What is a Brachycephalic animal?

The hallmark of a brachycephalic animal is their distinctive flat-faced appearance, with big round eyes, wrinkled foreheads and short nose with closed in nostrils. Examples of brachycephalic breeds are Bulldogs (French, Australian and British), Pugs, Boston Terriers with less obviously brachy breeds being breeds like Cavalier King Charles Spaniels and Shih Tzus.

Cats can also be brachycephalic, examples of breeds affected are Persians. Sadly, this unique conformation predisposes these pets to several health issues that can significantly and negatively impact their quality of life.

Breathing Difficulties

One of the most critical health issues in flat-faced animals is Brachycephalic Obstructive Airway Syndrome (BOAS). This condition stems from anatomical abnormalities of the skull and neck, with affected animals often having small, narrowed nostrils, constricted airways, increased soft palate length, increased thickness of the soft tissues of the throat and smaller and less structurally sound (hypoplastic) tracheas. This leads to restricted airflow causing many of the common clinical symptoms.

These may present as:

· Snoring
· Open mouth breathing
· Struggling to sleep
· Exercise intolerance
· Snorting
· Choking
· Coughing
· Abdominal breathing (sucking in the belly to breathe)
· Collapsing

Aerodigestive Disorders

It is less commonly understood by owners, but gastrointestinal signs (Aerodigestive disease) are also related to some abnormalities of the breed and also increased negative pressure from restricted airflow.

Common gastrointestinal signs seen include:

Regurgitation
Vomiting
Lip licking
Drooling

Surgery to correct BOAS improves capacity to breathe but also reduces many of the secondary gastrointestinal disease symptoms, showing how closely related these issues are.

Brachycephalic Conditions

Gastroesophageal Reflux Disorder (GORD)

All brachycephalics breathe with more effort than normal dogs. This increased effort acts to cause reflux acid from the stomach to the oesophagus. Lip smacking, gagging and coughing, vomiting can be a sign of GORD. Often these symptoms are overlooked but can treatment can create considerable improvement in quality of life.

Dermatology

Chronic skin conditions are very common in brachycephalic patients like French Bulldogs. We are able to diagnose and treat many of the common (and not so common) skin disorders of brachy patients. Licking feet, scratching, rubbing bums/belly, spinning can all be signs of significant dermatological disorders which can be alleviated with medical treatment and sometimes surgery.

Brachcephalic Ocular syndrome (BOS)

Also known as Exposure Keratopathy Syndrome, this is a combination of disorders including protrusion of the eyeball (exophthalmos), inability to close the eyelids (lagophthalmos) and abnormally large eyelid openings (macroblepharon). It's characterized by corneal dryness and potential damage due to incomplete eyelid closure, leading to corneal ulceration and pigmentation. We can manage these conditions medically and support Dr Ema Bowman in surgery to reduce the risk of long term damage to the eye(s)

Intervertebral Disc Disease (IVDD)

Brachycephalic dogs are more susceptible to IVDD due to their specific spinal anatomy and potential for disc degeneration. As GPs we are sometimes the first line in diagnosis and management of this disease however as advanced imaging (MRI/CT) maybe required these cases may need prompt referral to a specialist centre.