary Anaesthesia and Analgesia, 48 (3), pp. 305-313. https://doi.org/10.1016/j.vaa.2020.09.008
Franklin, P.H., Liu, N.C. and Ladlow, J.F. (2021) Nebulization of epinephrine to reduce the severity of brachycephalic obstructive airway syndrome in dogs. Veterinary Surgery, 50 (1), pp. 62-70. https://doi.org/10.1111/vsu.1352

Gastroesophageal reflux and regurgitation

Fernandez Alasia, A.C., Levionnois, O. and Raillard, M. (2021) A Systematic review of the methods of assessment of gastro-oesophageal reflux in anaesthetized dogs. Animals, 11 (3), no. 852. https://doi.org/10.3390/ani11030852
Costa, R.S., Wetmore, L.A. and Stein, A. (2021) Randomized, blinded, controlled clinical trial to assess gastroesophageal reflux and regurgitation in dogs undergoing general anesthesia after hydromorphone premedication with or without acepromazine or dexmedetomidine. American Journal of Veterinary Research, 82 (9), pp. 695-700. https://doi.org/10.2460/ajvr.82.9.695
Fenner, J.V., Quinn, R.J. and Demetriou, J.L. (2020) Postoperative regurgitation in dogs after upper airway surgery to treat brachycephalic obstructive airway syndrome: 258 cases (2013‐2017). Veterinary Surgery, 49 (1), pp. 53-60. https://doi.org/10.1111/vsu.13297
Costa, R.S. et al. (2020) Postoperative regurgitation and respiratory complications in brachycephalic dogs undergoing airway surgery before and after implementation of a standardized perianesthetic protocol. Journal of the American Veterinary Medical Association, 256 (8), pp. 899-905. https://doi.org/10.2460/javma.256.8.899

Temporary tracheostomy tube placement

Worth, D.B. et al. (2018) Risk factors for temporary tracheostomy tube placement following surgery to alleviate signs of brachycephalic obstructive airway syndrome in dogs. Journal of the American Veterinary Medical Association, 253 (9), pp. 1158-1163. https://doi.org/10.2460/javma.253.9.1158
Stordalen, M.B. et al. (2020) Outcome of temporary tracheostomy tube‐placement following surgery for brachycephalic obstructive airway syndrome in 42 dogs. Journal of Small Animal Practice, 61 (5), pp. 292-299. https://doi.org/10.1111/jsap.13127
Nicholson, I. and Baines, S. (2012) Complications associated with temporary tracheostomy tubes in 42 dogs (1998 to 2007). Journal of Small Animal Practice, 53 (2), pp. 108-114. https://doi.org/10.1111/j.1748-5827.2011.01167.x

Breeding and caesarean section

Concerns around breeding of brachycephalic breeds include the impact of extreme conformation on the welfare of the offspring along with concerns about the increased requirement for caesarean section to deliver the puppies.

Ravn-Mølby, E.M. et al. (2019) Breeding French bulldogs so that they breathe well—A long way to go. PLoS ONE, 14 (12), https://doi.org/10.1371/journal.pone.0226280
Evans, K.M. and Adams, V.J. (2010) Proportion of litters of purebred dogs born by caesarean section. Journal of Small Animal Practice, 51 (12), pp. 113-118. https://doi.org/10.1111/j.1748-5827.2009.00902.x
O’Neill, D.G. et al. (2017) Canine dystocia in 50 UK first‐opinion emergency‐care veterinary practices: prevalence and risk factors. Veterinary Record, 181 (4), pp. 88. https://doi.org/10.1136/vr.104108
O’Neill, D. G. et al. (2017) Canine dystocia in 50 UK first-opinion emergency-care veterinary practices: prevalence and risk factors. Veterinary Record, 181 (4), pp. 88-93. https://doi.org/10.1136/vr.104108.
A journal watch summary of this article is available.
O’Neill, D.G. et al. (2019) Canine dystocia in 50 UK first‐opinion emergency care veterinary practices: clinical management and outcomes. Veterinary Record, 184 (13), pp. 409. https://doi.org/10.1136/vr.104944
Adams, D.J. et al. (2022) Risk factors for neonatal mortality prior to hospital discharge in brachycephalic and nonbrachycephalic dogs undergoing cesarean section. Veterinary Surgery, 51 (7), pp. 1052-1060. https://doi.org/10.1111/vsu.13868
Batista, M. et al. (2014) Neonatal viability evaluation by Apgar score in puppies delivered by cesarean section in two brachycephalic breeds (English and French bulldog). Animal Reproduction Science, 146 (3-4), pp. 218-226. https://doi.org/10.1016/j.anireprosci.2014.03.003
Estevam, M.V. et al. (2022) Congenital malformations in brachycephalic dogs: A retrospective study. Frontiers in Veterinary Science, 9. https://doi.org/10.3389%2Ffvets.2022.981923
Borisoot, M. (2020) In pregnant bitches, is elective caesarean section more effective than vaginal delivery at improving puppy survival? Veterinary Evidence, 5 (3). https://doi.org/10.18849/ve.v5i3.319
Genetic welfare problems of companion animals. English Bulldog: Dystocia due to foetal-pelvic disproportion [UFAW][online]. Available from: https://www.ufaw.org.uk/dogs/english-bulldog-dystocia [Accessed 10 February 2023]

Cats

Frejlich, M. and Payen, G. (2025) Prevalence and characteristics of feline ulcerative keratitis and corneal sequestra in a referral population and comparison between brachycephalic and nonbrachycephalic cats. Veterinary Ophthalmology. https://doi.org/10.1111/vop.70048
Farnworth, M.J. et al. (2018) In the eye of the beholder: Owner preferences for variations in cats’ appearances with specific focus on skull morphology. Animals, 8 (2), no. 30. https://doi.org/10.3390/ani8020030
Farnworth, M.J. et al. (2016) Flat feline faces: is brachycephaly associated with respiratory abnormalities in the domestic cat (Felis catus)? PLoS ONE, 11 (8), p. e0161777. https://doi.org/10.1371/journal.pone.0161777
Berteselli, G.V. et al. (2023) Flat-faced or non-flat-faced cats? That is the question. Animals, 13 (2), no. 206. https://doi.org/10.3390/ani13020206
O’Neill, D.G. et al. (2019) Persian cats under first opinion veterinary care in the UK: demography, mortality and disorders. Scientific Reports, 9, no. 12952. https://doi.org/10.1038/s41598-019-49317-4
Schmidt, M.J. et al. (2017) The relationship between brachycephalic head features in modern Persian cats and dysmorphologies of the skull and internal hydrocephalus. Journal of Veterinary Internal Medicine, 31 (5), pp. 1487-1501. https://doi.org/10.1111/jvim.14805
Schlueter, C. et al. (2009) Brachycephalic feline noses: CT and anatomical study of the relationship between head conformation and the nasolacrimal drainage system. Journal of Feline Medicine and Surgery, 11 (11), pp. 891-900. https://doi.org/10.1016/j.jfms.2009.09.010
Gleason, H.E., Phillips, H. and McCoy, A.M. (2022) Influence of feline brachycephaly on respiratory, gastrointestinal, sleep, and activity abnormalities. Veterinary Surgery. https://doi.org/10.1111/vsu.13931
Brunner, A. et al. (2023) Comparison of the trachea in normocephalic versus brachycephalic cats on the basis of CT-Derived measurements. Veterinary Sciences, 10 (10), no. 602. https://doi.org/10.3390/vetsci10100602
Mestrinho, L.A. et al. (2018) Oral and dental anomalies in purebred, brachycephalic Persian and Exotic cats. Journal of the American Veterinary Medical Association, 253 (1), pp. 66-72. https://doi.org/10.2460/javma.253.1.66
Oksa‐Minaļto, J. et al. (2022) Ocular surface physiology and aqueous tear secretion in cats of diverse cephalic conformations. Veterinary Ophthalmology. https://doi.org/10.1111/vop.13051
Sieslack, J. et al. (2021) Correlation of brachycephaly grade with level of exophthalmos, reduced airway passages and degree of dental malalignment’in Persian cats. PLoS ONE, 16 (7), p. e0254420. https://doi.org/10.1371/journal.pone.0254420
Pavletic, M.M. and Trout, N.J. (2023) Successful correction of stenotic nares using combined Alar Fold Lift-Up and Sulcus Pull-Down Techniques in brachycephalic cats: 8 cases (2017–2022). Journal of the American Veterinary Medical Association. https://doi.org/10.2460/javma.23.01.0054
Genetic welfare problems of companion animals. Persian: Brachycephaly [UFAW][online]. Available from: https://www.ufaw.org.uk/cats/persian-brachycephaly [Accessed 10 February 2023]

Rabbits

Harvey, N.D. et al. (2019) What makes a rabbit cute? Preference for rabbit faces differs according to skull morphology and demographic factors. Animals, 9 (10), no. 728. https://doi.org/10.3390/ani9100728
Hedley, J., Ede, V. and Dawson, C. (2022) Retrospective study identifying risk factors for dacryocystitis in pet rabbits. Veterinary Record, 191 (5), e1903. https://doi.org/10.1002/vetr.1903

Miscellaneous

Prodger, A., Khan, S., and Harris, G. (2025) Prevalence of structural and idiopathic epilepsy in brachycephalic and non-brachycephalic dogs in the context of the International Veterinary Epilepsy Task Force guidelines. Journal of Small Animal Practice. https://doi.org/10.1111/jsap.13857
Rohdin, C. et al. (2024) Assessment of glial fibrillary acidic protein and anti-glial fibrillary acidic protein autoantibody concentrations and necrotising meningoencephalitis risk genotype in dogs with pug dog myelopathy. Veterinary Record, e3895. https://doi.org/10.1002/vetr.3895
van Renen, J. et al. (2024) Allele frequency of a genetic risk variant for necrotizing meningoencephalitis in pug dogs from Europe and association with the clinical phenotype. Frontiers in Veterinary Science, 11. https://doi.org/10.3389/fvets.2024.1407288
Butterfield, S. et al. (2023) Bacterial meningitis secondary to otogenic infection in 10 French bulldogs: A retrospective case series. Veterinary Record Open, 10, e263. https://doi.org/10.1002/vro2.63

About evidence collections

Evidence collections bring together collections of published papers on topics of interest and importance to the veterinary professions. Papers are chosen for relevance and accessibility, with the full text of articles either being available through the RCVS Knowledge library, on open access or from other publications to which a significant number of veterinary professionals are likely to have access. This means that there may be relevant evidence that is not included.

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